In a previous post I discussed my on-going battle with adult acne and how I was successfully treated by my dermatologist. It may be unbelievable to some, but it is true, adults get acne too. As my dermatologist tells me, there are patients who come to her office who are in their eighties and still have acne. This is not a skin disease which only affects teens. One of the medications I have used over the years to treat my adult acne is called Tazorac or Tazarotene. Tazorac  is a topical retinoid which comes as a cream or a gel. There may be some initial side effects to using Tazorac such as burning, redness, or dry flakey skin. If you can tolerate some of these temporary side effects, it has been my experience that this medication really worked to prevent and control my acne outbreaks.

Note: What works for me may not work for you. Speak to your dermatologist about which acne medications are right for your particular skin type.

I have been successfully using this prescription acne medication now for almost ten years. So imagine my surprise when I get a notice from my insurance company that my request to have my prescription filled had been DENIED. Actually the insurance denial letter had come after several unsuccessful attempts to get my prescription filled and making numerous calls to my pharmacy, my dermatologist, and my insurance company.

Figuring out why a particular prescription cannot be filled is somewhat like a Scooby Doo mystery. There are usually twist and turns in the story as well as the leaving out of vital information and clues. Only at the end do you finally get to understand what really happened. Come with me on my journey through insurance red tape to find out why my prescription was denied. You too could be faced with a similar challenge especially if you are a woman who is prescribed a retinoid type of acne medication.

My story begins with our insurance changing which pharmacy we could use to fill prescriptions. Although I had been using Tazorac for almost a decade, my insurance company was viewing me as a brand new patient. When I went to get my prescription filled I was told that I would need pre-authorization from my doctor. Okay. So I call my doctor who tells me that she has completed this pre-authorization step and to call the pharmacy back. This begins a week long phone tag where one party sends me to another party and back again. I go to my pharmacy in person and they tell me they have not received any such pre-authorization for my Tazorac and that I need to call my doctor again and/or my insurance company. The pharmacist there added his speculation that the insurance company doesn’t want to pay for acne medication for someone who is older. Thanks Bud. So *ahem* older people can’t get acne? We know this is not true.

Hypothesis #1 for the insurance to deny my prescription acne medication: I am too darn old to have acne.

I then call my insurance company who assures me that I can get my prescription filled as soon as my doctor fills out that pre-authorization form of only eleven questions. I continue to wonder what could be holding up this process which had previously worked for years. The next call is to my doctor. It seems she had filled out this pre-authorization form weeks ago. I audibly sigh in frustration. The nurse on the phone is compassionate. She tells me she does not understand this hold-up either and will look into it. She then offers her theory as to why the insurance company may be giving us a hard time. In the nurse’s opinion, Tazorac is one of the best retinoids out there and along with treating acne; it is also one of the best anti-aging treatments.