Medical coverage (Canada/Quebec) with Industrial Alliance
I am looking for advice for anyone who encountered issues with getting the approval for their prior authorization form by their insurance provider for Zepbound. My employer now covers weight management medication under certain conditions. My doctor first submitted the form with an incorrect BMI which Industrial Alliance rejected it because for BMIs under 35, a comorbidity factor is required. Fine, my doctor corrected the information ( my BMI is actually 36.7) and resubmitted the form. I don’t have a comorbidity so he left that section blank. Now they’re rejecting it again because there is no comorbidity factor, to which I am at loss of words. Their customer service is absolutely not helpful and I am at risk of not being able to afford my medication this month. Anyone has ever encountered a similar issue, particularly with a Canadian insurer? I feel like they’re purposefully make it very hard to approve these requests despite legitimate medical reasons.
Any help is appreciated.