Launching July 1
Zepbound denied by CVS Caremark?You don't just have to switch.
Claimable's tool builds and submits a personalized, expert appeal to help you fight the switch to Wegovy – and stay on what works.
Get early access to Zepbound appeals
We're working on opening up early access to Zepbound switching appeals. Join the waitlist to be notified as soon as they're available.
Your information will only be used to contact you about Claimable appeals support. View our privacy policy.
Coming Soon!
GLP-1 coverage denied?
You’re not out
of options.
Claimable builds and submits personalized, expert appeals for you — in minutes.
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Available May 22: Zepbound and Wegovy support
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Available mid-June: Ozempic, Mounjaro and Rybelsus support
Limited-Time Offer!
In support of the 137 million Americans eligible for GLP-1s, we're offering:
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Free appeals for the first 137 sign-ups
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50% off for everyone else
Your information will only be used to contact you about GLP-1 appeal support. View our privacy policy.
As seen in
You have the right to appeal
Appeals work. This isn't just a request – in many situations, insurers are required to honor your appeal.
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Expert-crafted Zepbound appeals
Our custom-built AI matches clinical, legal, and policy insights with your story for the most effective appeal.
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Create your appeal in quickly and easily
Appeals generate in minutes, not days. We guide you through simple questions to build your case.
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Guaranteed delivery & response – fast
We fax your appeal instantly to CVS Caremark. They'll have 72 hours to review – getting you the answer you need, fast.
Is this the right appeal for me?
You should submit a formulary exception appeal for Zepbound if one or more of the following apply to you:
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You were prescribed Zepbound, and it’s working
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You got a formulary change letter from CVS Caremark
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Your doctor recommends continuing Zepbound
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You want to avoid switching to Wegovy due to side effects, lower efficacy, or medical need
Didn't get the CVS letter, but still got denied for your GLP-1?
Learn more about the other GLP-1 coverage denials we fight→
More than 137 million adults in the U.S. qualify for GLP-1s. Most will face barriers to access. We’re here to help change that — one appeal at a time.
Claimable is the kind of change we need to see in the world. After struggling with access to treatment and then denied treatment by United Healthcare, Claimable was able to help us get the appeal approved. We thank you beyond measure.
Betsy C.
★★★★★
Let's get you covered
Medications and conditions we support
Weight loss and Obesity
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Zepbound
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Wegovy
Zepbound Appeal Eligibility
To qualify, you must meet the following criteria
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You have a diagnosis of obesity (BMI ≥ 30 kg/m2 )
OR -
You are overweight (BMI ≥ 27 kg/m2) with at least one weight-related condition:
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Obstructive sleep apnea
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High blood pressure (hypertension)
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High cholesterol or triglycerides (dyslipidemia)
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Pre-diabetes / Gestational diabetes
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Cardiovascular disease
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PCOS
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Let's get you covered
Medications and conditions we support
Frequently Asked Questions
For more, read our full guide to the CVS Caremark formulary change on the blog.
To make the case that you need to stay on Zepbound, you'll submit an appeal letter requesting a formulary exception from CVS Caremark.
On July 1, you'll be able to create this formulary exception appeal with Claimable, using a series of short questions to build your unique case. We recommend asking your provider for a Letter of Medical Necessity as soon as possible so you'll have it on hand when you start your appeal.
Creating and sending your appeal with Claimable takes just minutes.
Once you've submitted, CVS Caremark will have 72 hours to review and respond to the appeal, so you'll know quickly whether you'll be able to stay on Zepbound. And if they deny it again, you have the right to appeal multiple times and with multiple levels of review – including an independent review.
Both options can work, but generally we recommend that you appeal with your provider's Letter of Medical Necessity attached. Patient appeals have stronger legal rights, are entitled to multiple appeals, and typically mandate responses on faster timelines.
Starting July 1, 2025, CVS Caremark is removing Zepbound from its formulary after making Wegovy the preferred GLP-1. This is a business decision based on rebate contracts – not patient outcomes or medical necessity.
No. Zepbound and Wegovy are different medications and not interchangable. Zepbound uses dual GIP/GLP-1 receptor agonists, while Wegovy is GLP-1 only. Zepbound may offer greater weight loss and better tolerability, especially for patients with obstructive sleep apnea (OSA).
If you're on Zepbound and it's working well for you, there's no medical reason for you to switch to Wegovy – and it could cause negative effects.
A strong appeal letter should include the following:
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Your medical results on Zepbound (weight loss, symptom control, etc.)
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Any prior medications that you’ve tried and failed
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Specific medical conditions like OSA that Zepbound uniquely treats
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A letter from your doctor supporting continued use
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Clinical studies, applicable laws and insurance regulations, and precedents from successful appeals with similar cases to yours
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Supporting evidence like lab results, weight logs, dosing history and medical records
Claimable's appeals are custom built to include all of these things, personalized with your specific medical history and situation.
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Yes. Under federal law, you have the right to request a medically necessary exception when a formulary change puts your care at risk.
On top of federal productions, many states have laws preventing insurers from forcing stable patients to switch medications mid-year. Check the laws in your state to find out if you have additional protections to support your case to stay on what's working for you.
We’ve built our GLP-1 appeal support in partnership with patients, experts, and advocates — and we’re just getting started. Your feedback helps us improve.
Want to share thoughts or join a live session? Email us anytime at support@getclaimable.com.