Check your plan’s formulary for the specific medication
Confirm whether the drug is covered for weight loss or only for diabetes
Review prior authorization requirements
Verify whether step therapy is required
Ask your doctor to document medical necessity
Make sure your BMI and health conditions meet coverage criteria
Gather records of failed diet, exercise, or other weight-loss attempts
Request a prescription from a provider who can support the appeal
Ask for the exact diagnosis code your insurer requires
Submit all required lab results and clinical notes
Have your doctor complete the prior authorization form promptly
Appeal any denial within the insurer’s deadline
Include supporting letters from your doctor
Ask whether a formulary exception is possible
Check if the medication is covered under a different indication
Call the insurer and request the coverage criteria in writing
Ask about preferred alternatives that may be covered
Use the insurer’s appeal process if coverage is denied
Request a peer-to-peer review between your doctor and the insurer
Keep copies of every form, note, and denial letter
Recheck coverage each plan year during open enrollment
Use a flexible spending account or health savings account if available
Ask the pharmacy to run a test claim before filling
Consider manufacturer savings programs if insurance will not cover it