Prior Authorization Denials - Next Steps

If your prior authorization is denied, your insurance will not pay for the medication prescribed, which means you can pay for your medication out-of-pocket at the pharmacy. There are some next steps - let your Care Team know how you wish to proceed.

NEXT STEPS:

• Submit an Appeal

Please note that appeals can take up to 30 days. If you are prescribed a weight management medication, you may require either a type 2 diabetes diagnosis or weight loss medication coverage (depending on the medication) in order for appeal approval.

OR

• Booking a follow-up with your provider to be prescribed an alternate medication

We advise that you contact your insurance to verify what medications and under what diagnosis are covered.

OR

• Cash Pay Medications (requires a follow-up appointment with the doctor)

1. PLENITY is another option for $98 dollars

https://www.myplenity.com/plenity-otc?gclid=Cj0KCQiAqOucBhDrARIsAPCQL1Z-rA8fpWvIxwQdbYXbJaJgZhRQTyLT7gJoW_PwNkX4sfqlXbrLDRgaAkdIEALw_wcB

2. Contrave is another cash pay option for $99 dollars for home delivery

https://www.contravehcp.com/savings-support/free-home-delivery/