Prior authorization for emergency prescription

Never been more frustrated. I am recovering from foot surgery and had some pain in my calf so was referred for an ultrasound. Sure enough, diagnosed with a blood clot (DVT). They said I should go to the ER (not sure why I couldn’t go next door to a PCP but that’s their protocol). Went to the ER and they prescribed me a Xarelta starter pack. Went to the pharmacy and they said insurance denied it. I have Anthem Blue Cross Blue Shield but rX benefits are handled by Express Scripts. I called Express Scripts and they said the prescription needs a prior authorization which could take 24-72 hours. I called the ER doctor and she said they don’t do that (and normally aren’t asked) and I’d have to have my PCP do it. My PCP is out of the office (Friday afternoon) so it wouldn’t get submitted to Monday and then approved by Express Scripts 24-72 hours after that.

If I don’t take the medicine, I have a risk of a potentially fatal pulmonary embolism. I would therefore classify this medicine as an emergency medicine. My question is, how can insurance companies deny (I.e. require a pre-auth) medicine when not taking it ASAP can be fatal? What kind of s*** country (United States, I’m in California) do we live in where this is legal??!!

I spoke to a manager at Express Scripts who empathized but said his hands were tied. I spoke to Anthem and they said they couldn’t do anything. Im just so frustrated. Luckily I was able to find a coupon for a free starter pack, so I’m at least starting the medicine. But seriously, we have to rely on coupons for what could be considered life saving medicine??