New retiree; prior authorizations denied by my new Part D plan even though these drugs were covered by my previous employer plan
Well, I had wrongly assumed that the part D part of Medicare would be the easy part. I have been taking tadalafil for ED and testosterone for weakness/lethargy and my employer prescription plan had been covering them. But then the first time I went to get them refilled after retirement with my new Medicare Part D plan (through Humana), I learned that Humana required prior authorization for both of them. Went through the process to get my doctor’s office to communicate with Humana, and the prior authorizations were denied for both medications by Humana.
I kinda get the tadalafil denial. It seems insurance companies don’t want to pay for ED treatment, but I was surprised by the testosterone denial.
My questions: Is it worth the trouble to appeal the denial? Are such denials common for part D plans when a prior prescription plan was already covering them? Am I likely to have luck getting them covered if I change to another part D provider? Suggestions? Thanks!