What if my insurance denies coverage for GLP-1 medications?

Insurance denial is common but appealable. First, understand the specific reason for denial - it may be step therapy requirements, lack of documented comorbidities, BMI below threshold, or non-formulary status. Request a formal letter of medical necessity from your prescriber detailing: your BMI, qualifying comorbidities, previous weight management attempts, and health risks of untreated obesity. Include relevant lab values (A1C, blood pressure, lipids) and any obesity-related conditions. Many denials are overturned on first appeal. If denied again, request an external review by an independent third party. Consider patient assistance programs - Novo Nordisk and Eli Lilly offer programs for qualifying low-income uninsured patients. Manufacturer coupons can reduce copays to $25 for commercially insured patients. Some patients use compound pharmacies ($200-500/month) as an alternative. Finally, consider switching to an employer plan with better obesity coverage during open enrollment.