Battling your prescription drug insurance denial

The transcript discusses a woman's struggle with knee pain and her challenges in getting insurance approval for the drug Zilretta. Despite initial denial, she paid out-of-pocket for the treatment. Dr. Richard Lehman shares his experiences battling insurance companies, highlighting the role of algorithms in denying treatments. The transcript offers strategies for overcoming insurance denials, such as switching drugs, requesting exceptions, and step therapy. It emphasizes the importance of having a doctor as an advocate and mentions consumer assistance programs available in some states. The narrative concludes with the woman preparing for her next insurance battle, determined to get coverage.

What strategies can a patient use if their medication is denied by insurance?

What advice is given regarding the role of the doctor in advocating for the patient?