BariatricNurseD said:My insurance denied my PA related to cost and coverage.
Same pattern here, and in the same order.
josh_phd_bmore said:paige_pharma said: ...my insurance denied cost and coverage coverage because...
Insurance update relevant to cost and coverage: I just got my prior auth approved through UnitedHealthcare after 1 attempts.
What finally worked: a letter from my endocrinologist documenting BMI history (>3 years), failed diet attempts, comorbidities (PCOS + insulin resistance), and referencing the SELECT trial data.
If your PA keeps getting denied, don't give up. Request a peer-to-peer review between your doctor and the insurance medical director. That's what finally broke through for me.
josh_phd_bmore said:paige_pharma said: ...my insurance denied cost and coverage coverage because...
Thank you for spelling out the reasoning rather than just the conclusion.
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Browse GL BiochemFrom the other side of the consultation, briefly.
Insurance coverage hack for cost and coverage: if your insurance denies brand Wegovy/Ozempic, consider these alternatives:
- Prior authorization appeal with peer-to-peer review
- Manufacturer copay card (for commercial insurance)
- Patient assistance programs (Novo Nordisk, Eli Lilly)
- Compounded medication from a 503B pharmacy ($149/month)
- Canadian pharmacy (requires prescription, ~40-60% savings)
Don't let cost prevent access to effective treatment. There are options at every price point.
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