09/03/2026
โWhy isnโt my medication covered?โ Letโs break it down ๐
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Covered: Your insurance includes the medication on its formulary, but you may still have a copay or deductible.
โ Not covered: The medication may be excluded from your plan, so insurance will not pay for it.
๐ Prior authorization (PA): Your insurance needs additional information from your prescriber to determine whether the medication meets its coverage requirements before approving payment.
Coverage does not always mean free, and a PA does not guarantee approval.
Coverage varies by insurance plan. This is general education, not medical advice.
