A Prior Authorization (or PA) is a requirement created by insurance companies for more information from the Doctor to decide whether they will offer any coverage on a medication. Even though your Doctor prescribed the medication to treat a specific issue, your insurance may require chart notes about previously tried medications before deciding whether or not to offer coverage. PAs will be either Approved or Denied. Even if a PA is approved, the insurance company may decide to only offer a small percentage of coverage.
It can take up to a business week to get a decision back from the insurance company, but we will let you know the outcome as soon as we receive one. If the PA is denied, we will work with you and your Doctor to determine the next best steps forward.