I am a senior citizen and a military veteran. My wife recently had an increase in one of her medications ordered by her doctor. [The insurance company] refused to fill the prescription as written, leaving her at 2/3 of the required dosage. The doctor filed the form for a prior authorization and [the insurance company] refused to honor it. As I was preparing a detailed appeal letter, we received a second letter from [the insurance company] saying that they approved the increased dosage. Had they not made the approval, my next step would have been to have the doctor write a prescription for the most expensive alternative medicine available (some of them approach $1,000 for a 3-month supply). Here's where the prior authorization went wrong in this case. The reason for approval was a clause in the contract between [the insurance company] and [the pharmacy benefit manager] that says [the pharmacy benefit manager] must fill prescriptions using the cheapest available method. Prior authorization is not always about medical need - it's all about the money.