Patients and Physicians Speak Out
Prior authorization burdens negatively impact patients and health care professionals around the country every day. Explore their stories and share your own experiences to make your voice heard on the need to #FixPriorAuth.
Featured Stories
Yes, just last year I needed knee surgery. The insurance made me go through 2 weeks of resting it then 3 weeks of physical therapy plus a fluid removal attempt. All this before I could even get an MRI that my ortho doc with 40 yrs experience knew I needed in the first place. After the MRI I had to wait 2 more weeks for approval. From start to finish I was laid up 4 months and even lost my job because I ran out of FMLA. Now I have a wrist injury and I am not going for treatment because I really like my new job and I am afraid to go through it all again.
I went almost two weeks without long-acting insulin and two days without even short-acting insulin waiting for prior authorizations. This landed me in the ER 3 times and sent me into a pancreatitis flare. And wasted about 3 hours of my doctor’s time to get insulin. This was not new either; I have been diabetic since I was a kid, so about 25 years. They also made me switch what kind I use, and that caused my sugar to be out of control for weeks, even after I finally got the insulin, while I determined my correct bolus dose of the new insulin.
Share Your Story
Have you ever gone to the pharmacy to fill a prescription only to be told that your insurance company requires approval before they'll cover your treatment?
Have you ever waited days, weeks or months for a test or medical procedure to be scheduled because you needed authorization from an insurer?
Are you a physician frustrated with the administrative headaches and their impact on your patients?
Have prior authorization delays caused you to take more sick days, be less productive at work or miss out on day-to-day life?
Share how prior authorization has impacted you, your loved ones or your patients to draw attention to the need for decision-makers to address this issue. Your voice can make an impact.
All Stories
Use the buttons below to explore how prior authorization impacts both health care professionals and patients throughout the country.
Prior authorizations routinely delay patients being able to see me and to get radiologic and other studies done in a timely fashion. I am a gyn oncologist, and I have seen patients with cancer wait for months to get an appropriate referral to a gyn oncologist. One recent cancer patient of mine waited 6 months to see 3 physician specialists for surgery. Once she had seen them and set up her surgery, her scan was repeated (she had to wait a month to get this approved also) and she had disease progression and was no longer eligible for surgical cure. This patient was 27 years old. I had to call her and tell her we needed to cancel her surgery. She may never be eligible for curative surgery again. This delay most likely significantly worsened her prognosis and will contribute to a family losing their daughter, wife and mother. This needs to end now.
My insurance quit covering my rescue inhaler and didn’t list any on the approved list, so I had to call them. [I] was given the names of two replacements, one of which isn’t working well for me, but the other requires [prior authorization]. So, until approved, I must use an ineffective medication to breathe!
I have narcolepsy. There is no cure, but there is a medication that lets me live a normal life if I follow its precise schedule. It is the only medication of its kind, because of patents, and it costs thousands of dollars for a week's worth of medication, because there is no generic competition. I am forced to get this medication through insurance, or I would quickly go into debt just trying to stay awake and have a normal day. I have recently switched insurances. There will be a four-month gap between when I lost my old insurance, and when I will be able to see a new sleep doctor to re-prescribe the same medication. Then there will be extra delays as prior authorization decides if I am allowed to have the medication necessary to let me drive safely, hold a job, and experience life without constant debilitation.
I have been rationing my sleep medication, hoping to make it to the sleep doctor before it runs out. I am actively sabotaging my own health, hoping the system deigns me worthy to continue receiving care in a relatively timely manner, before I am non-functional. But soon I will be forced to switch insurances again--meaning a doctor visit, and a re-prescription, could be even further away, and my health may deteriorate further as I wait. Every day I do not take my medication, is a day I do not get restful sleep. After two weeks of not taking my full dose of medication, I would be unable to drive safely or perform at work. American healthcare, and prior authorizations, are forcing me to either go into debt, or put my safety and my job at risk.
My daughter is allergic to amoxicillin and requires another drug. Every time she needed antibiotics, her doctor gave me samples because the insurance company took 10 days.
I waited 4 months for a prescription of budesonide for treatment of microscopic lymphocytic colitis (uncontrollable diarrhea). Twice.