But they are denying me because my doctor put in the prescription for type 2 diabetes and Sleep Apnea. Blue Shield denied the prior auth saying that Zepbound is not authorized for diabetes. They said Mounjaro is approved for diabetes.
They also said they require me to be on a weight loss program that includes a low-calorie diet, physical activity, and behavior therapy (all three) for 6 months. They say it needs to be in my health records.
Should I try and appeal this decision or have the doctor prescribe mounjaro. Could my doctor just say that I've been in a program for 6 months to get them to approve it?
u/Ashmodai20 — 10 days ago