The gap in who gets GLP-1 medication is not explained by insurance or by blood sugar, because researchers controlled for both.
A review of 4.2 million prescriptions found Black patients with diabetes received GLP-1 prescriptions at 49% the rate of white patients with identical A1C levels and identical coverage per Capital B. Same numbers, same plan, half the prescriptions.
That leaves the prescribing conversation itself. BlackDoctor.org asked physicians to walk through what a patient can do about it: the clinical criteria that qualify you, the paperwork that goes with the request, and the appeal process when a request is declined per BlackDoctor.org.
Coverage is the second wall. Word In Black mapped state Medicaid programs and found twelve cover GLP-1s for diabetes with no prior authorization, eighteen require it, and six do not cover them at all per Word In Black.
What to do with this: if you have a diabetes diagnosis and have never been offered a GLP-1, that is a question worth asking directly at your next appointment, along with a request to note the answer in your chart. A documented decline is what an appeal is built on.