Long story short. My rx is on the way.
I called the pharmacy this morning and apparently I needed a “Medication Review” done on the Latuda before it could be processed. What is a medication review you ask? Well, Apparently Latuda is a non formulary drug with my insurance. So, in order to cover it, they have to make sure that I absolutely need it and make sure I can’t switch to something else, at their suggestion. Then they review the matter. You can get an expedited review, which is 24 hours, but only if you doctor tells insurance that it is an emergency. Otherwise, it takes 72 hours. If all goes well, they will approve your review. Think of it another kind of Prior Authorization.
I contacted the clinic to talk to a nurse. The nurse had never heard of such a thing. The PA was in place so she didn’t understand why I needed this other thing. They called and took care of it. The pharmacy called me an hour later to tell me I needed to pay my balance before they could ship my Latuda. So, that is how I found out that everything got sorted out. About 4 hours later the clinic called to tell me that they took care of it and I should have my meds in a week.
I’ve been on meds for over 10 years, and I have NEVER had this happen before. Of course, most of my meds have been covered by insurance. But since I’ve been on it for so long, they grandfathered me in.
I paid my balance with the pharmacy and now I am waiting for them to give me a ship date on the Latuda so I can pay that. (a great deal! $150 for a 90 day supply)