- Formulary
- The list of medicines a particular insurance plan covers.
- Prior authorization
- The plan’s advance review before agreeing to cover a medicine.
Ask for an answer you can keep
- Does my plan list this particular medicine?
- Does the reason for treatment affect coverage?
- Is an advance review needed?
- What information must the clinician (the health professional evaluating your problem) send?
- What would I pay if coverage is refused?
- Can I have that answer in writing?
If you have a medical spending account
Health savings accounts and flexible spending accounts reserve money to pay medical costs.
The U.S. tax agency is the Internal Revenue Service. Its account guidance separates treatment of a doctor-diagnosed disease from expenses that benefit general health alone.
Ask the person who manages your account whether this expense qualifies and what proof of a diagnosed condition they need.
An advert saying you can use your account money for a treatment is not an answer from the person who manages your account.
U.S. tax guidance checked: September 26, 2026.