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Resources ▾PricingFAQ Get started Close Modal Close Modal Appeals explained Zepbound appealsWegovy appealsMounjaro appealsOzempic appeals Prior authorization denials Zepbound PA denialsWegovy PA denialsMounjaro PA denialsOzempic PA denials denial Reasons Explained Weight loss plan exclusionStep therapy denials Resources Zepbound appeals explainedWegovy appeals explainedOzempic appeals explainedMounjaro appeals explainedZepbound prior authorization denialsWegovy prior authorization denialsMounjaro prior authorization denialsOzempic prior authorization denialsWeight loss plan exclusions explainedStep therapy denials explained PricingFAQ Get started Honest Care introduces free appeal letters! Click 'Get started' to see all our package options. Excellent FILE YOUR APPEAL YOUR GLP-1 COVERAGE, DENIED APPROVED HONEST CARE HELPS FIGHT DENIALS FOR OZEMPIC, MOUNJARO, WEGOVY AND ZEPBOUND BY SIMPLIFYING INSURANCE APPEALS. WE WRITE YOUR APPEAL SO YOU CAN FILE IT. How it works FILE YOUR APPEAL OVERTURN YOUR GLP-1 COVERAGE DENIAL HONEST CARE SIMPLIFIES YOUR APPEAL PROCESS BY PREPARING THE DOCUMENTS NEEDED TO OVERTURN YOUR GLP-1 INSURANCE DENIAL. How it works Appeals explained I WAS DENIED INSURANCE COVERAGE FOR... Zepbound® Wegovy® WHAT YOU GET WITH HONEST CARE WE CRAFT YOUR STRONGEST CASE FOR COVERAGE USING YOUR ONLINE ASSESSMENT About online assessment WE WRITE YOUR APPEAL LETTER AND EVIDENCE EXPLAINING WHY YOU SHOULD BE COVERED View sample appeal WE OFFER SUPPORT SO YOU OR YOUR DOCTOR CAN FILE YOUR APPEAL WITH CONFIDENCE Our four step process Resources Zepbound appeals explainedWegovy appeals explainedOzempic appeals explainedMounjaro appeals explainedZepbound prior authorization denialsWegovy prior authorization denialsMounjaro prior authorization denialsOzempic prior authorization denialsWeight loss plan exclusions explainedStep therapy denials explained PricingFAQ Get started Why you should appeal your insurance denial See our recent videos and blogs regarding appeals HOW TO APPEAL A ZEPBOUND DENIAL HOW TO APPEAL A WEGOVY DENIAL APPEAL YOUR INSURANCE DENIAL Start learning how to appeal your insurance with our step-by-step guides PRIOR AUTHORIZATION FOR OZEMPIC: CRITERIA, PROCESS AND DENIALS PRIOR AUTHORIZATION FOR MOUNJARO: CRITERIA, PROCESS AND DENIALS PRIOR AUTHORIZATION FOR WEGOVY: CRITERIA, PROCESS AND DENIALS PRIOR AUTHORIZATION FOR ZEPBOUND: CRITERIA, PROCESS AND DENIALS HOW TO APPEAL AN OZEMPIC INSURANCE DENIAL HOW TO APPEAL YOUR MOUNJARO INSURANCE DENIAL HOW TO GET WEGOVY COVERED BY INSURANCE HOW TO APPEAL A WEGOVY INSURANCE DENIAL 5 STEPS TO APPEAL A ZEPBOUND COVERAGE DENIAL SAVE ON ZEPBOUND | COUPONS, SAVINGS CARDS, COPAY CARDS, INSURANCE COVERAGE HOW TO GET ZEPBOUND COVERED BY INSURANCE WHAT IS ZEPBOUND AND OTHER COMMON QUESTIONS ABOUT THE NEW GLP-1. * * * * * * * * * * * * * * WHAT'S COVERED IN OUR ONLINE ASSESSMENT Complete your assessment today and we'll get started on your appeal. INSURANCE COVERAGE We tailor your appeal to address your insurance's prior authorization requirements and reason for denial. MEDICAL HISTORY We argue why coverage is medically necessary based on your health conditions such as obesity, diabetes, metabolic syndrome, hypertension, sleep apnea and many more. PRESCRIPTION HISTORY We identify arguments against trying different medications first based on your past medications, health conditions and clinical research studies. WEIGHT LOSS ATTEMPTS Some insurers require you to participate in organized weight loss programs before approving coverage. We'll position your weight loss attempts to meet the requirement. DIET & EXERCISE ROUTINE We confirm to your insurance that your GLP-1 will be used as an 'adjunct to lifestyle modification' based on your current diet and exercise routine. FDA CRITERIA We check if you meet the FDA criteria for coverage and emphasize your eligibility if you do. More on assessment ▾ GATHER THE RIGHT EVIDENCE TO SUPPORT YOUR INSURANCE COVERAGE YOUR WEIGHT LOSS & GLP-1 GOALS YOUR GOALS & BUDGET Getting your health insurance to approve GLP-1 coverage can be difficult. Your Honest Care Report makes it easy by summarizing why you are motivated to lose weight and why you think a GLP-1 medication is right for you. YOUR PREVIOUS WEIGHT LOSS ATTEMPTS YOUR GOALS & BUDGET Your insurance will want to see your previous weight loss attempts. Your Honest Care Report summarizes your diet and exercise history, your past weight loss attempts, weight loss medications you previously tried, and any unique challenges you face that make a GLP-1 medically necessary. YOUR GLP-1 CLINICAL ELIGIBILITY YOUR GOALS & BUDGET Your insurance will