Called my insurance today about the prior auth and after being on hold forever, they finally confirmed the appeal went through and my coverage is approved going forward. Honestly I did a little happy dance because I'd been bracing for another denial after nearly 40 lbs down on this journey. Has anyone else dealt with a long appeals process like this, and did your copay stay stable after approval?
Coverage update from today - here's what happened
Mine took almost three months and the copay did shift a bit once it went through, so brace for that. Curious whether yours came back at the same tier or got bumped
Mine didn't budge at all after the appeal cleared, so maybe it varies by plan., but the copay holding steady is the one part of this I haven't had to worry about.
My copay held steady for about six months then jumped maybe 30 bucks, so approval and price don't seem to move together. Did yours come through at the same tier you had before the appeal?
Mine stayed flat for the first two fills after approval then jumped 25 bucks on the third, so I would not count on it holding. Worth calling back in a month to confirm the new number before it surprises you at pickup.
My copay held steady for a few months after my approval then bumped a little at renewal, nothing dramatic though. Still cheaper than paying out of pocket so I just budget around it
Mine stayed flat for about six months after approval then jumped 25 bucks at the last refill, so stable was only temporary for me. Curious whether yours holds past the first couple cycles
Curious whether your copay changed at all once the appeal cleared, since mine shifted a bit even after approval and I never got a straight answer on why
Did your plan give you the new copay number in writing on that call, or did you have to wait for the pharmacy to spring it on you?
did your copay change right away or did it take a few months to show up? Mine stayed flat for the first couple fills and I keep waiting for the other shoe to drop.
My copay held for two fills then crept up about 15 bucks, no explanation given. Did they tell you when the approval period resets?
My copay held steady for about two refills then crept up a bit, nothing dramatic though. Curious whether yours came with any paperwork explaining the change or just a new number at the counter
Mine stayed flat for about two refills then inched up, so the approval email wasn't the last word on price. Worth checking the claim detail before you refill
Mine held steady for the first refill then crept up a bit at the second one, so i'd keep an eye on the next couple of statements rather than just the first.
Mine came back approved but the copay changed at the plan year reset
My copay came out the same on the other side of the appeal, no surprise bump. I keep a screenshot of the approval in my phone just in case billing gets cute later.
Did your copay stay the same once the approval went through, or did it shift?
My copay crept up about ten bucks after approval and nobody could tell me why, so a small shift doesn't mean the whole thing fell apart