Honest Care introduces free appeal letters! Click 'Get started' to see all our package options.
File your appeal

Rated excellent

Your GLP-1 coverage,
denied approved

Doctor talking to patient about GLP-1 (semaglutide) injectable medications like ozempic, wegovy, zepbound, and mounjaro.

What you get with Honest Care

We craft your strongest case for coverage using your online assessment

About online assessment

We write your appeal letter and evidence explaining why you should be covered

View sample appeal

What's covered in our online assessment

Complete your assessment today and we'll get started on your appeal.

Insurance coverage

We tailor your appeal to address your insurance's prior authorization requirements and reason for denial.

Medical history

We'll argue why your coverage is medically necessary based on your health conditions such as obesity, diabetes, metabolic syndrome, hypertension, sleep apnea and many more.

Prescription history

We identify arguments against trying different medications first based on your past medications, health conditions and clinical research studies.

Gather the right evidence to support your insurance coverage

Doctor talking to patient about GLP-1 (semaglutide) injectable medications like ozempic, wegovy, and mounjaro.

Your weight loss & GLP-1 goals

Your goals & budget

Getting your health insurance to approve GLP-1 coverage can be difficult. Your Honest Care Report makes it easy by summarizing why you are motivated to lose weight and why you think a GLP-1 medication is right for you.

Your previous weight loss attempts

Your goals & budget

Your insurance will want to see your previous weight loss attempts. Your Honest Care Report summarizes your diet and exercise history, your past weight loss attempts, weight loss medications you previously tried, and any unique challenges you face that make a GLP-1 medically necessary.

Your GLP-1 clinical eligibility

Your goals & budget

Your insurance will need to review whether you are clinically eligible for a GLP-1. Your Honest Care Report includes detailed information confirming your GLP-1 eligibility by aggregating your BMI, health conditions, current medications and drug allergies in a single page.

Your insurance documents

Your goals & budget

Along with your Prior Authorization or Formulary Exclusion the Honest Care Report packages all the necessary information your insurance will require to approve coverage.

Your goals & budget

Your Appeal Letter

Your final step will be to submit an appeal letter, that we create for you, to your insurance company. Tailored to your specific denial reason, this letter summarizes all the necessary information for you to get approved such as your prior weight loss attempts, alternative weight loss medications you have tried, unique personal challenges to losing  weight, and clinical issues you have had.

How it works

Complete your online assessment

Answer simple online questions at your convenience that gather all the necessary appeal evidence to fight your denial.

Images of sample questions we will ask you during your Honest Care assessment where we will figure out if GLP-1 (semaglutide) medications like ozempic, wegovy, and mounjaro are right for you.

We write your appeal letter

Your dedicated appeal specialist will review your assessment and write your appeal to make the strongest case for coverage.

Your appeal will cover

  • Why your prescription is necessary
  • Step therapy requirements
  • Diabetes, heart disease, and obesity eligibility
  • Why alternative medications are ineffective
  • Academic research supporting your case

Receive your appeal packet

Appeal letter
You'll receive a professionally written and editable appeal letter you can submit to your insurance with confidence.
Included with all packages

Supporting documents
We’ll create a supporting evidence report that further justifies your appeal letter, to send your insurance along with your appeal.
Included with our paid packages

View sample appeal

File your appeal with our support

You can mail or fax your appeal to your insurance, or your doctor can file on your behalf. A dedicated appeal specialist is available to walk you through your appeal so you can file with confidence.
Included with paid packages

  • Review your appeal letter & evidence
  • Provide guidance on the appeals process
  • Review and identify your alternative GLP-1 options

Hear from our satisfied customers

5 etoiles trustpilot
July, 18 2024

The assistance HonestCare provides is very well thought out and effective. They helped me create a very professional appeal letter that gave me confidence to go through with appeal process.

D
David
5 etoiles trustpilot
July 11, 2024

I don’t think I could navigate this by myself, I get too overwhelmed. I’m so grateful that someone else had used you and was talking about you.. You guys are doing Gods work, we’re very grateful for you!

L
Laura
5 etoiles trustpilot
July 10, 2024

Glad I didn’t have to do it myself. My doctor was even impressed saying  ‘this is a good letter, it’s a really good well constructed and crafted letter.

