Dr.GastroMayo said:Denials are usually procedural rather than clinical, and the order that works reflects that.
Insurance update relevant to cost and coverage: I just got my prior auth approved through UnitedHealthcare after 3 attempts.
What finally worked: a letter from my endocrinologist documenting BMI history (>3 years), failed diet attempts, comorbidities (sleep apnea + prediabetes), 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.
One thing that is still open after Dr.RaviCardio’s answer:
How long did you give it before you decided it was working?
josh_phd_bmore said:Insurance update relevant to cost and coverage: I just got my prior auth approved through UnitedHealthcare after 3 attempts.
Telehealth prescriber review for cost and coverage: I've used 4 different telehealth platforms to get my GLP-1 prescription. Comparison:
| Feature | Platform A | Platform B | Platform C |
|---|---|---|---|
| Initial Consult | $59 | $89 | $0 |
| Monthly Follow-up | $39 | Included | $59 |
| Prescription Speed | Same day | 24-48 hours | Same day |
| Lab Monitoring | Required | Optional | Required |
I settled on the one that required labs — it shows they care about safety, not just prescribing volume.
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Update: approved on the third attempt after a peer-to-peer. Nothing about my case changed; only who was doing the talking.
LindaRN_retired said:Telehealth prescriber review for cost and coverage: I've used 4 different telehealth platforms to get my GLP-1 prescription.
Financial impact of cost and coverage weight loss beyond medication cost:
- Groceries: SAVED $228/month (eating less)
- Restaurants: SAVED $218/month (fewer meals out)
- Alcohol: SAVED $168/month (stopped drinking)
- Life insurance: Premium REDUCED by $38/month (lower BMI)
- Copays: SAVED $78/month (fewer BP/cholesterol meds)
Net impact after medication cost: approximately BREAKING EVEN. The medication pays for itself through reduced food spending and healthcare costs. This surprised me.