International health insurance and GLP-1 — need advice

Short answer first, then the reasoning. Denials are usually procedural rather than clinical, and the order that works reflects that. Get the denial reason in writing, because it names the criterion you failed. Then supply the documentation that criterion asks for — usually documented BMI with a comorbidity, or a failed prior therapy. Then appeal, and ask for a peer-to-peer review, because a prescriber talking to a reviewing clinician resolves a large fraction of denials that written appeals do not. Manufacturer copay assistance is separate and applies mainly to commercial insurance, and patient assistance programmes are means-tested rather than a discount.

Dr.KarenChen said:

Denials are usually procedural rather than clinical, and the order that works reflects that.

Agreed, and coverage criteria are plan-specific rather than insurer-specific. Two people with the same insurer and different employers have different rules, which is why "my insurer covers it" is not transferable information.

tom_AK said:

One order arrived in nine days, one was held at the border for a fortnight, and one came back with a seizure notice.

Same pattern here, and in the same order.

Clinical perspective, offered as context rather than as advice.

International shipping tracking for cross-border ordering orders: my experience with customs in the US when ordering from overseas:

Required FDA import alert review, delayed 10 days.

Tips: always include a copy of your prescription, declare medication properly on customs forms, keep quantities reasonable (personal use = 3 month supply max), and use a vendor who has experience shipping to your country.