Three years here, mostly lurking through the prior-auth threads, and I finally got the letter I’d been half-expecting: my BCBS plan is moving my GLP-1 to a different tier starting July 1. Not a denial yet — just a “new prior authorization may be required” notice and a formulary PDF.
I’m trying not to spiral, because I remember a thread last fall where a few people said the first rep gave wrong info and a second call fixed it. My concrete detail: I’ve been stable on the same prescription for 14 months, same pharmacy, no gaps.
For those who’ve dealt with a mid-year formulary change, did you wait for the pharmacy to flag it, or start the paperwork as soon as the letter came? I’d rather not spend a week in phone-tree purgatory if there’s a smarter order of operations.
Mods, delete if this belongs in the insurance megathread.