J
Jeni
5 etoiles trustpilot
June 12, 2024

You covered all my questions, the letter looked every clinical and professional instead of me trying to write it up. Considering what the price of this is versus the price of the drug and what I would have to pay without insurance it’s a no brainer. I’m surprised y’all don’t charge more

A
Andrea
5 etoiles trustpilot
May 8, 2024

I’m extremely satisfied. On a personal level this is extremely overwhelming for me and I’m really happy I tripped across this website because it made something so confusing dealable for me. This is extremely stressful and to have the letter, supporting evidence and plus this phone call is absolutely remarkable and I have recommended this service to a coworker of mine who’s also going through this process with me.

K
Kelly
5 etoiles trustpilot
Mar 7, 2024

I really like the letter that was put together and I thought it was very detailed and I think it covered everything that I would need to present. It’s worth paying extra to have the consultation, insurance is so confusing and I can see why people walk away because it’s so tedious and time consuming and confusing on top of it.

L
Lisa

We specialize in appeals for the biggest insurance companies so you don't have to

Frequently asked questions

Why is 'Starter' free?

We believe every insurance denial should be appealed and every patient should fight for access to the best treatments, because access to great healthcare is a human right.

Insurance companies purposely make this process convoluted and difficult to understand in order to deter decision challenges and protect their bottom line. That’s where we come in. We’re bridging the gap between insured individuals and their access to needed medications by creating a free customized insurance appeal letter. We’ll do all the hard work for you - you just need to include a few small edits, then you can send your appeal letter to your insurance provider through their outlined appeal process.

What is the Honest Care service guarantee?

We believe every insurance denial should be appealed and every patient should fight for access to the best treatments we’ve made generating a strong appeal letter free.

We also offer paid services to access our team of GLP-1 experts. If you are not satisfied with our team's services, email our support team at support@findhonestcare.com and we will be happy to remedy any issues. You can also request a refund within 60 days of purchase of our services so long as your appeal hasn't been submitted to your insurance. Once our appeal packet has been submitted to your insurance, we will no longer issue refunds. Refunds are processed to the original payment method within 5 to 10 business days.

How does Honest Care help with insurance denials?

We help patients fight insurance coverage denials so they can get access to the medications and treatments they deserve. We currently specialize in insurance coverage denials for Ozempic, Mounjaro, Wegovy and Zepbound.

If you are denied coverage for Ozempic, Mounjaro, Wegovy or Zepbound, Honest Care can help fight your denial by submitting an ‘appeal’ to your insurance. An appeal is a formal request to your health insurance company to overturn their denial and grant coverage on your behalf. An appeal generally consists of a formal letter, addressed to your insurance, explaining why a medication should be covered on your behalf and why your insurance’s initial denial should be overturned.

You have the right to appeal to your insurance’s coverage denial. Honest Care simplifies the appeals process by writing an appeal letter and supporting documents on your behalf making your best arguments for medication coverage, following your completion of our proprietary GLP-1 denial assessment.

Should I appeal if my insurance denied coverage?

If your insurance denied coverage for Ozempic, Mounjaro, Wegovy or Zepbound, you have the legal right to ask your insurance to reconsider the coverage denial by sending an ‘appeal’.  Unfortunately coverage denials too often go unchallenged. A study from September 2023 found that 69% of people who were denied coverage by their insurance didn’t know they could appeal, and 85% of people never tried to appeal.

We believe it always makes sense to appeal. Here is why:

Appeals work: According to a study analyzing data from several U.S. states, patients who appealed directly to their insurance provider (an internal appeal) experienced a success rate between 39-59%.

Denials are often issued by mistake: A computer almost always makes the initial decision to deny medication coverage. This results in denials that don’t actually consider your personal health situation or denials made by mistake. In the case of Ozempic, Mounjaro, Wegovy and Zepbound, incorrectly entered information about your BMI, labs including A1c, your health conditions and diagnoses, your medication history and current medication use can all lead to an automatic denial. When you appeal, your information is reviewed by a real person.

Doctors review appeals, not computers: Having a doctor consider your unique circumstances makes submitting an appeal a powerful process for overturning denials getting covered.

