Eli Lilly patient assistance programs — eligibility and application guide

InsuranceTom said:

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

Insurance update relevant to cost and coverage: I just got my prior auth approved through Cigna after 1 attempts.

What finally worked: a letter from my endocrinologist documenting BMI history (>3 years), failed diet attempts, comorbidities (PCOS + insulin resistance), and referencing the SELECT trial data.

If your PA keeps getting denied, don't give up. Request a peer-to-peer review between your doctor and the insurance medical director. That's what finally broke through for me.

InsuranceTom said:

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

I read this differently from InsuranceTom, on substance rather than tone. The affordability discussion here usually stops at individual tactics. At list price this class is out of reach for most of the people who would benefit, and no amount of appeal strategy changes that — it is a pricing problem wearing a paperwork costume.

LipidDoc_ATL said:

The affordability discussion here usually stops at individual tactics.

My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.

PharmacoVig_BOS said:

Insurance update relevant to cost and coverage: I just got my prior auth approved through Cigna after 1 attempts.

Same experience, arrived at from the opposite direction. I had assumed I was the exception until I read this.