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What insurers are checking: Confirmed type 2 diabetes diagnosis: ICD-10 code E11.x must be in your chart and referenced on the PA submission HbA1c documentation: Most plans want elevated A1c (typically 7.07.5%) showing inadequate glycemic control Step therapy: Many plans require documented metformin use first unless theres a clinical reason to bypass it intolerance, contraindication, or specific cardiovascular risk factors Letter of medical necessity: A prescription alone isnt enough your doctor needs to submit clinical documentation justifying Ozempic specifically Once approved for the diabetes indication, Ozempic lands on Tier 3 or 4 (preferred brand or specialty)

doi: 10.1186/s12933-021-01417-0 7 DruckerDJ

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