Tool · Letter templates

Insurance appeal letter templates

Free, fill-in-the-blanks appeal letters for GLP-1 coverage denials — medical-necessity denials and formulary exclusions.

Templates, not advice. These are drafting aids to bring to your prescriber or send to your insurer — they are not legal or medical advice, and your clinician should adapt the clinical details to your case.

Denied for medical necessity

Appeal letter template: GLP-1 denied as "not medically necessary"

For appealing a denial that claims the medication isn't medically necessary. Appeals succeed more often than people expect — most plans must respond within 30 days, and you have the right to an external review if the internal appeal fails.

Drug excluded from formulary

Appeal letter template: GLP-1 excluded from your plan's formulary

For requesting a formulary exception when the drug isn't on your plan's covered list at all. The key is documenting why covered alternatives don't work for you.