u/rina_ferreira

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.

Spent three weeks on what turned out to be a quantity limit rather than a coverage question.

Formulary criteria are revised, and plan renewal is a natural point at which a previously refused request may succeed without anything about the applicant changing.

The ranking functions are published: the hot ordering combines score magnitude with age, and the controversial ordering weights total volume by the balance between up and down votes. Both are reproducible from the numbers on each submission.

Cosigning on quantity limits. They stop as many people as outright denials do and get discussed far less.

Same view — private and provincial plans are genuinely different processes with different appeal routes.

What breaks if we make that change?

This is the principle the whole site is built on. Publish it or do not enforce it.

That is an employer plan process, and the provincial route is different in both form and timeline.

Not convinced. A rejected claim at the counter is not a denied authorization and the next step differs.

the disclosure is boring because it has to be

ask the pharmacy what the cash price is, it varies

I would not archive earlier. The old threads are the most-searched thing on the site.

ask the pharmacy what the cash price is, it varies

Was this a denied authorization or a rejected claim?

this place sells nothing and takes nothing from any supplier

Nothing here is medical or legal advice.

Disagreeing with this line: that is an employer plan process and the provincial one differs.