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by whatthesmack 1 hour ago
I had the same issue with Zepbound (tirzepatide) 10mg/0.5ml when they wanted to push me to Wegovy (semaglutide), even though Zepbound was already working and helping. Zepbound isn't even on their formulary now.

I wrote the insurance company a detailed letter (helped by AI) containing evidence for the benefits of Zepbound over Wegovy and Zepbound over nothing, as well as documented the benefits I already experienced taking the medication. They approved coverage based on this pushback, and I just paid $25 for 3 months' supply.

Might be a potential avenue for some folks...