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.