@bens1 Step One is to look at the drug formulary for your Medicare Supplement to see which drugs are covered, whether prior approval is required, and whether "step therapy" (cheaper options failing) is a prerequisite. If you don't know where to find your specific formulary, call the number on your insurance (not Medicare) card and ask.

Once you know the rules for your policy, work with the doctor to initiate the prior approval. Also ask if the least-restricted med might work for your wife. They probably have dedicated staff to navigate the prior approval process, and they are really good at it.

Initial denials are common, and the reasons given quite specific. If you receive one, call the doctor's office immediately, and have them appeal. Appeals must be handled within a certain number of days, and sometimes a second-level appeal directly to Medicare is required.

I know this is frustrating, but it is one of the ways companies are trying to keep costs down.