Doctor won’t write appeals. Changed insurance and was denied GLP1 coverage (even thought i was already on it)

Anonymous
Find a new doctor
Anonymous
Anonymous wrote:Use Call On Doc which is the telehealth for Lilly Direct. They will do an appeal for you.


The problem with using Lilly Direct is the amount of information of yours they are going to gather and share with EVERYONE. Skip to number 2 to see what crazy information they are collecting and they basically say they are going to give it to everyone and anyone and aren't limited to sharing with medical professionals.

Why is everyone ignoring this?


From https://privacynotice.lilly.com/

1. Sources of Personal Data
We collect Personal Data about you from the following sources:

Directly from you. We may collect Personal Data you provide to us directly, such as when you contact us through our Digital Properties, interact with us in person, fill out our surveys, register for an event, sign up for offers or newsletters, communicate with us, or sign up for an account or other services.
Data collected automatically and through Cookies. We may automatically collect information or inferences about you, such as through cookies, pixels, tags, scripts, and other tracking technologies (collectively, “Cookies”), when you interact with our Digital Properties. This may include information about how you use and interact with our Digital Properties, information about your device, and internet usage information.
From third parties. We may collect Personal Data from third parties, such as customers, other consumers, service providers, our affiliated companies and subsidiaries, business partners, investors and shareholders, healthcare professionals, patients and clinical trial participants, clinical investigators and staff conducting clinical trials, clinical trial participants, government officials, adverse event reporters and subjects, data brokers, social media companies or other parties who interact with us.
From publicly available sources. We may collect Personal Data about you from publicly available sources, such as public profiles, social media, and websites.
We may combine information that we receive from the various sources described in this Privacy Statement, including third party sources, and use or disclose the combined information for the purposes identified below.


2. Types of Personal Data We Collect
Depending on your interactions with us, we may collect the following types of Personal Data about you.:

Identifiers, such as your name, alias, email address, physical address, telephone number, business contact information, social media username, unique personal identifier, and device identifiers (e.g., cookie IDs and IP address).
Records about you, such as signatures; financial information (e.g., payment card number or account information); physical characteristics or a description of you; the content, timing and method of communications you have with us, such as online chats, calls, and emails; and information you share with or upload to our Digital Properties, such as reviews and comments.
Demographic information, such as age (including birthdates), marital status, gender, and information about your lifestyle and social circumstances.
Commercial information, such as information related to your transactions; products or services purchased, obtained, or considered (including survey responses providing your opinion about our products and services); or other purchasing or consuming histories or tendencies.
Internet or other electronic network activity information, such as your browsing history, search history, preference information (including marketing and purchasing preferences), account settings (including any default preferences), and other information regarding your interactions with and use of the Digital Properties (including inferences about your health derived from the activities, usage information, and location information that we collect). For more information about Cookies, please see Section 5 (Cookies).
Non-precise geolocation data, such as your location as derived from your IP address.
Audio, electronic, visual, or other sensory information, such as photographs and audio/video recordings.
Professional or employment-related information, such as job title; organization; professional licenses, professional memberships, credentials, or affiliations; and other professional information.
Education information.
Inferences drawn from any of the information we collect about your preferences or behavior, including to assess the level of interest in our products and services based on frequency of visits and contact and determine your preferred frequency for receiving offers.
Sensitive Personal Information, including the following:
Social Security number, driver’s license number, tax ID number, visa number, or passport number.
Precise geolocation.
Racial or ethnic origin, political opinions, religious or philosophical beliefs, or union membership.
Information about your health (such as medical condition(s), diagnoses, or information that could result in an inferred health status).
Information concerning your sex life or sexual orientation.
3. How We Use Personal Data
We may use Personal Data for the following purposes:

