I have been taking prescription Nascobal (B12) spray for PA for several years. My insurance, AV Med, is now denying this medication and ANY vitamin replacement prescription or non prescription. My physician and myself have appealed and sent lab results, gastric biopsy, etc. confirming the diagnosis of PA and were still denied B12. I am told I cannot absorb B12 via oral or sublingual route and need the nasal spray or injectable form. Any ideas on how to pursue this with my insurance company?