need to review whether you are clinically eligible for a GLP-1. Your Honest Care Report includes detailed information confirming your GLP-1 eligibility by aggregating your BMI, health conditions, current medications and drug allergies in a single page. YOUR INSURANCE DOCUMENTS YOUR GOALS & BUDGET Along with your Prior Authorization or Formulary Exclusion the Honest Care Report packages all the necessary information your insurance will require to approve coverage. YOUR GOALS & BUDGET YOUR APPEAL LETTER Your final step will be to submit an appeal letter, that we create for you, to your insurance company. Tailored to your specific denial reason, this letter summarizes all the necessary information for you to get approved such as your prior weight loss attempts, alternative weight loss medications you have tried, unique personal challenges to losing weight, and clinical issues you have had. Continue HOW IT WORKS COMPLETE YOUR ONLINE ASSESSMENT Answer simple online questions at your convenience that gather all the necessary appeal evidence to fight your denial. Get started WE WRITE YOUR APPEAL LETTER Your dedicated appeal specialist will review your assessment and write your appeal to make the strongest case for coverage. Your appeal will cover * Why prescription is necessary * Step therapy requirements * Diabetes, heart disease, and obesity eligibility * Why alternative medications are ineffective * Academic research supporting your case RECEIVE YOUR APPEAL PACKET Appeal letter Receive a professionally written and editable appeal letter you can submit to your insurance with confidence. Included with all packages Supporting documents We’ll create a supporting evidence report that further justifies your appeal letter, to send your insurance along with your appeal. Included with payed packages View sample appeal FILE YOUR APPEAL WITH OUR SUPPORT You can mail or fax your appeal to your insurance, or your doctor can file on your behalf. A dedicated appeal specialist is available to walk you through your appeal so you can file with confidence. Included with payed packages * Review your appeal letter & evidence * Provide guidance on the appeals process * Review and identify your alternative GLP-1 options WE GUARANTEE YOU'LL BE SATISFIED WITH OUR SERVICES ll y a 3 jours SUPER ACCOMPAGNEMENT Super accompagnement, excellente réactivité ! L’équipe de DIGIDOP a été à nos côtés dans le développement de notre site web. L'équipe est vraiment à l'écoute et offre une capacité d'adaptation à toutes nos demandes spécifiques (refonte du site, création de landing pages etc...) ! Merci pour votre proactivité et votre soutien ! CHLOE DURAND 18 déc. 2021 L'AGENCE POUR VOTRE SITE WEBFLOW ! Digidop nous a accompagné dans la refonte intégrale de notre site web. L'agence webflow Digidop a repensé toute notre charte graphique, notre maillage interne, le maquettage du site ainsi que le développement Webflow. Nous sommes très satisfait par leur accompagnent et conseils en référencement naturel SEO. L'équipe Digidop nous accompagne maintenant dans le développement d'un site e-commerce Webflow. FABIO COZZOLINO 1 déc. 2021 EQUIPE TRÈS RÉACTIVE ET AVEC UN VRAI… Equipe très réactive et avec un vrai souci du détail ! Florian est très disponible et prend le temps d'expliquer ses choix/options à chaque étape. Je recommande vivement ses services ARNAUD DELUBAC 15 nov. 2021 MEILLEURE AGENCE NOCODE ! Meilleure agence nocode ! L'équipe Digidop est ultra réactive, disponible et proactive. Nous avons fait appel à elle pour la création d'une landing page. Elle a su comprendre notre besoin et a été très rapide dans le développement de cette landing page. LÉA MU "THE BEST DECISION WAS FILLING OUT THAT FORM...SIMPLY AMAZING AND WORTH EVERY PENNY" After both my PA and Appeal were denied, I was beyond annoyed and upset. I knew I was too emotionally attached at the time to really tackle the issue. I had seen Honest Care mentioned on Reddit before and took a screenshot. I decide to try their services and it was by far the best decision I could have made. Truthfully, I was still nervous but all that went away after I received my Appeal Packet and subsequent phone call with Daniel. Simply amazing and worth every penny. Without hesitation, I recommend Honest Care. It was one of the best decisions I made for my health. M J, USA "I'D RECOMMEND THEM TO ANYONE NEEDING A HAND WITH INSURANCE APPEALS - THEY'RE GREAT AT WHAT THEY DO!" “Right from the start, the team was super quick to respond and really understanding my insurance challenges. They put together a compelling appeal letter that captured my need for Zepbound coverage. I’d recommend them to anyone needing a hand