unpopular opinion: most of what gets said here about Canada is guesswork
unpopular opinion: most of what gets said here about Canada is guesswork, and I am aware this is a minority view on this board.
Spent three weeks on what turned out to be a quantity limit rather than a coverage question.
The pharmacist sorted in five minutes what the phone line had not managed in a fortnight.
Compared cash prices across four pharmacies before pursuing coverage and the spread was larger than I expected.
Tell me where this is wrong. That is the useful part of posting it.
best — the order this archive was captured in
Special authorization is a documented exception process with published criteria. Applications that answer those criteria explicitly, point by point, fare better than general clinical narratives.
Employer-sponsored plans have their own criteria and appeal processes, independent of the provincial formulary. Which one applies determines everything about the route.
Which province?
Read the special authorization criteria and wrote the application against them line by line. Approved first time after a previous refusal.
Province added to the title. Coverage is provincial and the thread could not be answered without it.
quantity limits are as common a barrier as coverage itself
Push back: approval by the national regulator says nothing about whether any plan will pay.
Moved provinces and the coverage position changed completely. Same person, same history, different formulary.
the same product can be covered in one province and not the next
- 1Province added to the title. Coverage is provincial and the thread could not…6 comments in this branch · started by u/lane_watcher