Mounjaro Help

[Anonymous]

I've been on MJ since August and have lost about 35 lbs. On 12.5mg now. Struggled to get it last month from PillPack with my savings card, switched to Walmart and had no problem. Now I'm trying to move up to 15mg and Walmart says no one can use their savings card with out a Type 2 Diabetes diagnosis after the first of this year (despite my card not saying this, I got it before that was a requirement and it doesn't expire till 12/23). They send a prior authorization to my doctor because I do have some insurance coverage, but that's gone nowhere thus far and I don't have a lot of faith that it will get covered even with a PA. I think they will require me to do step therapy at best ... which I would do if needed.

I'm just at a loss of how to get this now ... paying $1000+ a month is not realistic for me. Anyone else trouble shooting this as well right now and have advice? I'm super frustrated by it all. I get that the demand is HUGE, but some of us truly do need this for weight loss for our health. I want to lose at least another 85 lbs, so I'm not taking this for pure vanity purposes. I wish they'd maybe but a BMI minimum on this to start vs completely trying to restrict it for weight loss only.

[Anonymous]

You should join the facebook groups. You'll get better advice there

[Anonymous]

Many insurances will pay for it with BMI 30 or above, or 25 with one weight related comorbidity such as high blood pressure. That’s what your doctor’s office will put on the PA. It may work.

[Anonymous]

Anonymous wrote:You should join the facebook groups. You'll get better advice there

I have joined one, but they decline almost any posts about the savings card. It's frustrating. Maybe I need to join another one? Is there one in particular you recommend?

[Anonymous]

Anonymous wrote:Many insurances will pay for it with BMI 30 or above, or 25 with one weight related comorbidity such as high blood pressure. That’s what your doctor’s office will put on the PA. It may work.

Ok, good to know. Mine is well over 30 unfortunately.

[Anonymous]

You may need to switch to Ozempic. It's approved for weight loss, where Mounjaro is not (yet).

[Anonymous]

Anonymous wrote:

Anonymous wrote:You should join the facebook groups. You'll get better advice there

I have joined one, but they decline almost any posts about the savings card. It's frustrating. Maybe I need to join another one? Is there one in particular you recommend?

OP I went through something very similar except I got mine filled for 2 months with the savings card from my doctor and then for the 3rd fill they were like your insurance wont cover it, you need a PA. I was confused because the tech told me last time my insurance covered it and that was the first time they had seen that. Regardless, my endo was able to get the PA completed and submitted, and it was approved in less than 24 hours. I did have the benefit of being on metformin about 10-12 years ago which caused dizzy spells/nausea (hypoglycemic symptoms) and then Trulicity 1.5 year ago, which did nothing.

You may just need to get a PA and take it from there. The pharmacies arent filling around here because of the savings card debacle. They are worried they wont be reimbursed properly if filled for those who dont have a PA/T2D.

[Anonymous]

Anonymous wrote:You may need to switch to Ozempic. It's approved for weight loss, where Mounjaro is not (yet).

I have Cigna and am obese but not diabetic. I can’t get either covered unfortunately.

[Anonymous]

Anonymous wrote:You may need to switch to Ozempic. It's approved for weight loss, where Mounjaro is not (yet).

I would be open to doing that, but the coverage is the same for my insurance... only with a PA and step therapy. But since it's approved for weight loss I might have an easier time getting it approved you think?

I've never tried any weight loss medication except phentermine and that did nothing for me. The only thing I ever had success on was HCG, and to a lesser extent, keto. Neither were very sustainable, where as this feels much more doable.

[Anonymous]

Switch to Ozempic and buy it from Canada

[Anonymous]

Anonymous wrote:Switch to Ozempic and buy it from Canada

I've seen this mentioned but no one has ever been able to tell me exactly how and when I research, it's hard to tell what's legit. Can you tell me who you buy through and approximate costs?

[Anonymous]

Anonymous wrote:I've been on MJ since August and have lost about 35 lbs. On 12.5mg now. Struggled to get it last month from PillPack with my savings card, switched to Walmart and had no problem. Now I'm trying to move up to 15mg and Walmart says no one can use their savings card with out a Type 2 Diabetes diagnosis after the first of this year (despite my card not saying this, I got it before that was a requirement and it doesn't expire till 12/23). They send a prior authorization to my doctor because I do have some insurance coverage, but that's gone nowhere thus far and I don't have a lot of faith that it will get covered even with a PA. I think they will require me to do step therapy at best ... which I would do if needed.

I'm just at a loss of how to get this now ... paying $1000+ a month is not realistic for me. Anyone else trouble shooting this as well right now and have advice? I'm super frustrated by it all. I get that the demand is HUGE, but some of us truly do need this for weight loss for our health. I want to lose at least another 85 lbs, so I'm not taking this for pure vanity purposes. I wish they'd maybe but a BMI minimum on this to start vs completely trying to restrict it for weight loss only.

Try to get your script transferred to CVS - never had a problem with coverage or supply. I'm not T2, strictly weight loss. I'm in Fairfax, fwiw.

[Anonymous]

The problem is you are using a drug that isn't approved for weight loss. Neither is Ozempic. Wegovy is the only approved drug with a weight loss indication. You are not going to be able to get around coverage restrictions for off-label use of the drug at this point in time. And given the drug shortages, all of them are going to be hard to get. Would highly recommend against going to Canada (a great way to get counterfeit drugs) and please stay far away from any compounding pharmacy offering this. An ethical compounder will not compound this drug for you and no physician will recommend you pursue compounded options. The manufacturers are saying shortages should alleviate within a few months, but the way the TikTok crowd is going after this stuff, I'm not so sure. There are other weight loss drug options available...you may want to discuss those with your doc if you haven't already given how difficult the situation with these drugs have gotten. Otherwise you may need some patience for a few months.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Switch to Ozempic and buy it from Canada

I've seen this mentioned but no one has ever been able to tell me exactly how and when I research, it's hard to tell what's legit. Can you tell me who you buy through and approximate costs?

Np. Get a physical paper script from doctor. Contact marks Marie pharmacy in Vancouver, Canada. They have a website. It's about $350 a month. They are very helpful. They are legit, I used them for a year before switching to MJ.


But back to your MJ question, what walmart are you using? Mine has been great, but I will admit I haven't gotten my January fill yet.

[Anonymous]

Anonymous wrote:You may need to switch to Ozempic. It's approved for weight loss, where Mounjaro is not (yet).

Ozempic is absolutely not approved for weight loss. And it won't be given that Novo also manufacturers Wegovy, which does have a weight loss indication.