Wegovy for PCOS — 32 pounds, regular cycles, but PA fight took 4 months.

PCOS diagnosed at 22. Spent 9 years on metformin + spironolactone + birth control. Lost 8-10 pounds repeatedly, gained back. Endocrinologist recommended Wegovy at my 30-year visit because insulin resistance was worsening (HOMA-IR 4.8). BCBS plan denied: 'weight-loss-only indication not covered.' Endocrinologist appealed citing PCOS-related insulin resistance + obesity + irregular cycles preventing conception. Second denial. Third appeal with reproductive endocrinology co-sign succeeded. Once approved: $25/month with savings card. Lost 32 pounds in 9 months. Cycles regular for the first time since I was 16. HOMA-IR dropped to 2.1. Spironolactone discontinued at month 6 because androgenic symptoms (acne, facial hair) significantly improved. Still on metformin per endo recommendation. What worked: appealing with reproductive endocrinology angle, not just obesity. PCOS-specific framing made the difference. What I struggled with: hair shedding in months 2-4 (telogen effluvium from rapid weight loss) was alarming. Resolved by month 6. The savings card 12-month limit is approaching — planning to switch to NovoCare direct $499/mo for one month while my plan re-reviews my appeal.