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Type 2 Diabetes: when insurers say no, reviewers often say yes

In 137 published external-review decisions involving type 2 diabetes, independent physician reviewers overturned the insurer’s denial 75.9% of the time.

Published decisions
137
2001–2026
Overturned
75.9%
104 denials reversed

Most-fought treatments for type 2 diabetes

What insurers denied — and how those fights ended.
TreatmentDecisionsOverturned
Mounjaro34
76.5%
Ozempic22
68.2%
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 type 2 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 type 2 diabetes? 75.9% won.

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