with insurance appeals – they're great at what they do!” Dorlene M., Washington USA "I KNEW I NEEDED THIS SUPPORT, AND FINDING IT SO EASILY WAS A GAME-CHANGER FOR ME." "Having the letter prepared in advance was incredibly helpful, especially since navigating through the process was confusing. I appreciated the automated form that collected all my information and seamlessly created a letter for me. Discovering this service was a relief. The blend of automation with personal assistance made all the difference. I knew I needed this support, and finding it so easily was a game-changer for me." S J, California USA "THIS REALLY TAKES THE BURDEN OFF OF ME. I COULD HAVE WRITTEN A LETTER BUT IT WOULD NOT HAVE BEEN THIS DETAILED" "I think you guys did a great job gather the data and putting the letter together. This really takes the burden off of me. I could have written a letter but it would not have been this detailed because I’m coming from an emotional stand point of just being frustrated with my insurance. Whether it’s denied or accepted I would give you 10/10." Irene M., Texas USA July, 18 2024 Very quick to respond. High Quality Service. Very quick to respond and very professional. They certainly know what they’re doing regarding GLP drug denials and how to create a professional appeal letter. Highly recommend them! D Daren July 11, 2024 5 Star Service Honest Care has an easy to use, informative website. They are transparent with their costs/options. The customer service team is very responsive and kind. I am still fighting my appeal with hopes we'll be successful but it will be an uphill battle. Very grateful to have a supportive and responsive team to lean on. KE Kelly July 10, 2024 Saved me a lot of time! Letter was comprehensive and used my input data accurately. BR Brenda June 12, 2024 Great service Great service, quick response and you know WHAT? I got my appeal approve. BR Abigail Joseph May 8, 2024 Exceptional service, highly recommend Having the letter prepared in advance was incredibly helpful, especially since navigating through the process was confusing. I appreciated the automated form that collected all my information and seamlessly created a letter for me. Discovering this service was a relief. The blend of automation with personal assistance made all the difference. I knew I needed the support, and finding it so easily was a game-changer for me. SJ S Jamwal Mar 7, 2024 The BEST decision was filling out that form After both my PA and Appeal were denied, I was beyond annoyed and upset. I knew I was too emotionally attached at the time to really tackle the issue. I had seen Honest Care mentioned on Reddit before and took a screenshot. I decide to try their services and it was by far the best decision I could have made. Simply amazing and worth every penny. Without hesitation, I recommend Honest Care. It was one of the best decisions I made for my health. MJ M J WE SPECIALIZE IN APPEALS FOR THE BIGGEST INSURANCE COMPANIES SO YOU DON'T HAVE TO GET STARTED NOW! TAKE 3 MINUTES TO TELL US ABOUT YOUR DENIAL AND SEE WHICH APPEALS PACKAGE IS RIGHT FOR YOU. FREQUENTLY ASKED QUESTIONS General Traditional care vs telehealth Insurance coverage & eligibility WHY IS THE SELF-SERVICE APPEAL LETTER FREE? At Honest Care, we believe that everyone should have access to the healthcare they need without the stress of navigating complex insurance appeals. One of the hardest parts of appeals is collecting the right information and writing a strong appeal letter. To make this process more accessible and equitable, we offer our appeal letter service for free. This way, everyone has an equal chance to overturn their denial and secure the coverage they deserve. WHAT IS THE HONEST CARE SERVICE GUARANTEE? We believe every insurance denial should be appealed and every patient should fight for access to the best treatments we’ve made generating a strong appeal letter free. We also offer paid services to access our team of GLP-1 experts. If you are not satisfied with our teams’ services, email our support team at support@findhonestcare.com and we will be happy to remedy any issues. You can also request a refund within 60 days of purchase of our services so long as your appeal hasn't been submitted to your insurance. Once our appeal packet has been submitted to your insurance, we will no longer issue refunds. Refunds are processed to the original payment method within 5 to 10 business days. HOW DOES HONEST CARE HELP WITH INSURANCE DENIALS? We help patients fight insurance coverage denials so they can get access to the medications and treatments they deserve. We currently specialize in insurance coverage denials for Ozempic, Mounjaro, Wegovy