Switching insurance providers can be a massive headache, as one Reddit user recently learned. Frustrated by the experience, BizarroMax took to the UnitedHealthIsEvil subreddit to vent, alleging that United Healthcare had denied a prescription his wife needed to control her pre-diabetes.
BizarroMax explained that his wife had “gestational diabetes and has been pre-diabetic for the last 15 years. She’s on Mounjaro which has prevented her from getting full-blown diabetes.”
He claimed the issue happened because of a job change. He alleged, “We switched from Anthem to United due to a job change, and they denied her prescription as unnecessary. After all, she’s not diabetic! So OBVIOUSLY she doesn’t need it!”
That is when something happened that confused him even further. He claimed, “And then they sent her a bathroom scale. It is a really nice scale but … it’s pretty insulting.” In response, one Redditor had a straightforward piece of advice for BizarroMax. They wrote, “Keep kicking at this.”
The confusions of Prior Authorization
One of the first questions a user asked was, “Are you missing Prior Authorization?” According to the Cleveland Clinic, a prior authorization is essentially permission a healthcare provider must obtain from your insurance company to ensure they will cover a requested treatment or medicine. Per the site, insurers use these authorizations to save money, manage costs by pushing for generic alternatives, or ensure that care isn’t deemed unnecessary.
That same user broke down United’s rules about prior authorization. They noted, “UHC requires a Prior Authorization for all GLP-1 and dual GIP/GLP-1 medications. Ensure that your doctor submits your exact ICD-10 code for Type 2 Diabetes and recent A1C lab results through the UHC provider portal.” BizarroMax quickly replied to them, stating, “Doctor submitted it. Still denied.”
That same user then broke down some of the most common reasons for such a denial. Perhaps the doctor didn’t submit enough documentation to confirm a Type 2 diagnosis. They detailed the rest, writing, ”The plan requires prior authorization or step therapy before approving Mounjaro. Your employer chose a more restrictive pharmacy benefit. The prescription was requested for weight loss rather than diabetes treatment.”
The Cleveland Clinic explains that if you find yourself staring down a prior authorization denial, you aren’t necessarily stuck. Working with your provider to appeal the decision is a standard path toward getting the care you need. In fact, the Cleveland Clinic states that about 4 out of 5 appeals end up overturning an earlier denial. Earlier this year, a physical therapist was denied surgery that every doctor said she needed. United disagreed.
The clinic recommends that patients check their plan documents. They can also talk to HR if the insurance is provided by an employer, or contact their state’s department of insurance if they need to file a grievance.
The Cleveland Clinic highlights that insurance can be hard to understand even under ideal circumstances, and in health-related situations, it can feel truly overwhelming. They suggest that patients don’t have to navigate these hurdles alone and should ask their healthcare providers for guidance on how to move forward.
The site noted that the provider wants to help their patient. There is no better example of this than Dr Elizabeth Potter. Last year, she took to TikTok to slam United Healthcare after she was forced to scrub out of surgery to justify a breast cancer patient’s care.
Another Redditor in the comments provided some support by sharing a personal story. They wrote, “You know what I did? They tried to send me home with collapsed hips with no surgery date and a month supply of tramadol. I became my own advocate and I said I wasn’t moving til we had a plan. That changed everything.”
United Healthcare has not commented on the decision.
Published: Jul 27, 2026 08:25 am