My prior auth went to review and it is sitting there and honestly it took my patience with it

2026-10-08 02:42

small rant. I’ve been on this medication for about a year and a half, down 63 lbs, and the scale has been grinding in the same four-pound window since winter. That part I can handle.

What’s driving me up the wall is the insurance side: my plan changed PBMs in January, so my renewal got flagged as a brand-new request. I sent the same chart notes, the same labs, the same proof of the nutrition and strength work I’ve been doing.

Still got a letter asking for “additional clinical documentation” with a deadline that’s basically yesterday. I spent 47 minutes on hold, got transferred twice, and the rep couldn’t tell me whether my current prescription would keep processing. I’m not asking for a magic fix.

I just want to know if I need to ration what’s left before the next refill window. Anyone else deal with a PA renewal that felt like starting from zero?

2026-10-14 04:55

Oh man, I feel this. Our PBM switched a couple years back and my renewal got treated like I’d never been on anything—same chart notes, new request, whole deal.

What finally unstuck it was calling my HR benefits person and asking for a continuity-of-care review; our little local pharmacy also told me to keep a copy of the old approval letter in my file. Have you tried asking your plan for that?

Not medical advice, just admin. And for the winter plateau: I quit daily weigh-ins and did waist/hip measurements every two weeks.

Scale stayed in a 4-lb window but inches moved. Hang in there.

2026-10-16 11:26

Ugh, the PBM switch resetting everything as "new" is so common and so maddening. Did they give you an actual denial reason, or just a vague "under review"?

If it's the former, get the criteia in writing — half the time it's one specific note that wasn't in the original packet. Meanwhile, that 4-lb window is exactly when I stopped weighing daily and leaned on tape plus bar speed.

My scale sat flat for about five months while my squat crept up and my waist dropped close to two inches. Recomp looks like nothing on the scale and then suddenly shows up.

Not saying that's your situation, but the data's there if you log it.

2026-10-16 12:37

man the portal refresh during a review is its own boss fight. my last renewal just sat in "processing" with zero eta and i kept checking at 2am between matches like it was a queue pop lol.

one thing that helped me not spiral was tracking the dumb stuff: i swapped my late night soda for sparkling water + zero sugar drops and logged it next to my weight. turns out i was drinking way more when i was tilted.

did yours ever show what step it was stuck on, or is it just a black box "in review"?

2026-10-20 21:59

congrats on 63 lbs—that’s huge, even if the scale is being stubborn. The same four-pound window since winter would make me squirrelly too.

One thing that helped me during a long stall was switching from daily weigh-ins to a Sunday non-scale check-in: energy, sleep, how my jeans fit, and whether I got my walks in. I also keep a phone note called “wins that aren’t weight” for frustrating weeks.

While your review just sits there, what’s one habit you can control this week? Maybe we do a 7-day check-in together—no scale, just sleep, steps, and mood.

2026-10-28 02:41

I do the same spreadsheet thing, and the insurance stall made me split tabs: one for PA calls (date, rep, ref #, next follow-up) and one for body data. My weight trendline has been flat since Feb too, but waist is down 1.5 in and my 7-day average is finally drifting 0.2 lb/wk.

Have you checked any non-scale trendlines during the four-pound window? Also, did they give you a written criteria checklist or just leave it in review?

Requesting the specific review criteria in writing is the only thing that got my last renewal unstuck.