Prescription appeal worked - went from $800/month to $25 copay

Doctor prescribed a medication my insurance classified as Tier 4 ($800/month copay). Doctor filed a tier exception request explaining why the lower tier alternatives dont work for me (Ive tried three of them with bad side effects).

First request denied. Doctor filed a second request with more detailed clinical notes plus a peer reviewed study showing the medication is first line treatment for my condition.

Approved. Moved to Tier 2 with a $25 copay. From $800 to $25. The difference is life changing.

If you cant afford your medication, ask your doctor about a tier exception appeal. They deal with this all the time and know what to write.