and Zepbound. If you are denied coverage for Ozempic, Mounjaro, Wegovy or Zepbound, Honest Care can help fight your denial by submitting an ‘appeal’ to your insurance. An appeal is a formal request to your health insurance company to overturn their denial and grant coverage on your behalf. An appeal generally consists of a formal letter, addressed to your insurance, explaining why a medication should be covered on your behalf and why your insurance’s initial denial should be overturned. You have the right to appeal to your insurance’s coverage denial. Honest Care simplifies the appeals process by writing an appeal letter and supporting documents on your behalf making your best arguments for medication coverage, following your completion of our proprietary GLP-1 denial assessment. SHOULD I APPEAL IF MY INSURANCE DENIED COVERAGE? If your insurance denied coverage for Ozempic, Mounjaro, Wegovy or Zepbound, you have the legal right to ask your insurance to reconsider the coverage denial by sending an ‘appeal’. Unfortunately coverage denials too often go unchallenged. A study from September 2023 found that 69% of people who were denied coverage by their insurance didn’t know they could appeal, and 85% of people never tried to appeal. We believe it always makes sense to appeal. Here is why: Appeals work: According to a study analyzing data from several U.S. states, patients who appealed directly to their insurance provider (an internal appeal) experienced a success rate between 39-59%. Denials are often issued by mistake: A computer almost always makes the initial decision to deny medication coverage. This results in denials that don’t actually consider your personal health situation or denials made by mistake. In the case of Ozempic, Mounjaro, Wegovy and Zepbound, incorrectly entered information about your BMI, labs including A1c, your health conditions and diagnoses, your medication history and current medication use can all lead to an automatic denial. When you appeal, your information is reviewed by a real person. Doctors review appeals, not computers: Having a doctor consider your unique circumstances makes submitting an appeal a powerful process for overturning denials getting covered. You deserve the best care: You have the legal right to fight the treatment you need. As a part of the Affordable Care Act, all health insurance plans are required to allow their members to appeal their coverage decisions. This spans all insurance coverage - whether you are insured through your employer, purchased an insurance plan through your state marketplace, or are insured through a government program like Medicare or Medicaid. HOW DOES HONEST CARE’S PAID APPEAL SERVICE WORK? We currently offer appeal services for Ozempic, Mounjaro, Wegovy and Zepbound. After purchasing Honest Care and completing your online denial assessment, you can expect to receive your appeal letter within 2 business days. 1. Online denial assessment: Complete the online assessment at your convenience that gather all the necessary appeal evidence for your insurance. The assessment reviews your medication history, including any GLP-1s, weight loss or diabetes medications you have taken, your health conditions and diagnoses, your past weight loss, diet and exercise attempts, and details on your insurance coverage and denial. 2. Case evaluation & appeal strategy: One of our dedicated appeal specialist will review your assessment and insurance denial and identify your best appeal arguments for coverage. This will include an evaluation of your medication history, medical diagnoses, weight loss attempts and clinical research studies that strength your appeal case. 3. Appeal letter & supporting documents: Your assigned appeal writer will compose a professional appeal letter addressing your denial reason and detailing your case for coverage. We’ll create a supporting evidence report that further justifies your appeal letter, to send your insurance along with your appeal. 4. Specialist Consultation & Support: After you receive and review your appeal letter & evidence, your dedicated appeal specialist will be available to answer your questions. They will be available to make updates to your appeal, if required. You will also have the option to schedule a phone or video call at a time of your convenience to you speak to your dedicated appeal specialist. 