How are people getting weightloss medication approved by insurance?

[Anonymous]

Are people paying out of pocket

[Anonymous]

People are paying $300ish out of pocket for compounded meds

[Anonymous]

Some insurance plans pay for it, some do not. My previous employer included weight loss medicine as part of our plan with CIGNA while my current employer does not. Both plans were CIGNA OAP, but because employers choose what is covered within that plan, my previous employer chose a different prescription plan than my current employer, which is (a) owned by a private equity firm and (b) run by a bunch of old white men married to their hot skinny second wives.

[Anonymous]

I was on Wegovy for $25/month and just found out that Blue Cross Blue Shield won't cover it, so now it's $775/month. There's no way I can stay on the meds now. That's a problem I haven't figured out the answer to yet.

[Anonymous]

Anonymous wrote:I was on Wegovy for $25/month and just found out that Blue Cross Blue Shield won't cover it, so now it's $775/month. There's no way I can stay on the meds now. That's a problem I haven't figured out the answer to yet.

The answer is above, compounded meds.

[Anonymous]

I had a heart attack.

[Anonymous]

Anonymous wrote:I was on Wegovy for $25/month and just found out that Blue Cross Blue Shield won't cover it, so now it's $775/month. There's no way I can stay on the meds now. That's a problem I haven't figured out the answer to yet.

$75 is much less than the retail price which is over $1000

[Anonymous]

Anonymous wrote:

Anonymous wrote:I was on Wegovy for $25/month and just found out that Blue Cross Blue Shield won't cover it, so now it's $775/month. There's no way I can stay on the meds now. That's a problem I haven't figured out the answer to yet.

$75 is much less than the retail price which is over $1000

You missed a digit.

[Anonymous]

Really safe

[Anonymous]

My insurance covers it if you meet BMI guidelines. Just depends on your insurance.

[Anonymous]

I have PCOS and mine covered it until last month. Now they will only cover it with a diagnosis of type 2 diabetes, which I don't have. I will have to pay $800 out of pocket per month if I want to stay on the meds, which have helped me lose about 30 pounds over 2 years. I'm still obese but it prevents me from gaining.

[Anonymous]

The compounded meds work very well. Just use them.

[Anonymous]

I pay out of pocket for compound. Been on it for almost 2 years. Just in maintenance now, which is about $80/month (low dose shots every 2 weeks).

[Anonymous]

Anonymous wrote:I was on Wegovy for $25/month and just found out that Blue Cross Blue Shield won't cover it, so now it's $775/month. There's no way I can stay on the meds now. That's a problem I haven't figured out the answer to yet.

It's not that they don't cover it, it's that they moved it to a different tier of coverage so it's more expensive. There were a few threads about this and people changing insurers in response. It does suck, I'm sorry you're in the situation.

I'm getting the brand name, prescribed through a weight loss clinic, and the clinic has been able to sort out the prior auth. But, I don't know of any insurance as cheap as the old BCBS coverage was.

[Anonymous]

Anonymous wrote:I was on Wegovy for $25/month and just found out that Blue Cross Blue Shield won't cover it, so now it's $775/month. There's no way I can stay on the meds now. That's a problem I haven't figured out the answer to yet.

Wild that you "just found out" about this. It's all anyone has talked about in diet forums on the internet for months.