I have a prescription for Wegovy and insurance won’t cover

[Anonymous]

Manufacturer’s coupon only gets me down to $900 a month. Do I have any other options to get it cheaper? People have mentioned using a compound pharmacy but I don’t know what that means. I’m obese for what that’s worth. TIA!

[Anonymous]

If you do Zepbound instead it’s $550 a month with the coupon. Not low, but lower.

[Anonymous]

Our insurance covered after a pre auth but can’t find a damn pharmacy that has it.

[Anonymous]

Prices will likely come down….already who would pay $1000 for Wegovy if Zepbound is $550? Prices are also high because the injection pens are harder to scale up than a pill would be. So my guess is a year from now they can make more, prices will halve again and more insurers will cover it. But it sucks in the meantime. There’s no way I could cover $550/month.

[Anonymous]

I’m in a similar boat and have been looking into options. If your doctor is willing to write a compound prescription, they just have to state FOR COMPOUNDING and send it to a compounding pharmacy. A compounding pharmacy mixes the active ingredients of a medication, rather than getting it premixed. They’ll send you a vial with the medication along with syringes for the injections, rather than the prefilled pen you’d get from the manufacturer. The biggest problem with a compound is that you have to hope you have a good, honest pharmacy. A lot of VC forms have opened online compound pharmacies and their oversight, quality, cleanliness are questionable.

[Anonymous]

Did you really think that all it takes is a prescription to guarantee insurance coverage?

[Anonymous]

Anonymous wrote:Did you really think that all it takes is a prescription to guarantee insurance coverage?

What a stupid question. Who said anything about that?

[Anonymous]

Don’t you know that this is a a rich person’s tool? If you have money you get to be beautiful. That’s how it works. So you pay the $900 or you don’t. Again, this is how it works. Just ask Bella Hadid’s face. Weight loss is the same.

[Anonymous]

My dr said absolutely avoid compound pharmacies; the quality and dosages are famously inconsistent.

I recommend looking into Canadian pharmacies. I had to wait a few weeks for Ozempic to be restocked, but the cost was about half of US prices out of pocket.

[Anonymous]

Anonymous wrote:My dr said absolutely avoid compound pharmacies; the quality and dosages are famously inconsistent.

I recommend looking into Canadian pharmacies. I had to wait a few weeks for Ozempic to be restocked, but the cost was about half of US prices out of pocket.

Importing prescription drugs from Canada is generally not legal in the US:

“Personal importation — individuals filling prescriptions in Canada to take back to the U.S. — is generally allowed under Canadian law; it’s technically illegal in the U.S., but the FDA permits bringing medicines over the border under certain circumstances.”

https://www.fda.gov/industry/import-basics/personal-importation

[Anonymous]

Anonymous wrote:

Anonymous wrote:Did you really think that all it takes is a prescription to guarantee insurance coverage?

What a stupid question. Who said anything about that?

It’s literally the title of the post.

[Anonymous]

I am Type 2 and need it to lower my A1C and have a prescription for Ozempic but my insurance will only pay half. It’s still $500/month. I am not obese and my BMI is in the normal range. Not everyone with Type 2 is obese or overweight.

[Anonymous]

The compounding pharmacy I use charges $75 for a 2.5mg vial. They compound it, send it to a lab for testing, then dispense it. It’s a local pharmacy in Leesburg that’s been around forever. I haven’t had any issues getting it and it works as expected.

[Anonymous]

OP, ask your dr for an RX for Zepbound - it’s tirzepatide so same medicine as Mounjaro. It’s very effective and the manufacturer Eli Lilly has issued a savings card that brings down the price to $550 a month.

You can use an online telehealth service such as Join Fridays or Amble to pay for compounded semaglutide (active medicine in Wegovy) for $250 a month - shipped to you.

If you want to stick with Wegovy you need to understand your insurance plan coverage. It could be covered with a prior authorization or potentially completely excluded as a benefit and therefore not covered at all. You can call the 1-800 # on the back of your insurance card to ask about it.

Good luck to you! I’m on Mounjaro and have zero regrets!

[Anonymous]

Anonymous wrote:

Anonymous wrote:My dr said absolutely avoid compound pharmacies; the quality and dosages are famously inconsistent.

I recommend looking into Canadian pharmacies. I had to wait a few weeks for Ozempic to be restocked, but the cost was about half of US prices out of pocket.

Importing prescription drugs from Canada is generally not legal in the US:

“Personal importation — individuals filling prescriptions in Canada to take back to the U.S. — is generally allowed under Canadian law; it’s technically illegal in the U.S., but the FDA permits bringing medicines over the border under certain circumstances.”

https://www.fda.gov/industry/import-basics/personal-importation

Ozempic is fda approved and therefore legal to import from Canada for personal use.

https://www.fda.gov/about-fda/fda-basics/it-legal-me-personally-import-drugs