5. Send your appeal: You can submit your appeal yourself or have your doctor submit your appeal on your behalf. Most insurance companies accept appeals by mail or fax. Instructions on how to submitted appeal will be included within the written explanation on why you initially denied medication coverage, sent at the time at you were denied. WHAT IS INCLUDED IN HONEST CARE’S APPEAL PACKET? For payed package, your appeal packet will include two main documents: 1) Your appeal letter and 2) Your supporting evidence. You can review a sample Honest Care appeal that includes an abridged appeal letter and evidence for demonstration. WHAT IS AN INSURANCE APPEAL? An insurance appeal is a formal request you make to your insurance company, asking them to reconsider a decision about your claim. This could be when they've denied your claim, not paid enough, or made a decision you disagree with. The appeal is your chance to argue your case, showing them why their decision should be different. It involves submitting a well-structured letter, along with any supporting evidence like medical records or repair estimates, to make your case stronger. WHAT IS AN INSURANCE APPEAL LETTER? An insurance appeal letter is your way of asking the insurance company to reevaluate a decision, such as a denied claim. It's essentially your argument in writing, explaining why you believe their decision should be different. This is a common document patients can use to advocate for themselves with their insurance to cover their medical costs even prior to being denied for a treatment. This letter will include your policy details, specific decision you disagree with, and provide solid reasons and evidence (like weight loss efforts, past and present medications, labs, receipts etc) for your appeal. The letter should be clear, concise, and respectful, ending with a specific request for what you want your insurance to do. You can submit an appeal letter directly to your insurance or through your health care provider as part of your insurance appeal process. WHAT IS SUPPORTING INSURANCE EVIDENCE? Insurance supporting evidence is the documentation or information you provide to back up your claim or appeal with your insurance company. It's the proof that supports your case, like medical history, diet and exercise efforts, medication history, or relevant medical studies. This evidence is crucial because it shows the insurance company why they should approve your claim or reconsider a decision they've made. We provide 3 types of supporting insurance evidence. (1) Appeal Evidence - is the information you provide when you disagree with your insurer's decision about a claim or coverage. This could include detailed medical records, letters from your doctor explaining the necessity of a treatment, or information about how a treatment is standard for your condition. This evidence is crucial for challenging a denial or underpayment of a claim. Our role is to help you gather and present this evidence effectively, ensuring it clearly supports your need for the treatment or service claimed. (2) Prior Authorization Evidence - is required when your health plan needs you to get approval before it covers certain medications or procedures. This evidence typically includes medical records, lab results, and a detailed rationale about why this specific medication or procedure is necessary for your condition. Our service involves assisting you in compiling comprehensive and relevant documentation to justify the medical necessity, aiming to secure approval from your insurance company for the required treatment. (3) Step Therapy Exclusion Evidence - is used when you need to bypass the 'step therapy' protocol of your insurance plan. This protocol usually requires trying less expensive treatments before more costly ones are approved. Exclusion evidence might consist of medical records showing previous treatment attempts and failures, clinical data indicating why standard treatments are unsuitable or harmful for you, and detailed explanations about the necessity of the specific, often more expensive, treatment. We help you collect and organize this evidence to make a compelling case to your insurer that the standard step therapy process is not appropriate for your situation, thereby aiming for an exemption. HOW CAN WORKING WITH A REGULAR DOCTOR INCREASE YOUR CHANCE OF INSURANCE COVERAGE COMPARED TO TELEHEALTH? Working with your regular doctor can increase your chance of insurance coverage in several ways, including: * When your insurance plan is making a decision on whether to cover your GLP-1 prescription, they will want to review your medical history and recent labs results. Your doctor already has this information within your patient chart, and if you don’t have recent labs, your doctor can order new labs during your appointment. Most online, telehealth-based GLP-1 clinics do not have access to your full medical history in your patient chart, which limits their ability to achieve