does private plan actually matter or is it forum lore at this point
does private plan actually matter or is it forum lore at this point — that is what I am asking, and I have already read the wiki twice. Cash pricing, which people skip because they assume coverage is the only route. Prices at the counter vary between pharmacies, sometimes substantially, in the same city. Members here…
Disagree — that is your province’s formulary position and it does not carry to another.
Yes. Cash prices vary and comparing them before assuming coverage is the only route is worth doing.
the same product can be covered in one province and not the next
Not convinced. A rejected claim at the counter is not a denied authorization and the next step differs.
Quantity limits restrict how much may be dispensed in a period even where coverage exists. They are a distinct barrier and require a distinct request.
Quantity limits restrict how much may be dispensed in a period even where coverage exists.
Adding the fastest step — ask the pharmacist. They can usually check in minutes.
a rejected claim is not the same as a denied authorization
This. The special authorization form is published and reading it before applying changes the outcome.
Nothing here is medical or legal advice. The pharmacist and the prescriber are the people who can act, and both are faster than a forum.
Confused a rejected claim with a denied authorization for a month and pursued entirely the wrong process.
Confused a rejected claim with a denied authorization for a month and pursued entirely the wrong process.
This is why every thread here needs a province in it.