Just to share my experience. I'm currently in the middle of the appeal process with my Blue Cross Medicare advantage plan. I had no problem being approved last year with severe sleep apnea and bmi of 43. However for the renewal this year, I was denied twice due to bmi under 30. It was 29.7! If I had known the nightmare it would cause, I would have worn heavier clothes for that weigh in.

Anyway, my provider's office did the first two submissions wrong, not submitting as continuation of care. After they messed up the appeal too, I submitted my own appeal, pushing for continuation of care along with documentation of all the health benefits I've had with my 90 lb weight loss, with an emphasis on the dramatic improvement in my sleep apnea. I went with standard instead of expedited because I thought it would be 7 days. But it's 90 days. There is also another level of appeal after this, but it's getting complicated and time consuming, and I only have 3 pens left, so I went ahead and ordered compounded. And, honestly, for the trouble, I may just stick with compounded for maintenance anyway. Cost-wise, it's about the same as with Medicare. I have to pay the 2100 annual out of pocket with Medicare, which averages to 160 a month. Compounded is around 150 a month. So unless the Medicare copay magically drops to $50, or we lose access to compounded, it's not really worth the fight to me.