insurance approval. * In the event your insurance plan initially denies coverage for your GLP-1, this decision can be appealed by your doctor by writing a “Letter of Medical Necessity” and sending it your insurance company. Writing an effective letter requires a doctor to have a real relationship with their patient. Online, telehealth-based GLP-1 clinics find it challenging to write effective "Letters of Medical Necessity" given their lack of personal relationships with patients. * Insurance plans are increasingly flagging and scrutinizing GLP-1 prescriptions written by online, telehealth-based GLP-1 clinics. Working with a regular doctor can help avoid this additional scrutiny. CAN THE HONEST CARE REPORT BE SHARED WITH TELEHEALTH DOCTORS? Yes - your Honest Care Report can be submitted to any doctor, including doctors working with online, telehealth-based GLP-1 clinics. Taking the Honest Care Assessment before engaging with a telehealth services presents several advantages, including helping you save money. By using Honest Care before engaging with a telehealth company, you’ll find out how likely you are to get a GLP-1 prescription and will receive guidance on any recommended steps to take before your GLP-1 appointment. This can save you money by avoiding paying subscription fees until you’re fully prepared for your telehealth appointment. WHO IS ELIGIBLE FOR GLP-1S? There are nearly 10 GLP-1 medications available in the United States. Currently three of those medications, Zepbound®, Wegovy® and Saxenda®, are FDA-indicated for weight-loss assistance. The FDA indicates that people with a BMI ≥ 30 kg/m2 OR people with a BMI ≥ 27 kg/m2 who have been diagnosed with at least 1 weight-related condition are eligible for GLP-1s. All other GLP-1 medications, including Ozempic® and Mounjaro®, are currently FDA-indicated for people diagnosed with Type 2 diabetes. I ALREADY KNOW I’M ELIGIBLE FOR GLP-1S BASED ON FDA-GUIDELINES. HOW CAN HONEST CARE HELP ME WITH ELIGIBILITY? While FDA-guidelines are critical for understanding GLP-1 eligibility, there are a number of other factors to consider for determining GLP-1 eligibility. Additional eligibility criteria that Honest Care takes into account include: * Weight-related conditions by importance in Prior Authorization (PA) - insurance plans often take certain conditions more seriously than others when determining GLP-1 eligibility. * Medication step therapy - many insurance plans only consider patients eligible for GLP-1 coverage only after trying lower-cost weight loss assistance medications first. * Ethnicity-based BMI guidelines for determining whether a patient is overweight by ethnicity. WHAT IS PRIOR AUTHORIZATION (PA)? DOES HONEST CARE HELP WITH INSURANCE? Prior Authorization (PA) is a process run by insurance plans to determine how necessary a medication is. Most insurance plans require Prior Authorization (PA) before approving coverage for GLP-1s. After your GLP-1 prescription is written, your insurance plan will notify your doctor if a PA is required and ask your doctor for additional documentation on why your medication is necessary. If a PA is required, your insurance plan will ask your doctor to submit detailed information on your diet and exercise history, your past weight loss attempts, weight loss medications you previously tried, and any unique challenges that you face that make a GLP-1 medically necessary. The Honest Care Report includes evidence requested by most insurance plans and can be submitted to your insurance during the PA process. During your appointment, your doctor can attach your Honest Care Report to your health record so it is submitted as supporting evidence to your insurance if Prior Authorization is required. GET ANSWERS Try it GET ANSWERS Try it GET ANSWERS Try it GET ANSWERS Try it LET’S GET STARTED Get Started LET’S GET STARTED Get Started LET’S GET STARTED Get Started LET’S GET STARTED Get Started LET’S GET STARTED Get Started Our mission is to enhance access to insurance coverage by raising awareness of consumer healthcare rights and offering services to simplify the insurance claims and appeals process. Honest Care’s service is for informational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. Honest Care is not offering advice, recommending or endorsing any specific prescription drug, doctor or telehealth provider, or other information on the site. Honest Care provides no warranty for any information. Please seek medical advice before starting, changing or terminating any medical treatment. Honest Care is not sponsored by or affiliated with any of the third-party brands identified. 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