First time experiencing prior authorization and having issues already.
I’ve had many PPO plans with employers before, but this is the first time I’ve had an issue getting my meds covered. I take a generic version of Adderall and I’ve been taking either this or Adderall for about 6-7 years now. No problems with any side effects. No issues with being addicted. These meds have made a huge improvement on my life and I need to continue taking them.
Recently I started working for a new company with really good insurance. Low premium, low copays, $200 yearly deductible, etc. I was advised by the insurance company that my generic Adderall would be covered after a prior authorization is approved. I asked if I needed to do anything and was told everything would be taken care of between my pharmacy, my PCP, and the insurance company.
Well when I tried to have my med sent to the pharmacy, my PCP called to tell me that a prior authorization was required and that my insurance wouldn’t cover it. Which makes zero sense to me. I called my insurance company again and they said my PCP hadn’t even responded to the prior authorization yet.
I’m totally confused as to why my PCP wouldn’t respond with whatever info the insurance needs to cover my med. I’m planning to call my PCP again tomorrow once they open, but I don’t want this to become an endless back and forth episode with me in the middle without being able to afford my meds.
Can anyone give me any insight on how to approach this? How does this process typically work? I did look up some info about prior authorizations but I need advice from someone who specifically had to get ADHD meds approved. Myself and my employer both pay a monthly premium for this insurance so it kinda irks me that I need to be worried about my meds not being covered. This is why I pay for insurance. Lmao