Anonymous
09/13/2025 15:48
Subject: Doctor and insurance diabetes medication issues
Anonymous wrote:Here’s what my doctor emailed me yesterday when I asked him to send the note and lab work to the new insurance company:
“As always mentioning before, this is extremely frustrating for patients (and we physicians) alike. Insurance companies repeatedly are telling patients that all we simply need to do is fill out paperwork, send them lab results, chart notes, etc. and these medications will be covered benefits. Repeatedly they have been denied for reasons we do not know
As I mentioned to you before, please bring this up with your insurance company and asked them "what criteria you need to meet for these to be approved". It does appear that these are approved benefits though if insurance continues to deny these despite efforts that they wish us to do, we simply have no control
Finally, you may wish to check and see if there are other GLP 1 weekly injection medications that are covered benefits. The 3 products on the prescription market would include Ozempic, Trulicity and Mounjaro
Good luck with your efforts here”
It sounds like he’s telling you he doesn’t know why the denied it, and offering to try again if you get “the script” for him to recite. That isn’t perhaps absolutely top tier, but you’re the one in relationship with the insurer.
Anonymous
09/13/2025 14:41
Subject: Doctor and insurance diabetes medication issues
Anonymous wrote:Anonymous wrote:You need a new doctor and if you have seeing this doc last 9 years I assume he’s a primary doc not a diabetic doc. Are you sure you are T2 vs T1?
Yes, I'm 55, obese, my a1c went from 5.7 last year to 9.1 this year. I've never been T1.
I was diagnosed T1 at age 30. It can happen.
Anonymous
09/13/2025 14:38
Subject: Doctor and insurance diabetes medication issues
Here’s what my doctor emailed me yesterday when I asked him to send the note and lab work to the new insurance company:
“As always mentioning before, this is extremely frustrating for patients (and we physicians) alike. Insurance companies repeatedly are telling patients that all we simply need to do is fill out paperwork, send them lab results, chart notes, etc. and these medications will be covered benefits. Repeatedly they have been denied for reasons we do not know
As I mentioned to you before, please bring this up with your insurance company and asked them "what criteria you need to meet for these to be approved". It does appear that these are approved benefits though if insurance continues to deny these despite efforts that they wish us to do, we simply have no control
Finally, you may wish to check and see if there are other GLP 1 weekly injection medications that are covered benefits. The 3 products on the prescription market would include Ozempic, Trulicity and Mounjaro
Good luck with your efforts here”
“As always mentioning before, this is extremely frustrating for patients (and we physicians) alike. Insurance companies repeatedly are telling patients that all we simply need to do is fill out paperwork, send them lab results, chart notes, etc. and these medications will be covered benefits. Repeatedly they have been denied for reasons we do not know
As I mentioned to you before, please bring this up with your insurance company and asked them "what criteria you need to meet for these to be approved". It does appear that these are approved benefits though if insurance continues to deny these despite efforts that they wish us to do, we simply have no control
Finally, you may wish to check and see if there are other GLP 1 weekly injection medications that are covered benefits. The 3 products on the prescription market would include Ozempic, Trulicity and Mounjaro
Good luck with your efforts here”
Anonymous
09/13/2025 14:07
Subject: Doctor and insurance diabetes medication issues
Adding - re Metformin, have you tried the extended release and perhaps split dosing?
Anonymous
09/13/2025 14:06
Subject: Doctor and insurance diabetes medication issues
If by “the doctor” you mean the physician himself, and not the office staff, you definitely need a new physician.
Also, regardless what was sent previously, nothing has been sent to the new insurer — perhaps this was not clear on the physician’s end.
The idea that you’re supposed to explain medical stuff to the insurer is ludicrous. That’s squarely in the physician’s court.
Also, regardless what was sent previously, nothing has been sent to the new insurer — perhaps this was not clear on the physician’s end.
The idea that you’re supposed to explain medical stuff to the insurer is ludicrous. That’s squarely in the physician’s court.
Anonymous
09/13/2025 13:50
Subject: Re:Doctor and insurance diabetes medication issues
And you should let people here know who this Dr is so we can avoid him.
Anonymous
09/13/2025 13:49
Subject: Re:Doctor and insurance diabetes medication issues
100% new doctor. What a terrible way to practice medicine,
Anonymous
09/13/2025 13:38
Subject: Doctor and insurance diabetes medication issues
Look up LADA. You may be Type 1
Anonymous
09/13/2025 13:36
Subject: Doctor and insurance diabetes medication issues
Anonymous wrote:You need a new doctor and if you have seeing this doc last 9 years I assume he’s a primary doc not a diabetic doc. Are you sure you are T2 vs T1?
Yes, I'm 55, obese, my a1c went from 5.7 last year to 9.1 this year. I've never been T1.
Anonymous
09/13/2025 12:43
Subject: Doctor and insurance diabetes medication issues
You need a new doctor and if you have seeing this doc last 9 years I assume he’s a primary doc not a diabetic doc. Are you sure you are T2 vs T1?
Anonymous
09/13/2025 12:43
Subject: Doctor and insurance diabetes medication issues
You need a new doctor. That is not acceptable professional behavior. Yes it’s a pain, but it’s what doctors do.
Anonymous
09/13/2025 12:40
Subject: Doctor and insurance diabetes medication issues
Anonymous wrote:Can you download your chart notes and submit them yourself? No idea if that’s how it works with insurance, but often you can find an option for downloads in medical portals.
I did download my labwork, but the insurance company said it has to come from my doctor.
Anonymous
09/13/2025 12:06
Subject: Doctor and insurance diabetes medication issues
Can you download your chart notes and submit them yourself? No idea if that’s how it works with insurance, but often you can find an option for downloads in medical portals.
Anonymous
09/13/2025 10:35
Subject: Doctor and insurance diabetes medication issues
I have Type 2 diabetes. You need a new doctor. Mine said they never deny Mounjaro for diabetics. I switched recently from Ozempic. The office handled everything and it took a few days. I actually see a PA at One Medical for most appointments. She is great and is always an advocate.
Anonymous
09/13/2025 10:31
Subject: Doctor and insurance diabetes medication issues
I'm a type II diabetic. I was diagnosed back in February. I tried metformin and glipizide, but my a1c just kept going up and the meds gave me diarrhea (especially metformin). My doctor prescribed mounjaro back in April, but my insurance denied it.
I just switched insurance companies this month and tried to get mounjaro approved again. My doctor won't resubmit the chart notes and labs, saying he has already done it and that now it is my job to talk to my insurance company about it. When I talk to my insurance company, they say that they need to see the chart notes and labwork before they can approve any of the glp-1 drugs.
What do I do if my doctor isn't willing to resubmit the information to my new insurance company, but my insurance company requires it before approval of the drug?
Meanwhile, I'm living with an a1c of 9.1, and blood sugars frequently in the mid-200s.
I've been seeing this doctor for 9 years, and I previously thought we had a good professional relationship. I feel hopeless and depressed about this.
I just switched insurance companies this month and tried to get mounjaro approved again. My doctor won't resubmit the chart notes and labs, saying he has already done it and that now it is my job to talk to my insurance company about it. When I talk to my insurance company, they say that they need to see the chart notes and labwork before they can approve any of the glp-1 drugs.
What do I do if my doctor isn't willing to resubmit the information to my new insurance company, but my insurance company requires it before approval of the drug?
Meanwhile, I'm living with an a1c of 9.1, and blood sugars frequently in the mid-200s.
I've been seeing this doctor for 9 years, and I previously thought we had a good professional relationship. I feel hopeless and depressed about this.