Home / Conditions / Diabetes

Diabetes: when insurers say no, reviewers often say yes

In 160 published external-review decisions involving diabetes, independent physician reviewers overturned the insurer’s denial 60.6% of the time.

Published decisions
160
2001–2026
Overturned
60.6%
97 denials reversed

Most-fought treatments for diabetes

What insurers denied — and how those fights ended.
TreatmentDecisionsOverturned
Byetta18
61.1%
Ozempic13
61.5%
How to use this in your appeal

These outcomes come from California’s external review program — an independent physician panel whose decision binds the insurer. Every state has an equivalent, and internal appeals succeed even more often. If your care for diabetes was denied, the published record says the denial is worth fighting.

SOURCE: CALIFORNIA DMHC INDEPENDENT MEDICAL REVIEW OUTCOMES (CHHS OPEN DATA) · DERIVED AGGREGATE STATISTICS ONLY · METHODOLOGY

Not legal or medical advice. Coverage Rights is a self-help tool that helps you prepare your own appeal. For advice about your specific situation, talk to a licensed attorney or your doctor.

Fighting a denial for diabetes? 60.6% won.

Explain my denial — free