The need for prior authorizations has caused me damage to my brain that I may never get back. I have multiple sclerosis, a lifelong illness, and my insurance company thinks they know what is best for me. WRONG! In 2015, my doctor wanted me on a medication called Gilenya, a [prior authorization] was sent to the insurance company and came back with a denial. Why? They wanted me to fail THREE medications of their choice before they would cover what my doctor said was best for me. I tried two of the three which led to terrible side effects and an allergy to one of them. Most of all it led to more lesions on my brain. In 2018, the need for a prior authorization for additional rounds of my current treatment led to 2 denials and a relapse during that time, again more damage that I may never recover from. I was told a board-certified neurologist would look at my appeal, I doubt they did. It wasn’t until I went to Facebook and posted on the insurance company’s page that I got momentum in the right direction. I was fed up with the process so on a post with the chief medical officer, I kindly asked if he could review my case. Less than 48 hours later my treatment was approved. It shouldn’t ever come to that. Insurance companies don’t know what’s best for a patient.

 

– Nicole S., Minnesota
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 for days, weeks, or months for a test or medical procedure to be scheduled because authorization from an insurer? Or are you a physician frustrated with the administrative headaches and their impact on your patient?

Prior authorization is a burden on patients and physicians alike. The process is confusing, time consuming, and — most importantly — can cause delays in patients receiving the care they need.

Please tell us know how prior authorization has impacted you. We are looking for stories from patients and physicians to highlight and draw attention to this issue that is impacting the health of so many Americans.

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