Fep Blue Standard GLP- coverage for obesity?

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Trying to sort this all out this morning.
Was told $639.49.

That's how much I paid this month.

Dr did suggest Noom.com and that BCBS provides a free membership. Cost of Wegovy should be $149 monthly.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Trying to sort this all out this morning.
Was told $639.49.

That's how much I paid this month.

Dr did suggest Noom.com and that BCBS provides a free membership. Cost of Wegovy should be $149 monthly.

Compounded?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Trying to sort this all out this morning.
Was told $639.49.

That's how much I paid this month.

Dr did suggest Noom.com and that BCBS provides a free membership. Cost of Wegovy should be $149 monthly.

Compounded?

I don't know .. I don't really want the compounded vs.. Just the pens like I've been on.. Will check into it and update.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
Trying to sort this all out this morning.
Was told $639.49.

That's how much I paid this month.

Dr did suggest Noom.com and that BCBS provides a free membership. Cost of Wegovy should be $149 monthly.

Compounded?

Yes -- compounded. You will not get Wegovy for $149 a month from Noom. You will get compounded semaglutide. Which my doctor will not write a script for because she doesn't consider it safe. But everyone has a different tolerance for risk.

[Anonymous]

Well after 3 years with a prior authorization (not always filled over that time) FEP BCBS denied my prior authorization. Not sure why yet given I have lots of other health issues. Thought I’d share because it may be a trend.

[Anonymous]

Anonymous wrote:Well after 3 years with a prior authorization (not always filled over that time) FEP BCBS denied my prior authorization. Not sure why yet given I have lots of other health issues. Thought I’d share because it may be a trend.

My bet is that with Trump negotiating for cash prices to drop there is a range of cost where insurers have determined that if its less than X dollars out of pocket then people will buy it using cash versus using insurance and then the insurer will still get all the benefits of those of us who have decreased BMI, decreased cholesterol, decreased inflammation, etc. without having to cost share it. They are negotiating Medicare/Medicaid costs for it so those who cant afford OOP will be covered thus leaving only LMC in the lurch.

Add in that Lilly has multiple new GLP-1s ++ in trials.

[Anonymous]

Anonymous wrote:Well after 3 years with a prior authorization (not always filled over that time) FEP BCBS denied my prior authorization. Not sure why yet given I have lots of other health issues. Thought I’d share because it may be a trend.

BCBS has been very clear about dropping GLP-1 coverage except for diabetes. They sent a letter about it.

It's a bummer but not a mystery.

[Anonymous]

Will they cover for someone pre-diabetic? DH is about to go on one and we have fed blue standard.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Well after 3 years with a prior authorization (not always filled over that time) FEP BCBS denied my prior authorization. Not sure why yet given I have lots of other health issues. Thought I’d share because it may be a trend.

My bet is that with Trump negotiating for cash prices to drop there is a range of cost where insurers have determined that if its less than X dollars out of pocket then people will buy it using cash versus using insurance and then the insurer will still get all the benefits of those of us who have decreased BMI, decreased cholesterol, decreased inflammation, etc. without having to cost share it. They are negotiating Medicare/Medicaid costs for it so those who cant afford OOP will be covered thus leaving only LMC in the lurch.

Add in that Lilly has multiple new GLP-1s ++ in trials.

Price has started to drop for Zepbound. It’s $450 for the vials at higher strength. I believe they are planning on a multi dose pen soon

[Anonymous]

Anonymous wrote:
Trying to sort this all out this morning.
Was told $639.49.

Me agin.
I now pay $0 for Zepbound
No clue how and I refuse to inquire.

Good luck!

[Anonymous]

again^

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Trying to sort this all out this morning.
Was told $639.49.

Me agin.
I now pay $0 for Zepbound
No clue how and I refuse to inquire.

Good luck!

It's likely a manufacturer promotion -- trying to get you loyal to zep.

[Anonymous]

Anonymous wrote:Will they cover for someone pre-diabetic? DH is about to go on one and we have fed blue standard.

No. They don't care at all about "pre-diabetic." That wasn't even one of the conditions ever considered for coverage (like sleep apnea or high blood pressure or cardiovascular disease).

[Anonymous]

If you have BCBS Standard you can get Wegovy through Caremark mail order for $250 for a 90-day supply (in 2025 it was $150 and BCBS just increased it for 2026). This only applies for the two highest doses-1.7mg and 2.4mg, so if you’re just starting out you’d have to pay the 50% per monthly coverage for the lower dose which is around $600, but that would only be for about three months until you move up to the higher doses.

[Anonymous]

You can go compound for cheaper. I don't bother with insurance. My PCP monitors me and it is very easy.