"Prior Authorization"

[its2much]

Has anyone ever needed a prior authorization to fill a refill, not the initial prescription which was filled in December 2013 and again 1/31/14? Medication has four refills left and the pharmacy is telling me that they need prior authorization to fill a REFILL. Didn't they get that already since they got the prior authorization when the new prescription (for a drug I have been on for a couple of years) was filled back in December 2013 with five refills?

[SNOOPY]

You may want to read your prescription label as many times it will say " 4 refills before (date)."

If your refill date is expired it doesn't matter how many refills you may have left a Drs. authorization will be needed.

[KatW]

Yes, I've had this before with a medication that I was on for years. I had to make an appt and get the RN to fill out the paperwork. It was a very cheap generic prescription so I don't know what the problem was. Very irritating.

[misslux]

Are you on a new policy now as per your previous thread?

http://msworld.org/forum/showthread.php?t=131863

My guess is that they need authorization again for this policy. You are best to call your insurance company to clarify.

[its2much]

No, not on a new policy

I got a new prescription in December 2013, for a drug I've been on for a couple of years. Drug container says refills through 12/26/14. Have only refilled once - there are four refills left.
Also just wondering, who usually contacts you when there is a problem with a prescription - the pharmacy or the doctor's office? Neither contacted me - I went to the pharmacy to pick it up to be told they were waiting for the prior authorization from the doctor (which the doctor claims to have not received).

[Alicious]

It keeps happening to me for Tecfidera. Roughly every 3 or 4 months, the need a new pre-auth, even though the previous one was supposed to last a full year. I've had the same policy for 5+ years.

[golfwidow]

Has anyone ever needed a prior authorization to fill a refill, not the initial prescription which was filled in December 2013 and again 1/31/14? Medication has four refills left and the pharmacy is telling me that they need prior authorization to fill a REFILL. Didn't they get that already since they got the prior authorization when the new prescription (for a drug I have been on for a couple of years) was filled back in December 2013 with five refills?

I have had it happen twice on Betaseron -- the pharmacy said insurance companies are double checking necessity on all specialty drugs and others.

I asked her if I had missed the announcement that there was a cure for MS !!

[Alicious]

political statement in quote

I have had it happen twice on Betaseron -- the pharmacy said insurance companies are double checking necessity on all specialty drugs and others.

I asked her if I had missed the announcement that there was a cure for MS !!

It's more a matter of insurance not wanting to pay for expensive meds if they don't have to.

[misslux]

Alicious is correct. Insurance companies have been doing this for YEARS. If they can get away with not paying, they will.