You deserve the best care: You have the legal right to fight the treatment you need. As a part of the Affordable Care Act, all health insurance plans are required to allow their members to appeal their coverage decisions. This spans all insurance coverage - whether you are insured through your employer, purchased an insurance plan through your state marketplace, or are insured through a government program like Medicare or Medicaid.

How does Honest Care’s paid appeal service work?

We currently offer appeal services for Ozempic, Mounjaro, Wegovy and Zepbound. After purchasing Honest Care and completing your online denial assessment, you can expect to receive your appeal letter within 2 business days.

1. Online denial assessment‍: Complete the online assessment at your convenience that gather all the necessary appeal evidence for your insurance. The assessment reviews your medication history, including any GLP-1s, weight loss or diabetes medications you have taken, your health conditions and diagnoses, your past weight loss, diet and exercise attempts, and details on your insurance coverage and denial.

2. Case evaluation & appeal strategy: One of our dedicated appeal specialist will review your assessment and insurance denial and identify your best appeal arguments for coverage. This will include an evaluation of your medication history, medical diagnoses, weight loss attempts and clinical research studies that strength your appeal case.

3. Appeal letter & supporting documents: Your assigned appeal writer will compose a professional appeal letter addressing your denial reason and detailing your case for coverage. We’ll create a supporting evidence report that further justifies your appeal letter, to send your insurance along with your appeal.

4. Specialist Consultation & Support: After you receive and review your appeal letter & evidence, your dedicated appeal specialist will be available to answer your questions. They will be available to make updates to your appeal, if required. You will also have the option to schedule a phone or video call at a time of your convenience to you speak to your dedicated appeal specialist.

5. Send your appeal: You can submit your appeal yourself or have your doctor submit your appeal on your behalf. Most insurance companies accept appeals by mail or fax. Instructions on how to submitted appeal will be included within the written explanation on why you initially denied medication coverage, sent at the time at you were denied.

What is an insurance appeal?

An insurance appeal is a formal request you make to your insurance company, asking them to reconsider a decision about your claim. This could be when they've denied your claim, not paid enough, or made a decision you disagree with. The appeal is your chance to argue your case, showing them why their decision should be different. It involves submitting a well-structured letter, along with any supporting evidence like medical records or repair estimates, to make your case stronger.

What is an insurance appeal letter?

An insurance appeal letter is your way of asking the insurance company to reevaluate a decision, such as a denied claim. It's essentially your argument in writing, explaining why you believe their decision should be different. This is a common document patients can use to advocate for themselves with their insurance to cover their medical costs even prior to being denied for a treatment.

This letter will include your policy details, specific decision you disagree with, and provide solid reasons and evidence (like weight loss efforts, past and present medications, labs, receipts etc) for your appeal. The letter should be clear, concise, and respectful, ending with a specific request for what you want your insurance to do.

You can submit an appeal letter directly to your insurance or through your health care provider as part of your insurance appeal process.

What is supporting insurance evidence?

Insurance supporting evidence is the documentation or information you provide to back up your claim or appeal with your insurance company. It's the proof that supports your case, like medical history, diet and exercise efforts, medication history, or relevant medical studies. This evidence is crucial because it shows the insurance company why they should approve your claim or reconsider a decision they've made.

We provide 3 types of supporting insurance evidence.

(1) Appeal Evidence - is the information you provide when you disagree with your insurer's decision about a claim or coverage. This could include detailed medical records, letters from your doctor explaining the necessity of a treatment, or information about how a treatment is standard for your condition. This evidence is crucial for challenging a denial or underpayment of a claim. Our role is to help you gather and present this evidence effectively, ensuring it clearly supports your need for the treatment or service claimed.

(2) Prior Authorization Evidence - is required when your health plan needs you to get approval before it covers certain medications or procedures. This evidence typically includes medical records, lab results, and a detailed rationale about why this specific medication or procedure is necessary for your condition. Our service involves assisting you in compiling comprehensive and relevant documentation to justify the medical necessity, aiming to secure approval from your insurance company for the required treatment.

