🍪 The GLP Lounge uses cookies to improve your experience, analyze traffic, and personalize content. By continuing to use this site, you agree to our Cookie Policy.
Evidence-based GLP-1 & peptide discussion since 2023
ForumsInsurance & AccessMy insurance FINALLY approved it - here is exactly what I did — what worked for you? Page 3

My insurance FINALLY approved it - here is exactly what I did — what worked for you?

PedsEndoPhilly Sun, Dec 28, 2025 at 12:12 PM 15 replies 985 viewsPage 3 of 3
emma_london
Member
312
1,456
Oct 2024
London, UK
Dec 29, 2025 at 3:08 PM#11
One more thing for Express Scripts specifically — they're a PBM, not an insurer, so the PA criteria come from whatever plan your employer chose. Make sure you're getting the criteria from Express Scripts, not your insurer's medical side. Pharmacy benefit PAs and medical benefit PAs are totally different pathways. Good luck!
Last edited: Dec 29, 2025 at 9:08 PM
11 9sarah_nash92, FitDadDave, RunnerRach and 8 others
Reply Quote Save Share Report

Similar Threads

Prior authorization success: step-by-step guide with templates5 replies
Cigna now covering Zepbound — how I got approved13 replies
Appeal letter template — denied PA for GLP-1 medications4 replies
Mounjaro savings card — manufacturer program changes 202610 replies
Medicare Part D GLP-1 coverage — what's covered in 202610 replies
ForumsNewTrendingMembersAccount

Log In

Forgot password?
No account? Register