Appeal Guides

Free, plain-English guides to overturning a denied health insurance claim. Most denials are never appealed — and most appeals win.

GLP-1 medications (by drug)

Zepbound (tirzepatide)

Denied Zepbound? It is FDA-approved for chronic weight management and for moderate-to-severe obstructive sleep apnea in adults with obesity — giving you two of the strongest appeal angles available for a GLP-1 denial.

Wegovy (semaglutide)

Denied Wegovy? It is FDA-approved for chronic weight management and for reducing cardiovascular risk in adults with heart disease and obesity — and that heart-health indication is a powerful, underused appeal angle.

Ozempic (semaglutide)

Denied Ozempic? It is FDA-approved for type 2 diabetes and for reducing cardiovascular and kidney risk in people with diabetes. Appeals are strongest when tied to glycemic control and those organ-protection indications.

Mounjaro (tirzepatide)

Denied Mounjaro? It is FDA-approved for type 2 diabetes. The strongest appeals tie it to glycemic control and document why the plan’s preferred alternatives are inappropriate for you.

By denial type

a Weight-Loss Medication (GLP-1) Denial

Denied for Zepbound, Wegovy, Ozempic, or Mounjaro? Step-therapy and "not medically necessary" denials are among the most overturnable — if you make the right argument.

an MRI or Imaging Denial

Imaging denied as "not medically necessary"? These denials are most often a documentation gap, not a coverage gap — which makes them very winnable.

an ER Visit Denied as "Non-Emergent"

Your insurer billed your ER visit as "not an emergency" based on your final diagnosis? Federal law says that is not how it works.

a Mental Health or Residential Treatment Denial

Denied for residential, IOP, or inpatient mental health care because "a lower level of care is available"? Parity law gives you a strong basis to fight back.

an Out-of-Network Denial

Denied because a provider was "out of network"? You may have more protection than the letter suggests — especially for emergencies or when no in-network option exists.

a Specialty or Prescription Drug Denial

Denied a prescription drug for "prior authorization" or "not medically necessary"? A well-documented medical-necessity appeal overturns many of these.

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