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c/glp1canada·submitted 2 years ago by u/liv_dumitru

private plan — 18 things I got wrong before I got it right

Questionbranch of 6 comments

private plan — 18 things I got wrong before I got it right, which sounds obvious until you try to state the evidence for it. National regulatory approval establishes that a product may be sold. Whether any plan pays for it is a separate decision, and public drug plans are administered provincially. Quantity limits…

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6 comments, started 2 years ago
u/marit_coelho154 points·2 years ago

Employer-sponsored plans have their own criteria and appeal processes, independent of the provincial formulary. Which one applies determines everything about the route.

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u/fasting_insulin_f-1 point·2 years ago

employer plans have their own criteria and their own appeals

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u/ayesha_radich179 points·2 years ago

Read the special authorization criteria and wrote the application against them line by line. Approved first time after a previous refusal.

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u/zeynep_duarte44 points·2 years ago

Criteria changed at plan renewal and the denial that had been immovable simply did not apply any more.

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u/a1c_arcT2D0 points·2 years ago

Small fix — that formulary position is another province’s and does not apply here.

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