Magen Mac
Region: US
Monday 29 June 2026 21:53:32 GMT
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Niki Daniel :
A prior authorization is not from the dr it’s from the insurance and it’s more info that they need to decide if they are going to cover it.
2026-07-22 17:54:33
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dawn0987654321 :
i am a primary care nurse. the med that was ordered is not a "preferred " med with your insurance. so your doctor has to justify why they are ordering something that is "not preferred " or change it to a preferred med. welcome to the insurance prior authorization nightmare!
2026-06-29 22:03:31
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Jmart075 :
It not prior auth from the doctor, it’s from the insurance- it can take. Few days
2026-07-10 04:20:37
2
Sandra Noel :
Dr can write a script for froot loops if he wants, doesnt mean insurance is gonna pay for it, i can walk out front and pull a box of froot loops and fill it as a script and bag it for you and you can pay out of pocket if you wanted to. Now….. if you can get your doctor to convince the insurance to pay for the froot loops…. Thats the prior authorization. Wasnt on your formulary when dr wrote the script but he convinces them, yes addtl info.
2026-07-15 14:27:34
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kal pal :
hi i'm a pharmacy tech!! basically a pa is when your insurance wants to play dr and wants chart notes on why you need the medication! it's so stupid bc he's the dr did prescribe it but insurance will alwayssss find a way to not pay for something! they are so annoying but once the paper is sent to your insurance depending on what state you live in they have usually 24-48 hours to confirm or deny the pa!
2026-07-02 04:32:04
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Shelbss :
Medication is extremely expensive and insurance does not want to cover it without a prior authorization because what the doctor is doing is basically telling them why you need the medication
2026-07-13 15:09:02
1
Britt - MomLife :
My insurance required prior auth for my birth control. So, I got pregnant with TWINS while waiting for approval 😂 Take that blue cross! Hope saving those few dollars was worth paying for all those weekly high risk doctor apts and NICU stays!
2026-07-03 03:12:06
5
Nurse Dimples :
I do these every day. Your insurance is trying to find out if you have tried other meds that cost less and they deem as effective. Mostly, they want to pay thr least amount as possible. We at the Dr office have to fill out a PA electronically that has questions and usually we have to upload progress notes. I understand how you feel. It's ridiculous.
2026-06-29 22:11:44
10
adamx1004 :
It’s your insurance who is requesting more info. We send Rx (not considered authorization) to pharmacy, pharm runs med through your insurance and is notified insurance is requiring prior auth, then pharm lets us know. Your insurance needs more info before they will cover it. We send the requested info to your insurance and then we wait to hear from your insurance as to whether or not they will cover it. It’s not the pharmacy’s fault. Blame your insurance. I know this because I do the appeals for the prior auths that your insurance rejected. Hope this helps a little.
2026-07-04 13:58:44
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Kimberly Hosmer Lund :
Yup. Exactly. They need more information as to why you need it. Also your insurance may require a step therapy before you get what the doctors prescriber or perhaps that medication is not on your insurance formulary. This is 100% insurance fault. Not the pharmacy or the doctor.
2026-07-01 01:15:10
2
Kathryn Whitmore :
It’s not in your “formulary” or preferred medication according to your plan. There is usually 4 tiers of medications for each plan. I do this all day at work and we do it all online. Most of the time we just have to upload the clinic note to support the need for the medication
2026-07-04 03:35:17
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JJaycee :
It's really a terrible phrase "prior authorization." What they shovels call "proof that you really need this because they don't trust your Dr. to do their job even though they've never met you and aren't medical doctors themselves and they don't wanna pay for it."But that's just too long. Well, first of all I to thank you for not blaming the pharmacy. Too many people do. The only good news in this entire thing is the most prior authorizations can be done electronically in about two or three minutes. I'm not saying your office will stay but they might they might stay because it really is just a couple of minutes.
2026-07-01 02:57:34
1
slithery lil sneky snek :
What the doctor prescribed is not formulary on your insurance. Insurance wants to know why you need a non-formulary drug.
2026-06-30 00:53:40
5
Nancy :
I had to have a PA for my daughter’s EpiPen. An EPIPEN. She’s been getting them every 4 months for 10 years. I don’t get it. No, the insurance isn’t new.
2026-06-30 00:17:21
3
piz :
clearly someone said "prior authorization" to you without explaining it. it doesn't actually mean literally asking the doctor to authorize something. it is asking the doctor why you can't be on something cheaper that is on formulary that they'd cover outright. if the doctor answers the questions correctly, you get your meds. if they don't you don't. it's a terrible system but there you go
2026-07-08 13:24:35
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Lauren Hartenstein Gore :
For me. It’s cheaper without insurance and using good rx. Talk to your pharmacist!
2026-06-30 01:44:56
3
Eva Ducette-Robinson :
It’s not prior authorization from the doctor I used to work for the insurance company. The medication may be above the quantity covered by your insurance company. It may be a drug that is only covered after certain other medication’s are tried or with certain diagnosis. If you have a plan with certain tears, it may be a tear three drug that requires certain approvals and additional information.
2026-06-30 02:06:30
1
Cydneee🫶🏾 :
These insurance companies are jokes! In the middle of my coverage year my insurance has decided I need to fail two other sleep medications before they’ll cover Quiviviq again.
2026-07-02 12:39:41
1
jamaface :
your plan will pay for cheaper alternatives. its an insurance hard stop to get them to write for another med or fill out extra info stating why you need it.
2026-07-01 04:36:44
1
user2258887745572 :
A prior authorization has to be sent to the doctor and they get with your insurance to try and get them to cover it.
2026-07-10 15:42:21
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Bobbie🩵 :
That’s how it works girlie silly but that’s how it works. They don’t normally come back the same day regardless. Sometimes takes a couple days. You could pay out of pocket if you prefer it now.
2026-07-14 12:17:38
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SparkleQueen :
Your insurance has preferred and no -preferred medications. If it’s non- preferred then the doctor will have to submit the PA and chart notes showing why you need the non-preferred med. Also, if it’s expensive med then a PA will need to be done.
2026-07-16 01:08:39
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lrider82 :
Prior authorization is not from the doctor. It’s a process that has to been done so to see if the insurance will cover the medication.
2026-07-07 03:12:35
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Delana Hall :
As soon as you said Pristiq in the first video I was like oooh that’s not gonna be covered by insurance 🫣 welcome to lovely healthcare in America and the nightmare we deal with as providers!
2026-07-07 02:26:47
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pk :
Yes, doc has to tell them you really need the med, it’s between the doc and insurance co. Not uncommon.
2026-06-29 22:21:51
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