United Healthcare and Ozempic
![[Post New]](/jforum/templates/default/images/icon_minipost_new.gif){kind=icon}
Anonymous
| What has your experience been getting Ozempic covered by United Healthcare, especially if you're in the category of BMI of 27 plus with other health conditions? |
Anonymous
| Unless you are diabetic, you won’t get Ozempic approved, you will get Wegovy. |
Anonymous
| I think I got ozempic at pre diabetic levels (I have geha/united) but I also had high blood pressure regulated by meds. When there were shortages however, I could not get it for over a week. Once I was officially diabetic, I have never had to wait for it. I think I was originally given wegovy but could not get it due to shortages do was switched to ozempic. |
Anonymous
| *so |
Anonymous
|
I have GEHA/United. I got Wegovy approved with an elevated BMI and another health condition. The process was a bit of a PITA. They denied the prior auth, then wouldn't accept an appeal from my doctor w/o a form from me authorizing my doctor to appeal. They told me this by a letter in the MAIL, in the year 2024. I called a couple of times to figure out what was going on/what I needed to do, and got different answers from different reps. Ultimately, they did approve it, and the approval is for a year so that's great!
|
Anonymous
| Thank you for this info. I assume Wegovy would be fine. I’ve taken Ozempic in the past but assume my doctor would be ok with either. |
Anonymous
| I’ve got prior authorization for wegovy from UHC but no pharmacy has wegovy. I hope to get it before the authorization expires this summer. |
Anonymous
|
Is it. Monthly prescription? What happens if you take it for a month, but it sis t available after that?
Amd if it’s approved only for a year, won’t you gain the weight back? |
Anonymous
I think you can get some doses for three months. However, when you're starting out, they typically assess how you're doing and adjust dosage, so you'd want to do month-by-month if possible. And yes, it's a problem when you can't find it and have to stop. That's the reason, though, that (at least for a while, perhaps still) the company prioritized the higher doses rather than the starting doses-- so the people who'd already started wouldn't be disrupted. |
Anonymous
My doctor wrote prescriptions for the first three dosage levels, and I did not start until I knew I could get all three. The higher doses are more readily available. If I am losing sufficient weight, my insurance will renew the authorization every six months. |
Anonymous
|
Hmmm my dr prescribed Zepbound which UHC denied of course. I wonder if I should have tried Wegovy.
Using compounded Zepbound. I was feeling a little under the weather before I started last week so I can’t tell if I have side effects. |
Anonymous
| Is your plan fully insured or self insured? What does your formulary cover? |
Anonymous
| I have UHC, BMI 35, pre diabetic, and UHC wouldn’t cover Ozempic. I believe I would have to have diabetes to get coverage. |