Best way to get a prior authorization reconsidered for a weight loss drug?

My Fiancee [f25] has been having problems with weight gain over the past couple of years, currently reaching 230lbs. She's type 1 diabetic, has a thyroid issue, and joint/tendon issues in her legs and wrists which makes intense physical activity quite painful overextended periods of time.

Recently, when she went to her last doctor's appointment, she asked about Wegovy for weight loss as we were told we could be approved with a prior authorization. Her doctor sent off for it, but our insurance (which is usually very open and reliable to covering prescription medications for us, and is quite expensive on top of it) declined the prior authorization without much context or reasoning. In case it matters, we are in North Carolina.

Needless to say this was quite upsetting for us, as we think in her case with her conditions she would benefit greatly from the opportunity to take this medication. We understand there are other brands of it as well, and are open to suggestions.

I plan on calling our insurance and trying to work this out, but I don't really know what I'm stepping into, what I should say, and if there are any tricks people use to smooth these things along. Any advice is appreciated, thank you.

submitted by /u/Random_Imgur_User
[comments]