Express Scripts denied pre-authorization for Ozempic. What to do now?

[Anonymous]

Anonymous wrote:Op no one cares if you get Wegovy, people are reacting to you wanting ozempic and for insurance to pay for it, because as you said previously, you’ve paid a lot to insurance over the years and want something back. THAT is what people are reacting to, because you don’t qualify for ozempic and you are trying to take diabetes medication away from diabetics, by contributing to the shortages. Get Wegovy and call it a day.

There is no Ozempic shortage. There IS a Wegovy shortage and Ozempic is the correct substitute.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Go to a real doctor?

I have been to two "real doctors". one prescribed ozempic and the other wegovy. thank you for your concern.

Then why aren’t you trying Wegovy? Because you have to pay? You’ll have to pay for the ozempic too. Thousands.

OMG OMG aren't you happy that i will be punished for being fat. i will pay thousands THOUSANDS!!

Yes I’m happy you will have to pay, because I believe people like you should be punished for the shortages. I have adult onset type 1.5 diabetes and for now, ozempic is the only thing that works, until I need insulin. People like you have made it so stressful for me to find my medication. I am not overweight and I didn’t get diabetes from a lifestyle choice. Other medications like metformin don’t work for me. I’m happy people like you are being punished by paying thousands and having your prescriptions denied.

Try Amazon Pharmacy. I get Ozempic in a couple of days. CVS has it too, but Amazon is less expensive. Super easy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m 52. Have worked out my entire life. I’m very tall and have always been bulky but strong. I get up at 5 am to work out. I eat 170O calories a day. I don’t drink. I’m in better shape than most 30 year olds I work out with. I hit menopause and gained 20 pounds out of nowhere and blood work completely off. I was fortunate enough to get Wegovy and insurance covers it. It helped regulate me again and i lost the extra weight that came out of nowhere. I could give 2 sh*ts what any of you think that I’m taking a short cut or breaking the rules. I 💯 percent guarantee I work harder and eat less than 90 percent of you.

Nobody needed your life story but wouldn’t HRT have done this? It’s an estrogen imbalance that causes midsection weight gain in menopause.

No. The point of my story is that there are people like myself on weight loss drugs who work out, eat healthy and aren’t lazy. I find it ironic that this thread is full of diabetics ( likely because of lifestyle) angry that overweight people benefit from the same drug. It’s like the pot calling the kettle black.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m 52. Have worked out my entire life. I’m very tall and have always been bulky but strong. I get up at 5 am to work out. I eat 170O calories a day. I don’t drink. I’m in better shape than most 30 year olds I work out with. I hit menopause and gained 20 pounds out of nowhere and blood work completely off. I was fortunate enough to get Wegovy and insurance covers it. It helped regulate me again and i lost the extra weight that came out of nowhere. I could give 2 sh*ts what any of you think that I’m taking a short cut or breaking the rules. I 💯 percent guarantee I work harder and eat less than 90 percent of you.

Nobody needed your life story but wouldn’t HRT have done this? It’s an estrogen imbalance that causes midsection weight gain in menopause.

Different poster: I’m on HRT AND Ozempic. I tried HRT alone for 6 months first thinking it would help with the 25lb weight gain. In spite of all the working out and tracking food, it did nothing. Once I started Ozempic (I’m prediabetic), weight started coming off.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m 52. Have worked out my entire life. I’m very tall and have always been bulky but strong. I get up at 5 am to work out. I eat 170O calories a day. I don’t drink. I’m in better shape than most 30 year olds I work out with. I hit menopause and gained 20 pounds out of nowhere and blood work completely off. I was fortunate enough to get Wegovy and insurance covers it. It helped regulate me again and i lost the extra weight that came out of nowhere. I could give 2 sh*ts what any of you think that I’m taking a short cut or breaking the rules. I 💯 percent guarantee I work harder and eat less than 90 percent of you.

Nobody needed your life story but wouldn’t HRT have done this? It’s an estrogen imbalance that causes midsection weight gain in menopause.

