Procedures

What to do, in order

Each of these is a procedure with deadlines. Missing a deadline usually ends the route, so start with the one that matches where you are.

Denise Ramirez, Coverage Editor · Updated August 2026

Your plan said no. What now?The deadlines and steps for appealing a commercial or employer plan denial of a GLP-1, including external review by an independent body.
How to ask Part D for an exceptionHow to request a formulary exception or get a step therapy or prior authorization requirement waived under Medicare Part D, and the deadlines that apply.
How to ask for a Medicaid fair hearingHow to request a Medicaid fair hearing after a denial, the federal 90-day ceiling on filing, and why your state's deadline may be shorter.