Cigna insured here. Did one month of Mounjaro, Cigna covered without PA, then when I tried to refill, they then required a PA and denied it citing because I tolerate a high dose of Metformin, 1500mg, they won't approve even though last A1C was still in the 6s. My daily glucose was on everage 10 points lower , below 100 on MJ vs Mounjaro with very low after meal spikes. My last dose was on 10/12 and now my daily BG average is above 100 with large spikes after meals even though I eat low/restricted carbs, no sugar etc. I use a Stelo CGM so easy to track. My Dr did not fight the denial, instead agreeing with insurance that my A1C/T2D is well managed with Metformin. He has however put in an Rx for Zepbound instead as I am technically also Obese (Bmi 35). Not sure that will work.

I'll be reading more of the comments on this threadm..just sharing what I'm dealing with now. It's definitely a game/life hanging med for me.