Prior authorization denied
Insurance says your medication does not meet its approval criteria.
GLP-1 Denial Appeal Support
Denied for Wegovy, Zepbound, Ozempic, or Mounjaro?We help you appeal.
We help you understand why insurance said no and prepare the appeal documents you need to move forward.
Upload your denial letter and get a clear explanation, next-step plan, doctor-office message, insurer call script, and document checklist. We do not prescribe medication, replace your doctor, or guarantee approval.
- [✓]Built for GLP-1 prior authorization denials, step therapy requirements, formulary exceptions, and plan exclusions.
- [✓]For Zepbound, Wegovy, Ozempic, Mounjaro, Saxenda, and similar medications.
- [✓]Most reviews delivered in 24–48 hours.
Appeal Packet
Packet
Ready
DENIAL TYPEPRIOR AUTH
DELIVERED24–48 HRS
$49
Denial Review
24–48 hrs
Typical delivery time
$49
Denial review
5+
Common denial types reviewed
1 packet
Appeal letter, doctor message, call script, checklist
Denial categories
What kind of denial did you get?
Step therapy required
Insurance says you need to try another medication or program first.
Drug not covered
Insurance says your medication is not on the formulary or requires an exception.
Plan excludes weight-loss medications
Your employer or plan may exclude coverage for weight-loss drugs.
Important: If your plan completely excludes weight-loss medications, a standard appeal may not work. In that case, we help you understand the issue and prepare benefits or employer escalation language.
Not sure
Upload your denial and we will help you understand what category it falls into.
GLP-1 denials are confusing. We make the next step clear.
When a GLP-1 medication is denied, it is not always obvious whether you need an appeal, a prior authorization resubmission, a formulary exception, step therapy documentation, or an employer benefits escalation. Most patients are left bouncing between the pharmacy, doctor's office, insurer, and benefits department.
Type 01
Prior authorization denied
Your insurer may need more documentation from your clinician before reviewing coverage again.
Type 02
Step therapy required
Your plan may require proof that other treatments were tried first or were not appropriate.
Type 03
Drug not on formulary
The medication may require a formulary exception or a different coverage pathway.
Type 04
Plan exclusion
Some plans exclude weight-loss medications. We help you understand whether the issue appears to be a plan-level exclusion and prepare next-step language.
How it works
How overturned_ works.
Step 01
Tell us what was denied
Choose the medication, insurer, and denial type. Upload your denial letter after checkout or start with a short summary.
Step 02
We review the denial type
We identify whether the issue appears to be prior authorization, step therapy, formulary restriction, missing documentation, plan exclusion, or medical necessity.
Step 03
You receive your appeal packet
You get a plain-English explanation, draft appeal letter, doctor-office message, insurer call script, and document checklist.
Step 04
You take the next step
Use the packet to speak with your doctor's office, insurer, pharmacy, or employer benefits department.
What your packet includes
What your packet includes.
Five clear pieces, organized around your specific denial. No legal jargon. Nothing combative. Just the documents and language you need to move forward.
- 01
Denial Summary
A plain-English explanation of what the insurer appears to be saying.
- 02
Recommended Next Step
Whether this looks like an appeal, prior authorization resubmission, formulary exception, step therapy response, or benefits escalation.
- 03
Doctor-Office Message
A copy-paste message asking your prescriber's office for the documentation that may be needed.
- 04
Insurer Call Script
Simple questions to ask your insurance company so you can confirm the appeal process, fax/upload instructions, deadlines, and criteria.
- 05
Document Checklist
A checklist of records that may support the case, such as chart notes, BMI history, diagnosis codes, prior medications, comorbidities, labs, or prior weight-loss attempts.
overturned_ does not prescribe medication, provide medical advice, provide legal advice, or guarantee approval. We help you understand your denial and prepare organized appeal-related documents.
Not every GLP-1 denial
needs the same response.
A generic appeal letter is not always enough. A GLP-1 denial may involve missing chart notes, BMI or diagnosis criteria, step therapy requirements, medication history, formulary restrictions, or plan-level exclusions. overturned_ helps you understand the type of denial first, then prepares the right next-step packet.
Option A
Generic appeal help
- [—]One-size-fits-all appeal letter
- [—]May not identify the denial type
- [—]May miss doctor-office next steps
- [—]May not address step therapy or formulary issues
Option B
overturned_
- [✓]GLP-1-focused denial review
- [✓]Denial-type triage
- [✓]Appeal or resubmission guidance
- [✓]Doctor-office message
- [✓]Insurer call script
- [✓]Document checklist
- [✓]HR/benefits escalation language when relevant
Common GLP-1 denial scenarios.
Educational examples only. Every denial is different — we help you understand which type yours is and what to do next.
ZepboundScenario #01
Zepbound prior authorization denied.
Possible next stepAsk what criteria were missing and prepare an appeal or resubmission packet.
WegovyScenario #02
Wegovy step therapy required.