To provide you or your company products and services, such as making our Digital Properties and other products and services available to you, including through the use of our AI tools; registering, verifying, and maintaining your account with us; providing and delivering you the goods and services you request; providing customer service; processing or fulfilling orders and transactions (including processing payments); verifying customer information and eligibility for certain programs or benefits; communicating with you (including soliciting feedback or responding to requests, complaints, and inquiries); hosting events and informational webinars; and providing similar services or otherwise facilitating your relationship with us.
To support public health and public interest initiatives.
For our internal business purposes, such as day-to-day operation of our business; maintaining internal business records, such as accounting, document management and similar activities; enforcing our policies and rules; training; management reporting; auditing; and IT security and administration.
For our internal research and product improvement purposes, such as verifying or maintaining the quality or safety of our products or services; improving our products or services, including AI, machine learning, and similar tools; designing new products and services; evaluating the effectiveness of our advertising or marketing efforts; and debugging and repairing errors with our systems, networks, and equipment.
For legal, safety or security reasons, such as complying with legal, reporting, and similar requirements; investigating and responding to claims against us, our personnel, and our customers; for the establishment, exercise or defense of legal claims; protecting our, your, our customers’, and other third parties’ safety, property or rights; detecting, preventing, and responding to security incidents and health and safety issues (including managing spread of communicable diseases); and protecting against malicious, deceptive, fraudulent, or illegal activity.
In connection with a corporate transaction, such as if we acquire assets of another business, or sell or transfer all or a portion of our business or assets including through a sale in connection with bankruptcy and other forms of corporate change.
For marketing and targeted advertising, such as marketing our products or services or those of our affiliates, business partners, or other third parties. For example, we may use Personal Data we collect to personalize advertising to you (including by developing product, brand, or services audiences and identifying you across devices/sites); to analyze interactions with us or our Digital Properties; or to send you newsletters, surveys, questionnaires, promotions, or information about events or webinars. We may use AI to improve the quality, speed, and value of our marketing analysis.
We may use anonymized or de-identified information for any purpose permitted by law.
Anonymous
That’s crazy.
Anonymous
Anonymous wrote:That’s crazy.


and yet it seems like no one cares that Lilly is doing this to them.
Anonymous
Anonymous wrote:
Anonymous wrote:That’s crazy.


and yet it seems like no one cares that Lilly is doing this to them.


Goodrx collects the same info. So does every company that offers a manufacturer's coupon for a medication.

Of course, insurance companies are panicking about these big prior auth programs. Lilly has a lot more resources to fight their denials.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Just go online and get a prescription! I took a picture of myself and filled out a form and got a prescription. First 3 months $350 and then it’s $100-200 a month after (depending on dose). Just go around your doctor.


How?


Don’t do this. You’ll be getting a compounded version with God knows what in it.


Not True. OP can go directly through NovoNordisc or through a company like Ro, Midi, etc.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:That’s crazy.


and yet it seems like no one cares that Lilly is doing this to them.


Goodrx collects the same info. So does every company that offers a manufacturer's coupon for a medication.

Of course, insurance companies are panicking about these big prior auth programs. Lilly has a lot more resources to fight their denials.


Goodrx collects ssns, credit information, job information, web searches, home address etc etc and gives it to anyone even non medical related businesses?
Anonymous
Anonymous wrote:My insurance denied coverage and I went to one of the weight loss companies and they a got brand name covered. I pay $30/month because they said it was medically necessary.

I think my doctor didn’t want to do the paperwork or didn’t know how to write the appeal properly. There are so many online now. At least call and ask. Do you have any medical issues? I have a few in addition to obesity and had recent labs.


Which one specifically?
Anonymous
Anonymous wrote:
Anonymous wrote:My insurance denied coverage and I went to one of the weight loss companies and they a got brand name covered. I pay $30/month because they said it was medically necessary.

I think my doctor didn’t want to do the paperwork or didn’t know how to write the appeal properly. There are so many online now. At least call and ask. Do you have any medical issues? I have a few in addition to obesity and had recent labs.


Which one specifically?


Which company please. Asking for a friend. Just kidding, asking for myself.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:My insurance denied coverage and I went to one of the weight loss companies and they a got brand name covered. I pay $30/month because they said it was medically necessary.

I think my doctor didn’t want to do the paperwork or didn’t know how to write the appeal properly. There are so many online now. At least call and ask. Do you have any medical issues? I have a few in addition to obesity and had recent labs.


Which one specifically?


Which company please. Asking for a friend. Just kidding, asking for myself.


Revolution Medicine. They are local in DC and I have been very pleased with them. I had to go to one in person appointment and the follow ups after have been virtual.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:That’s crazy.


and yet it seems like no one cares that Lilly is doing this to them.


Goodrx collects the same info. So does every company that offers a manufacturer's coupon for a medication.

Of course, insurance companies are panicking about these big prior auth programs. Lilly has a lot more resources to fight their denials.


Goodrx collects ssns, credit information, job information, web searches, home address etc etc and gives it to anyone even non medical related businesses?


GoodRx sold their customers' medical information to Google and Meta, among others.

And you left out all those drug manufacturer coupons that collect the same information.
Anonymous
Anonymous wrote:
Anonymous wrote:That’s crazy.


and yet it seems like no one cares that Lilly is doing this to them.


Because EVERY COMPANY is doing this to EVERYONE.
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