Patient FAQ

Patients drive the work we do, and we know the many steps of the prior authorization process can be confusing.

While CoverMyMeds streamlines the process, we do not have a direct impact on the prior authorization outcome. Our job is designed to facilitate and expedite the process for your healthcare provider.

Let us help by clarifying a few points:

What is a prior authorization?

A prior authorization is additional clinical information your insurance plan may require when approving a specific medication prescribed by a doctor. Reasons range from formulary requirements, less expensive (but just as effective) alternative medications or even a medication that better fits your symptoms. Your insurance plan just wants to be sure.

Where does CoverMyMeds come in?

CoverMyMeds has automated what was originally a strenuous paper-based process, full of a lot of back and forth between different parties. Through electronic prior authorization (ePA) we connect pharmacies, doctors and your health plan to streamline the prior authorization process, getting you the medication you need, more quickly.

Your mission says you help patients. Can I submit an ePA myself through CoverMyMeds?

We help patients get healthy by making jobs easier for pharmacists, nurses, doctors and their staff; therefore, a prior authorization must be submitted or initiated by a licensed healthcare professional. If you’re concerned you’re not going to get a prescribed medication in a timely manner, we recommend mentioning the CoverMyMeds solution to your doctor and their staff, or your pharmacist.

How do I find out if my prior authorization is approved?

Due to HIPAA requirements, our associates cannot provide an update on the status of a prior authorization. Your doctor or pharmacist should be able to give you an update on whether a prior authorization was submitted through CoverMyMeds, and in some cases, can provide an ETA on when you can expect to get your medication.

Is any action required on my part?

No action is required from you, but confer with your doctor or pharmacist if you have questions regarding your medication.