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c/insurancefights·submitted 1 year ago by u/honest_syringe19

copay: what the trials say vs what this community says

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Right, the formulary question again, but with numbers this time. I have 11 data points over 36 weeks. The pattern is consistent enough that I do not think it is chance, and boring enough that nobody is going to screenshot it, which is usually a good sign. The thing I would flag for anyone new: the effect I am…

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5 comments, started 1 year ago
u/formulary_fighterMOD384 points·1 year ago

Flair changed to match the content. Read the sidebar before posting next time and we are square.

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u/coring_the_stopper98 points·1 year ago

say which country and which plan type

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u/elin_lindqvist60 points·1 year ago

That is net peptide content, not purity. Different number, different meaning.

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u/adaeze_cabrera124 points·1 year ago

appeal letter templates are in the wiki

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u/fabio_kuipers91 points·1 year ago

copay is separate from coverage

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The paperwork war. Prior-authorisation criteria, denial reason codes, step-therapy documentation, external review, employer carve-outs, and the appeal letter templates the community has iterated on for three years. Mostly US-shaped but the tactics generalise.

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