Prior Authorization – What are Chances for Success?

I have some questions and would appreciate input regarding prior authorizations. I am looking at switching jobs and as I dig into the 4 plan options I can pick from (Aetna, Anthem, Cigna, UHC) they all have 4 of my wife's brand name drugs as non-formulary requiring a pior authorization. I understand the PA process but I've never dealt with it (I guess my current plan is pretty good). I'm wondering if it is a constant battle with the pharmacy benefit mangers looking for reasons to deny for cost reasons or is it a relatively painless process if your doctor is adept at filling out the forms correctly and you meet the criteria on the form?

My wife takes some drugs for some pretty serious mental health reasons and any switch is risky as we worked for many years to get the right mix. Two we definitely can't afford out of pocket. We've found the brand names work well for various reasons like an allergic reaction to one of them although I can't point to a specific ingredient. She's tried generics in the distant past with diff doctors, I'm not sure I could produce records of that or not.

Given she's been on these drugs 15 years I'm hesitating what I thought was going to be a great job opportunity and pay raise. Any other things I should ask or look into?

Thank you.

submitted by /u/CurlyTail99
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