u/Ashmodai20

I originally got my Tirzepatide approved and my local pharmacy called me before it was approved and said it was going to cost me $25 and what they get from insurance was going to leave them $30 short so they asked if they could transfer the prescription to bigger pharmacy so they could eat the cost. I said sure. Then the bigger pharmacy said my deductible would be $300. I looked on my insurance website and saw other pharmacies would be $50. I did see a coupon from Eli Lilly. For the $300 pharmacy with the coupon it would still be $150. Is it really rude to transfer the prescription to another pharmacy that would only be $50? And could I use the coupon again?

But they are denying me because my doctor put in the prescription for type 2 diabetes and Sleep Apnea. Blue Shield denied the prior auth saying that Zepbound is not authorized for diabetes. They said Mounjaro is approved for diabetes.

They also said they require me to be on a weight loss program that includes a low-calorie diet, physical activity, and behavior therapy (all three) for 6 months. They say it needs to be in my health records.

Should I try and appeal this decision or have the doctor prescribe mounjaro. Could my doctor just say that I've been in a program for 6 months to get them to approve it?