someone explain Canada to me like I have not read a paper in years
Slightly embarrassed to be asking this, but: someone explain Canada to me like I have not read a paper in years. Confused a rejected claim with a denied authorization for a month and pursued entirely the wrong process. Cash pricing, which people skip because they assume coverage is the only route. Prices at the…
The three separate questions people ask here as though they were one.
Is it approved for sale — a national regulatory question with one answer. Is it covered — a provincial or private-plan question with many answers. Can I actually get this quantity dispensed — a quantity-limit question that is separate from coverage and stops as many people.
Say which of the three you are asking and name your province and plan type. Threads that do this get answered in two replies; threads that do not generate a page of people talking past each other, all of them correct about somewhere else.
The three separate questions people ask here as though they were one.
Agreed — write the application against the published criteria rather than around them.
Small fix — that formulary position is another province’s and does not apply here.
Small fix — that formulary position is another province’s and does not apply here.
diego_almeida is right that a rejected claim and a denied authorization are different animals.
special authorization forms are published, read them before applying
That is an employer plan process, and the provincial route is different in both form and timeline.
Push back: approval by the national regulator says nothing about whether any plan will pay.
Have you seen the special authorization criteria for your province?