Different poster: I’m on HRT AND Ozempic. I tried HRT alone for 6 months first thinking it would help with the 25lb weight gain. In spite of all the working out and tracking food, it did nothing. Once I started Ozempic (I’m prediabetic), weight started coming off.

I’m the poster from above. Same here. HRT had zero effect.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m 52. Have worked out my entire life. I’m very tall and have always been bulky but strong. I get up at 5 am to work out. I eat 170O calories a day. I don’t drink. I’m in better shape than most 30 year olds I work out with. I hit menopause and gained 20 pounds out of nowhere and blood work completely off. I was fortunate enough to get Wegovy and insurance covers it. It helped regulate me again and i lost the extra weight that came out of nowhere. I could give 2 sh*ts what any of you think that I’m taking a short cut or breaking the rules. I 💯 percent guarantee I work harder and eat less than 90 percent of you.

Nobody needed your life story but wouldn’t HRT have done this? It’s an estrogen imbalance that causes midsection weight gain in menopause.

No. The point of my story is that there are people like myself on weight loss drugs who work out, eat healthy and aren’t lazy. I find it ironic that this thread is full of diabetics ( likely because of lifestyle) angry that overweight people benefit from the same drug. It’s like the pot calling the kettle black.

FACTS! All these diabetics have some nerve, with their equally unhealthy a$$! Give me a f'ing break.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m 52. Have worked out my entire life. I’m very tall and have always been bulky but strong. I get up at 5 am to work out. I eat 170O calories a day. I don’t drink. I’m in better shape than most 30 year olds I work out with. I hit menopause and gained 20 pounds out of nowhere and blood work completely off. I was fortunate enough to get Wegovy and insurance covers it. It helped regulate me again and i lost the extra weight that came out of nowhere. I could give 2 sh*ts what any of you think that I’m taking a short cut or breaking the rules. I 💯 percent guarantee I work harder and eat less than 90 percent of you.

Nobody needed your life story but wouldn’t HRT have done this? It’s an estrogen imbalance that causes midsection weight gain in menopause.

No. The point of my story is that there are people like myself on weight loss drugs who work out, eat healthy and aren’t lazy. I find it ironic that this thread is full of diabetics ( likely because of lifestyle) angry that overweight people benefit from the same drug. It’s like the pot calling the kettle black.

FACTS! All these diabetics have some nerve, with their equally unhealthy a$$! Give me a f'ing break.

Yes. Sorry you live in denial that somehow the lifestyle diabetic is more deserving than the lifestyle obese individual. They are both equally deserving or undeserving as any rational person would see it. But the diabetic whiner, “ but you are taking MY medicine away from me” is clearly not rational.

[Anonymous]

Anonymous wrote:Op no one cares if you get Wegovy, people are reacting to you wanting ozempic and for insurance to pay for it, because as you said previously, you’ve paid a lot to insurance over the years and want something back. THAT is what people are reacting to, because you don’t qualify for ozempic and you are trying to take diabetes medication away from diabetics, by contributing to the shortages. Get Wegovy and call it a day.

if this is true, it's completely ridiculous. it's a formality - the medicine is the same, and my doctor for some reason put ozempic.

people were complaining that i want my insurance to cover medicine that two doctors prescribed for me. i find that ridiculous.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Go to a real doctor?

I have been to two "real doctors". one prescribed ozempic and the other wegovy. thank you for your concern.

Then why aren’t you trying Wegovy? Because you have to pay? You’ll have to pay for the ozempic too. Thousands.

OMG OMG aren't you happy that i will be punished for being fat. i will pay thousands THOUSANDS!!

Mine is $15/month because I have diabetes. You don’t.

NP. For someone who gave himself type Ii diabetes mellitus through, cumulatively, years of poor health choices under their control…. You are confusingly smug about the OP’s BMI. It’s entirely unclear why you would feel superior to OP? I mean, your attempts at diet modification were so abysmal (or absent) that you killed your pancreas.

OP’s A1c tells us her pancreas isn’t as jacked up as yours is, by your own poor choices over a lifetime.

Congrats?

