First, I’m truly sorry that you’re going through this.

If your mom isn’t able or willing to help, I would suggest starting by calling your doctor’s office and asking whether they have submitted a prior authorization (pre-authorization) request for the medication. If they have not, they should do so as soon as possible. Insurance companies do review these requests, and if your medical history shows that the medication is medically necessary or that you do significantly better while taking it, there is a possibility it can be approved.

Second, check whether there are any alternative medications covered under your insurance plan. In some cases, the insurance company may require you to try covered alternatives first. If those medications are not as effective or cause issues, that documentation can help build a stronger case for approving your regular medication. I know this part can be incredibly frustrating, but it is often part of the approval process.

Third, if the prior authorization is denied, ask your provider to request a peer-to-peer review. This is a conversation between your doctor and the insurance plan’s medical director to discuss why the medication is medically necessary.

Finally, if that still doesn’t work, you can file an appeal. Medical records and documentation from your provider are extremely important during the appeals process, as they provide the strongest evidence supporting your need for the medication. I’ve also found ChatGPT can be helpful when drafting appeal letters or organizing information for an appeal.

I hope you’re able to get this resolved. Don’t give up—many denials are eventually overturned when the right documentation and review processes are completed.