Prescription for Wegovy but $1500?!?!

[Anonymous]

My dr sent in a prescription for Wegovy for me but Cigna is denying coverage and it’s over $1500 a month. I have PCOS and have been on metformin for years with no luck. Any suggestions? Thanks so much.

[Anonymous]

You can try goodrx.com for a coupon but sometimes there are restrictions

[Anonymous]

google semaglutide for sale. You can find peptide manufactures that will sell it too you

[Anonymous]

OP a few times over the years, I have had to appeal my insurance co's decision to reject a med prescribed by my doctor. Usually there is a form that your doctor can fill out. Worth a shot.

[Anonymous]

Buy direct from India. The name of the pharmacy is AllDayChemist.

[Anonymous]

Anonymous wrote:My dr sent in a prescription for Wegovy for me but Cigna is denying coverage and it’s over $1500 a month. I have PCOS and have been on metformin for years with no luck. Any suggestions? Thanks so much.

Denying coverage for what reason? What does your pharmacy formulary say- is it covered, requires PA, or covers a different Rx? If it says requires prior auth then your doctor needs to submit a PA stating that youve tried other meds. Just metformin may not be enough. This is why it is helpful to know if other meds with similar mechanisms are covered- trulicity, ozempic, mounjaro, etc.

Cigna and UHC were the first two insurances to cover mounjaro according to my endo. I have UHC and Mounjaro is covered with Prior auth.

I would also see if your A1C qualifies you for pre-diabetes, diabetes II. You also need to know the ICD code that your provider is using to submit the medication. Sometimes insurance will only cover medications for specific codes.

[Anonymous]

Try to find compounded semaglutide or get Ozempic from Canada.

[Anonymous]

I would try Mounjaro with the manufacturer's coupon also.

[Anonymous]

Appeal the decision. If that doesn't work complain to your state insurance commissioner.

[Anonymous]

Anonymous wrote:Buy direct from India. The name of the pharmacy is AllDayChemist.

Nope it's not available

[Anonymous]

Some (most?) insurance plans have a specific exemption for weight loss meds. My otherwise fantastic Cigna plan does.

[Anonymous]

My Cigna plan covered Ozempic. Maybe you need to try that first?

[Anonymous]

Anonymous wrote: Some (most?) insurance plans have a specific exemption for weight loss meds. My otherwise fantastic Cigna plan does.

but they arent exempted for non-weight loss purposes I assume? PCOS is a metabolic disorder.

-not OP

[Anonymous]

It may need a PA. Ask the pharmacy specifically. They may also cover a different drug in the class. No matter what, it requires a call in to your prescription insurance company.

[Anonymous]

All very helpful thank you! My A1C is 5.2 so not prediabetic at this time. I know that it’s common for PCOS so will watch out for that.

-OP