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Common Humana Denial Reasons "Plan exclusion" Weight loss is not a covered indication (most common) "Missing diagnosis code" Pharmacy didn't submit ICD-10 code (resubmit, don't appeal) "Prior auth not obtained" Medicaid plans require PA before filling "Step therapy required" Must try other meds first (Saxenda, Contrave) When an Appeal Makes Sense Medicaid PA denial you meet criteria but were denied anyway OSA coverage dispute Medicare denied despite valid sleep apnea diagnosis Wrong diagnosis code your doctor listed the wrong indication Renewal denial you showed 5% weight loss but were still denied If your situation fits one of these, appeals can work

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