[Private Plan] special authorisation approved on the second try
special authorisation approved on the second try. It is the sort of thing everyone half-believes and nobody writes down. Kept every form and reference number. When they had no record of a submission, I did. Confused a rejected claim with a denied authorization for a month and pursued entirely the wrong process. The…
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.
Province added to the title. Coverage is provincial and the thread could not be answered without it.
keep every form, every date, every reference number
Push back: approval by the national regulator says nothing about whether any plan will pay.
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.
Health Canada approval is not coverage
Careful, that criterion was updated at renewal and the version you are quoting is superseded.
quantity limits are as common a barrier as coverage itself