Insurance tool
Generate a templated external-review appeal letter your prescriber can hand to your carrier. ~40% of weight-loss-drug denials reverse on appeal — push the paperwork.
Generated letter
6/3/2026
[Insurance Carrier] Appeals Department
Re: Appeal of denial — Wegovy
Patient: [Patient name]
DOB: [Date of birth]
Member ID: [Member ID]
Original denial date: [Denial date]
To the Reviewer,
I am writing to formally appeal the denial of coverage for Wegovy for the patient named above. The clinical basis for this prescription is documented in the medical record and aligns with the FDA-approved indications.
Grounds for appeal:
1. Medical necessity for chronic weight management at BMI ≥30
Supporting documentation enclosed:
- Two most recent visit notes documenting BMI and clinical history
- Relevant lab values (A1C, lipid panel, blood pressure)
- Documentation of prior lifestyle intervention attempt
- FDA prescribing information for Wegovy
We respectfully request that this denial be reversed and Wegovy be approved at the standard formulary tier. Per state external-review rights, please respond within the regulatory timeframe (typically 30 days for standard appeals, 72 hours for urgent).
Sincerely,
[Prescribing clinician signature]
[Clinician name + credentials]
[Clinic address + phone]
[Patient signature acknowledging appeal request]