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 options. Let your Care Team know how you wish to proceed.

•  Option 1: 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.

• Option 2: Booking a follow-up with your provider to be prescribed an alternate medication
  • We advise that you contact your insurance first to verify what medications and under what diagnosis are covered.

• Option 3: Book a follow-up with your provider for an alternative Cash pay medication
  • PLENITY is a weight management medication through GoGoMeds pharmacy. It costs $98 dollars for a month’s supply.

Contrave is another at $99 a month for home delivery