Wevovy and FSBP

[Anonymous]

I’m considering switching from bcbs basic to fsbp because of the changes to wegovy coverage under bcbs. I’m close to reaching my goal weight so will soon start taking more of a maintenance dose. I have had bcbs forever and had no issues getting wegovy covered. What happens when you switch? Will my doc need to get preapproval again? I’m no longer obese. How will fsbp view that? I feel so ignorant about how insurance works. TIA!

[Anonymous]

💩

[Anonymous]

Anonymous wrote:I’m considering switching from bcbs basic to fsbp because of the changes to wegovy coverage under bcbs. I’m close to reaching my goal weight so will soon start taking more of a maintenance dose. I have had bcbs forever and had no issues getting wegovy covered. What happens when you switch? Will my doc need to get preapproval again? I’m no longer obese. How will fsbp view that? I feel so ignorant about how insurance works. TIA!

Likely to be a big problem.

Don't feel ignorant about this -- things are shifting like crazy in the obesity meds space when it comes to coverage. Even the insurance companies themselves aren't sure how things are ultimately going to work with these expensive meds and the huge demand for them. But at least for now, they are all shifting away from coverage rather than toward. Which makes sense, at least in the US the demand for Wegovy is pretty much bankrupting some plans.

[Anonymous]

The only reliable way to find out is to call and ask. My plan lists Wegovy as covered on the formulary listed on the website, but it isn't. They took it off earlier this year and never updated the list.