Zepound finally hits FEP BCBS

[Anonymous]

Happy Friday! Zepbound has finally been added to the FEP BCBS program.

Good new/ bad news/etc:

Etc: should be obvious, but you will need a prior authorization


Bad News— ouch. About $470/ month standard and $570 basic (costs more than with the coupon)

Better news— the Zepbound co-pay assistance card takes $150 off that. So $320 standard and $420 basic

The jumping for joy news: it should be available via mail order for standard only (basic has no mail order). With the savings card, a three month supply should be $25 ($125 or $80– not clear which tier it is— minus up to $150 to get the copay to $25.

Enjoy!

[Anonymous]

What is FEP?

[Anonymous]

Anonymous wrote:What is FEP?

Federal Employee Program

[Anonymous]

Anonymous wrote:Happy Friday! Zepbound has finally been added to the FEP BCBS program.

Good new/ bad news/etc:

Etc: should be obvious, but you will need a prior authorization


Bad News— ouch. About $470/ month standard and $570 basic (costs more than with the coupon)

Better news— the Zepbound co-pay assistance card takes $150 off that. So $320 standard and $420 basic

The jumping for joy news: it should be available via mail order for standard only (basic has no mail order). With the savings card, a three month supply should be $25 ($125 or $80– not clear which tier it is— minus up to $150 to get the copay to $25.

Enjoy!

Not according to the website?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Happy Friday! Zepbound has finally been added to the FEP BCBS program.

Good new/ bad news/etc:

Etc: should be obvious, but you will need a prior authorization


Bad News— ouch. About $470/ month standard and $570 basic (costs more than with the coupon)

Better news— the Zepbound co-pay assistance card takes $150 off that. So $320 standard and $420 basic

The jumping for joy news: it should be available via mail order for standard only (basic has no mail order). With the savings card, a three month supply should be $25 ($125 or $80– not clear which tier it is— minus up to $150 to get the copay to $25.

Enjoy!

Not according to the website?

They added it to their drug pricing tool yesterday. Prior to yesterday, it was listed as “not covered”. They still need to added it to the weight management prior authorization policy and elsewhere in the next couple days. But the PA policy should be the same as Wegovy, which costs more and is less effective.

https://www.fepblue.org/pilot/rx-cost-tool/search?defaultUY=true

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Happy Friday! Zepbound has finally been added to the FEP BCBS program.

Good new/ bad news/etc:

Etc: should be obvious, but you will need a prior authorization


Bad News— ouch. About $470/ month standard and $570 basic (costs more than with the coupon)

Better news— the Zepbound co-pay assistance card takes $150 off that. So $320 standard and $420 basic

The jumping for joy news: it should be available via mail order for standard only (basic has no mail order). With the savings card, a three month supply should be $25 ($125 or $80– not clear which tier it is— minus up to $150 to get the copay to $25.

Enjoy!

Not according to the website?

They added it to their drug pricing tool yesterday. Prior to yesterday, it was listed as “not covered”. They still need to added it to the weight management prior authorization policy and elsewhere in the next couple days. But the PA policy should be the same as Wegovy, which costs more and is less effective.

https://www.fepblue.org/pilot/rx-cost-tool/search?defaultUY=true

Is this program/company specific or BCBS wide?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Happy Friday! Zepbound has finally been added to the FEP BCBS program.

Good new/ bad news/etc:

Etc: should be obvious, but you will need a prior authorization


Bad News— ouch. About $470/ month standard and $570 basic (costs more than with the coupon)

Better news— the Zepbound co-pay assistance card takes $150 off that. So $320 standard and $420 basic

The jumping for joy news: it should be available via mail order for standard only (basic has no mail order). With the savings card, a three month supply should be $25 ($125 or $80– not clear which tier it is— minus up to $150 to get the copay to $25.

Enjoy!

Not according to the website?

They added it to their drug pricing tool yesterday. Prior to yesterday, it was listed as “not covered”. They still need to added it to the weight management prior authorization policy and elsewhere in the next couple days. But the PA policy should be the same as Wegovy, which costs more and is less effective.

https://www.fepblue.org/pilot/rx-cost-tool/search?defaultUY=true

Is this program/company specific or BCBS wide?

The OP says this is FEP. I know for Ozempic that the FEP would have covered me but my private BCBS plan did not, so it's probably not system wide.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Happy Friday! Zepbound has finally been added to the FEP BCBS program.

Good new/ bad news/etc:

Etc: should be obvious, but you will need a prior authorization


Bad News— ouch. About $470/ month standard and $570 basic (costs more than with the coupon)

Better news— the Zepbound co-pay assistance card takes $150 off that. So $320 standard and $420 basic

The jumping for joy news: it should be available via mail order for standard only (basic has no mail order). With the savings card, a three month supply should be $25 ($125 or $80– not clear which tier it is— minus up to $150 to get the copay to $25.

Enjoy!

Not according to the website?

They added it to their drug pricing tool yesterday. Prior to yesterday, it was listed as “not covered”. They still need to added it to the weight management prior authorization policy and elsewhere in the next couple days. But the PA policy should be the same as Wegovy, which costs more and is less effective.

https://www.fepblue.org/pilot/rx-cost-tool/search?defaultUY=true

Is this program/company specific or BCBS wide?

DP - I just checked my private BCBS and Zepbound is still not covered.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Happy Friday! Zepbound has finally been added to the FEP BCBS program.

Good new/ bad news/etc:

Etc: should be obvious, but you will need a prior authorization


Bad News— ouch. About $470/ month standard and $570 basic (costs more than with the coupon)

Better news— the Zepbound co-pay assistance card takes $150 off that. So $320 standard and $420 basic

The jumping for joy news: it should be available via mail order for standard only (basic has no mail order). With the savings card, a three month supply should be $25 ($125 or $80– not clear which tier it is— minus up to $150 to get the copay to $25.

Enjoy!

Not according to the website?

They added it to their drug pricing tool yesterday. Prior to yesterday, it was listed as “not covered”. They still need to added it to the weight management prior authorization policy and elsewhere in the next couple days. But the PA policy should be the same as Wegovy, which costs more and is less effective.

https://www.fepblue.org/pilot/rx-cost-tool/search?defaultUY=true

Is this program/company specific or BCBS wide?

DP - I just checked my private BCBS and Zepbound is still not covered.

Thanks. Me too.

[Anonymous]

I have FEP BCBS and am on Wegovy. Although I am within 15 pounds of my goal weight, Wegovy seems to have stopped working. Would Zepbound be indicated and covered if my doctor was willing to try me on it, even though I am almost out of the overweight category?

[Anonymous]

I am waiting to have my first Wegovy prescription filled because I cannot find it in stock anywhere. I have FEP BCBS Basic. Is Zepbound more widely available than Wegovy?

[Anonymous]

Yes friends, EVERY BCBS PLAN IS DIFFERENT BASED ON WHAT YOUR EMPLOYER NEGOTIATES WITH THE COMPANY. OP is talking about FEP only. DUH.

[Anonymous]

Are there requirements for being approved for coverage?

[Anonymous]

Anonymous wrote:I have FEP BCBS and am on Wegovy. Although I am within 15 pounds of my goal weight, Wegovy seems to have stopped working. Would Zepbound be indicated and covered if my doctor was willing to try me on it, even though I am almost out of the overweight category?

Where are you finding the wegovy?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have FEP BCBS and am on Wegovy. Although I am within 15 pounds of my goal weight, Wegovy seems to have stopped working. Would Zepbound be indicated and covered if my doctor was willing to try me on it, even though I am almost out of the overweight category?

Where are you finding the wegovy?

At my grocery store pharmacy in a western state.