Prior authorization drills are fun.

And by “fun”, what I really mean to say is “attempts by insurance companies to gatekeep patients away from necessary medications, attempting to justify not wanting to pay to cover them”. What happens is:

· your doctor decides that you need a medication, and prescribes it
· that prescription is given to your pharmacy
· your pharmacy attempts to fill that prescription for you
· this script is presented to your insurance for coverage
· insurance denies coverage of this script
· they request that your doctor fill out forms attesting to your need for it
· your doctor has to fill out forms stating that yes, you need this medication
· these forms are sent to your insurance to approve
· if approved, your insurance authorizes your pharmacy to fill the script
· you are able to pick up your medication from the pharmacy

Basically, it’s a really snarky, underhanded, “but do you really need the medication?”.

A few medications that I take require this, and they require documentation that I have tried to take other medications and that they have not worked on me to be submitted… every twelve months.. for my insurance to continue to approve these prior authorization forms (as though these medications that I have tried in the past will suddenly, miraculously work on me one day) so that I can continue taking necessary medication…

To say “it’s a hassle” might be understatement of the year, and we are only in January. But it’s the truth.

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