Tap to start →
Photo: Emma Simpson / Unsplash
1 / 6
Many GLP-1 denials come down to missing paperwork, such as a BMI not recorded in the chart, rather than a hard no.
2 / 6
Prior authorization , or PA, means your insurer must approve a drug before it will pay.
3 / 6
A recorded height, weight and BMI, often within the last 30 to 90 days Weight-related conditions documented with diagnosis codes, if your…
4 / 6
Denial reason Possible fix Drug excluded from plan Ask HR or the plan about exceptions; compare cash options BMI or condition not…
5 / 6
Your prescriber usually writes this, but you can draft it to save time.
6 / 6
Formulary : your plan's list of covered drugs, usually sorted into tiers that set your copay Exclusion: a drug or drug class the plan won't…
How prior authorization works for Zepbound, Wegovy and Ozempic, what insurers ask for, how to fix a denial, and a step-by-step appeal letter outline.
Tap below for the full page. Not medical advice; talk to your clinician about your care.