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Appeal guide · Medication

Medication and prescription denials

Drug denials happen at the pharmacy benefit (PBM) layer, separate from the medical benefit. They include non-formulary drugs, GLP-1s, specialty injectables, brand-name vs. generic, and prior-auth-required medications.

What gets denied

  • GLP-1s (Ozempic, Wegovy, Mounjaro, Zepbound)
  • Specialty biologics (Humira, Stelara, Dupixent)
  • ADHD medications (Vyvanse, Adderall XR)
  • Hepatitis C antivirals
  • Hormone replacement therapy
  • Compounded medications
  • Off-label prescription uses

Common denial reasons

  • Drug not on plan formulary (non-formulary)
  • Step therapy: cheaper alternative not tried first
  • Quantity limit exceeded
  • Plan claims indication not FDA-approved
  • Diagnosis ICD doesn't match approved indication

How we approach the appeal

Two paths: (1) tiering exception, request that the drug be moved to a covered tier; (2) formulary exception, request coverage of a non-formulary drug citing medical necessity. Manufacturer-published clinical packets accelerate exception filings.

Filing window

Urgent: 24-72 hours. Standard: 72 hours for Medicare Part D, 15 days for commercial. Filing window: typically 60 days.

Typical recovery

$200 – $20,000+ per month of medication

Documents we'll ask for
  • · Denial letter from pharmacy benefit
  • · Prescription / Rx record
  • · Prescriber's notes on indication
  • · Documentation of prior step-therapy trials

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This page provides general information about appeal strategy. It is not legal advice. Outcomes depend on documentation, plan terms, and timing.