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c/insurancefights·submitted 3 months ago by u/slow_logbook_notes

formulary is the most under-discussed thing in c/coldchain

Appealbranch of 7 comments

Something I noticed reading old threads that I have not seen said out loud. The advice on copay in this community changed substantially around the start of last year, and nobody went back and updated the older posts. So depending on which thread the search engine hands you, you get two contradictory answers with the…

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7 comments, started 3 months ago
u/marta_vanhecke150 points·3 months ago

redact member ids and group numbers from every screenshot

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u/ismael_nwosu96 points·3 months ago

Disagree but this is the good kind of wrong — it is specific enough to be checked.

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u/slow_logbook_notesOP-16 points·3 months ago

prior auth criteria are state-specific, formulary differs

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u/prior_auth_painappeals1 point·3 months ago

Which plan type? step therapy is different.

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u/muscle_cramp_mo1 point·3 months ago

formulary exclusions are negotiable sometimes

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u/teodor_duarte92 points·3 months ago

Which state? Coverage varies.

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u/janoshik_junkieindependent tester40 points·3 months ago

Small correction: the trial was 15 weeks, not 19. Does not change your point but people will quote it.

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