Don’t give up, appeal!
So, I was previously taking Wegovy until November of last year but stopped taking it due to severe GI issues. I saw that Zepbound was available and asked my doctor for a prescription in December. We submitted a PA but it got denied because I needed to try 3 other drugs first. I appealed over the phone and my appeal was denied and they said they were upholding their decision. I submitted a second written appeal using information from this sub. I wrote a letter, filled out a form to appeal and included screenshots showing that wegovy and saxenda are currently unavailable due to shortages. I also got a letter of medical necessity from my doctor. Finally, Zepbound is approved and will be $24.99. Don’t give up! Appeal! Zepbound was listed as not covered and not on my formulary through Aetna.