Possible next stepDocument prior treatments, medication history, contraindications, and clinician rationale.
Plan ExclusionScenario #03
Plan excludes weight-loss medications.
Possible next stepConfirm whether the exclusion is plan-level and prepare employer benefits escalation language.
OzempicScenario #04
Ozempic denied for non-covered diagnosis.
Possible next stepClarify the diagnosis and coverage criteria with the prescriber and insurer.
Self-pay vs with coverage.
Without coverage, GLP-1 medications run hundreds of dollars a month — even through manufacturer self-pay programs. With approved insurance coverage and a manufacturer savings card, eligible patients often pay as little as $25 a month. That gap is why a denial is worth appealing.
Medication
Self-pay (mfr. program)*
With coverage*
Wegovy
Self-pay$199–$499 / mo
With coverageAs low as $0–$25 / mo
Zepbound
Self-pay$299–$499 / mo
With coverageAs low as $25 / mo
Ozempic
Self-pay$199–$349 / mo
With coverageAs low as $25 / mo
Mounjaro
Self-pay$349–$499 / mo
With coverageAs low as $25 / mo
Saxenda
Self-pay$700–$1,350 / mo
With coverageAs low as $25 / mo
*Examples only, updated for 2026. Self-pay reflects current manufacturer direct-purchase programs (e.g. LillyDirect Zepbound $299–$499/mo, NovoCare Wegovy $199–$499/mo, Ozempic self-pay $199–$349/mo). With-coverage figures reflect typical commercially-insured copays when manufacturer savings cards are applied. Your actual cost varies by pharmacy, dose, region, plan design, and eligibility. overturned_ does not set prices and does not guarantee approval or any specific out-of-pocket cost.
What we do · what we don't
What overturned_ does and does not do.
We do
- [✓]Review your denial letter
- [✓]Explain the denial in plain English
- [✓]Identify likely next steps
- [✓]Prepare appeal-related documents
- [✓]Help organize what to ask your doctor and insurer
We do not
- [—]Prescribe medication
- [—]Replace your doctor
- [—]Guarantee approval
- [—]Provide medical or legal advice
- [—]Act as your insurance company or healthcare provider
Pricing
Three ways to get organized.
Tier
Denial Review + Next-Step Plan
$49
Best if you are not sure what your denial means or what to ask for next.
- [✓]Plain-English explanation of your denial
- [✓]Identification of the denial type
- [✓]Recommended next step: appeal, resubmission, formulary exception, step therapy response, or benefits escalation
- [✓]Document checklist
- [✓]Doctor-office message
- [✓]Insurer call script
Tier
Custom Appeal Packet
$149
Best if you want a more complete appeal packet prepared from your denial information.
- [✓]Everything in Denial Review
- [✓]More complete custom appeal letter draft
- [✓]Organized appeal packet format
- [✓]Stronger medical necessity framing based on the denial reason
- [✓]One round of revision after you review the packet
Tier
Guided Appeal Support
$299
Best if you want help staying organized after the packet is prepared.
- [✓]Everything in Custom Appeal Packet
- [✓]1–2 weeks of guided follow-up support
- [✓]Help organizing submission steps
- [✓]HR/benefits escalation language
- [✓]Follow-up questions to ask your insurer or doctor's office
We do not guarantee approval or coverage. Our role is to help you understand your denial and prepare organized appeal-related documents.
Intake
Start your denial review.
Tell us a little about your denial. We'll send next steps and prepare your packet within 24–48 hours.
FAQ
Common questions.
Do you prescribe GLP-1 medications?+
No. overturned_ does not prescribe medications, provide medical care, or operate as a pharmacy. We help patients understand insurance denial paperwork and prepare appeal-related documents.
Do you guarantee my insurance will approve the medication?+
No. We cannot guarantee approval or coverage. We prepare organized documents and next-step guidance that may help you respond to the denial.
What medications do you help with?+
We help with insurance denial paperwork related to GLP-1 and weight-loss medication coverage issues, including denials involving Zepbound, Wegovy, Ozempic, Mounjaro, Saxenda, and similar treatments.
What if my plan excludes weight-loss medications?+
Some plans exclude weight-loss medications entirely. In those cases, an appeal may be difficult. We can help you understand whether the issue appears to be a plan exclusion, formulary issue, prior authorization denial, or missing documentation issue, and provide next-step language for your insurer or employer benefits department.
What if my doctor's office already submitted a prior authorization?+
That is common. We can help you understand the denial, identify what documents may be missing, and prepare a message you can send to your doctor's office asking for specific information or next steps.
Is this legal or medical advice?+
No. overturned_ is not a law firm, medical provider, insurer, or pharmacy. The information and documents provided are for educational and administrative support only.
How fast do I get the review?+
Most denial reviews are delivered within 24–48 hours.
Intake Open · Delivered 24–48 hrs
Stop guessing
what insurance wants.
Get a clear appeal packet and next-step plan for your GLP-1 denial.
Start My Denial Review — $49