I have experienced denials from United Health Care (UHC) for over 9 months. I recommend that you first appeal the decision with BCBS and request your endocrinologist to assist you with the appeal. There are guidelines for receiving approval for anabolic osteoporosis drugs but you can still persist in your appeals. My t- score is -3.7 but I have never experienced a fracture despite many accidents throughout the years. After your initial appeal, prepare a report for Medicare and submit it to Medicare directly if the denials continue. You should expect delays and non- responses to your communication with BCBS since that is the norm. Do not let this deter you in your pursuit of drug approval. After 2 denials, submit your complaint to Medicare directly but include specific details. All Medicare Advantage plans are required to respond to you within 24-48 hours and they will after you file your complaint with Medicare. If you receive further denials, your next step is to request an internal peer to peer review with your endocrinologist. If your endocrinologist refuses to participate then find a new endocrinologist willing to fight with you against BCBS. After they refuse or ignore your request then request an outside independent review from an endocrinologist via the Medicare contractor C2C Innovated Solutions. Your appeal will be forwarded to them by Medicare and BCBS. If you are denied by C2C then your appeal can be referred to the Office Of Medicare Hearings And Appeals (OMHA) court for an expedited review of the appeal. The court refused to approve my request for an expedited review but proceeded with the 90 day review. I never heard from the court again but a couple of weeks later I received a letter from UHC approving my request claim for Tymlos. No explanation other than 3 sentences stating they appreciated me bringing this to their attention and after review, I am now approved. I started Tymlos on 07/20/2026.This process is quite arduous but worth it. Please note that Tymlos is over $7000/month but you are protected by the catastrophic drug limit by Medicare law limiting your exposure of $2100/year. Do not let BCBS cheat you should you gain approval. Good luck and be persistent.