Taking the question as asked, rather than the general version of it. 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.

MikeFit_NJ 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.

SaraMom3 said:

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

Adding a me-too, because a thread of one person's experience is not much use. Nothing to add that would improve it.

Adding the clinical framing, because it changes how the question reads.

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

Seized and destroyed — had to get a reshipped package.

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.