Answering the narrow version, because the broad one does not have a single answer. 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.

Dr.NateNeph 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.

SkepticalSean said:

Elective procedure in five weeks and two different sets of instructions from two different departments about when to stop.

Mine went the same way, slower. The detail I would add is minor and it is already implied above.

From the other side of the consultation, briefly.

Important PSA about surgery and anaesthesia and anesthesia: GLP-1 agonists delay gastric emptying, which increases aspiration risk during procedures requiring sedation or general anesthesia.

Current ASA guidelines recommend stopping GLP-1 agonists 1 week before scheduled procedures. ALWAYS tell your surgical team you're on this medication. Don't let this get overlooked.