(3) Step Therapy Exclusion Evidence - is used when you need to bypass the 'step therapy' protocol of your insurance plan. This protocol usually requires trying less expensive treatments before more costly ones are approved. Exclusion evidence might consist of medical records showing previous treatment attempts and failures, clinical data indicating why standard treatments are unsuitable or harmful for you, and detailed explanations about the necessity of the specific, often more expensive, treatment. We help you collect and organize this evidence to make a compelling case to your insurer that the standard step therapy process is not appropriate for your situation, thereby aiming for an exemption.

How can working with a regular doctor increase your chance of insurance coverage compared to telehealth?

Working with your regular doctor can increase your chance of insurance coverage in several ways, including:

  • When your insurance plan is making a decision on whether to cover your GLP-1 prescription, they will want to review your medical history and recent labs results. Your doctor already has this information within your patient chart, and if you don’t have recent labs, your doctor can order new labs during your appointment. Most online, telehealth-based GLP-1 clinics do not have access to your full medical history in your patient chart, which limits their ability to achieve insurance approval.
  • In the event your insurance plan initially denies coverage for your GLP-1, this decision can be appealed by your doctor by writing a “Letter of Medical Necessity” and sending it your insurance company. Writing an effective letter requires a doctor to have a real relationship with their patient. Online, telehealth-based GLP-1 clinics find it challenging to write effective "Letters of Medical Necessity" given their lack of personal relationships with patients.
  • Insurance plans are increasingly flagging and scrutinizing GLP-1 prescriptions written by online, telehealth-based GLP-1 clinics. Working with a regular doctor can help avoid this additional scrutiny.

Can the Honest Care Report be shared with telehealth doctors?

Yes - your Honest Care Report can be submitted to any doctor, including doctors working with online, telehealth-based GLP-1 clinics. Taking the Honest Care Assessment before engaging with a telehealth services presents several advantages, including helping you save money.

By using Honest Care before engaging with a telehealth company, you’ll find out how likely you are to get a GLP-1 prescription and will receive guidance on any recommended steps to take before your GLP-1 appointment. This can save you money by avoiding paying subscription fees until you’re fully prepared for your telehealth appointment.

Who is eligible for GLP-1s?

There are nearly 10 GLP-1 medications available in the United States. Currently three of those medications, Zepbound®, Wegovy® and Saxenda®, are FDA-indicated for weight-loss assistance. The FDA indicates that people with a BMI ≥ 30 kg/m2 OR people with a BMI ≥ 27 kg/m2 who have been diagnosed with at least 1 weight-related condition are eligible for GLP-1s.

All other GLP-1 medications, including Ozempic® and Mounjaro®, are currently FDA-indicated for people diagnosed with Type 2 diabetes.

I already know I’m eligible for GLP-1s based on FDA-guidelines. How can Honest Care help me with eligibility?

While FDA-guidelines are critical for understanding GLP-1 eligibility, there are a number of other factors to consider for determining GLP-1 eligibility.

Additional eligibility criteria that Honest Care takes into account include:

  • Weight-related conditions by importance in Prior Authorization (PA) - insurance plans often take certain conditions more seriously than others when determining GLP-1 eligibility.
  • Medication step therapy - many insurance plans only consider patients eligible for GLP-1 coverage only after trying lower-cost weight loss assistance medications first.
  • Ethnicity-based BMI guidelines for determining whether a patient is overweight by ethnicity.

What is Prior Authorization (PA)? Does Honest Care help with insurance?

Prior Authorization (PA) is a process run by insurance plans to determine how necessary a medication is. Most insurance plans require Prior Authorization (PA) before approving coverage for GLP-1s.

After your GLP-1 prescription is written, your insurance plan will notify your doctor if a PA is required and ask your doctor for additional documentation on why your medication is necessary.

If a PA is required, your insurance plan will ask your doctor to submit detailed information on your diet and exercise history, your past weight loss attempts, weight loss medications you previously tried, and any unique challenges that you face that make a GLP-1 medically necessary.

The Honest Care Report includes evidence requested by most insurance plans and can be submitted to your insurance during the PA process. During your appointment, your doctor can attach your Honest Care Report to your health record so it is submitted as supporting evidence to your insurance if Prior Authorization is required.