Aetna requiring multiple prior authorizations for parts of one procedure – is this normal?

I had a procedure approved by prior authorization. However, now they won’t fill the medication for it. They say I need a separate prior authorization for the medication needed to do the procedure. So, another submission from my doctor and 15 day wait time.

I talked to Aetna on the phone many times about this before the procedure was approved and the conclusion was when the procedure was approved I should be able to fill the medication. But now they say I need a prior auth for the medication too. I told them this was new information and the medication won’t come in if it doesn’t ship today from the pharmacy Aetna requires me to fill at. They told me to just pay cash for it so I didn’t miss my procedure.

So I did have to pay cash for the medication because my procedure is tomorrow and it won’t be approved and ship in time.

How can I avoid this in the future? I spent hours on the phone with them two weeks ago asking how I can fill the medication and the requirements and no one I spoke to told me correctly. I read the clinical policy bulletin for this medication and the procedure and it says precertification is needed, but no where does it say multiple/separate prior auths are needed. It is one procedure and this medication is normally used for the procedure to work correctly.

submitted by /u/dm_me_target_finds
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