In the culpability olympics, OP > you at this point on the timeline. If my insurance premiums must increase, I’d rather they benefit her over you. As it is, I’m sure I’m already indirectly paying for your DM-related glaucoma, erectile dysfunction, CKD meds and maybe foot care amd cardiac meds.

I’m not overweight and didn’t get type 2 from poor choices. You can also be thin and get type 2 diabetes.

So you were skinny fat then. Very few people develop Type 2 diabetes who are a healthy weight and in good physical shape. I doubt you are one of them.

Well then you’re dumb because I have family history of diabetes. I exercise and eat well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op no one cares if you get Wegovy, people are reacting to you wanting ozempic and for insurance to pay for it, because as you said previously, you’ve paid a lot to insurance over the years and want something back. THAT is what people are reacting to, because you don’t qualify for ozempic and you are trying to take diabetes medication away from diabetics, by contributing to the shortages. Get Wegovy and call it a day.

if this is true, it's completely ridiculous. it's a formality - the medicine is the same, and my doctor for some reason put ozempic.

people were complaining that i want my insurance to cover medicine that two doctors prescribed for me. i find that ridiculous.

You can find it ridiculous and you can boohoo all the way to the pharmacy, where you’re going to pay full price, because YOU DONT QUALIFY FOR OZEMPIC.

[Anonymous]

Insurance companies decide what is covered. Not your doctor, OP. You can get a prescription, no one is stopping you. But you won’t have it covered so stop complaining, or else eat more bad food so you get full blown diabetes and then it will be covered.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m 52. Have worked out my entire life. I’m very tall and have always been bulky but strong. I get up at 5 am to work out. I eat 170O calories a day. I don’t drink. I’m in better shape than most 30 year olds I work out with. I hit menopause and gained 20 pounds out of nowhere and blood work completely off. I was fortunate enough to get Wegovy and insurance covers it. It helped regulate me again and i lost the extra weight that came out of nowhere. I could give 2 sh*ts what any of you think that I’m taking a short cut or breaking the rules. I 💯 percent guarantee I work harder and eat less than 90 percent of you.

Nobody needed your life story but wouldn’t HRT have done this? It’s an estrogen imbalance that causes midsection weight gain in menopause.

No. The point of my story is that there are people like myself on weight loss drugs who work out, eat healthy and aren’t lazy. I find it ironic that this thread is full of diabetics ( likely because of lifestyle) angry that overweight people benefit from the same drug. It’s like the pot calling the kettle black.

FACTS! All these diabetics have some nerve, with their equally unhealthy a$$! Give me a f'ing break.

Yes. Sorry you live in denial that somehow the lifestyle diabetic is more deserving than the lifestyle obese individual. They are both equally deserving or undeserving as any rational person would see it. But the diabetic whiner, “ but you are taking MY medicine away from me” is clearly not rational.

It is when people like OP try to get a drug indicated for diabetes when the one for obesity isn’t available. I realize they’re the same formulary but from a rationing perspective, yeah, they are laying claim to drugs allocated to a different population who are, in fact, more deserving of the therapy than lazy fatties.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op no one cares if you get Wegovy, people are reacting to you wanting ozempic and for insurance to pay for it, because as you said previously, you’ve paid a lot to insurance over the years and want something back. THAT is what people are reacting to, because you don’t qualify for ozempic and you are trying to take diabetes medication away from diabetics, by contributing to the shortages. Get Wegovy and call it a day.

if this is true, it's completely ridiculous. it's a formality - the medicine is the same, and my doctor for some reason put ozempic.

people were complaining that i want my insurance to cover medicine that two doctors prescribed for me. i find that ridiculous.

Maybe look at what meds your insurance covers. There are others. Trulicity, etc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’m 52. Have worked out my entire life. I’m very tall and have always been bulky but strong. I get up at 5 am to work out. I eat 170O calories a day. I don’t drink. I’m in better shape than most 30 year olds I work out with. I hit menopause and gained 20 pounds out of nowhere and blood work completely off. I was fortunate enough to get Wegovy and insurance covers it. It helped regulate me again and i lost the extra weight that came out of nowhere. I could give 2 sh*ts what any of you think that I’m taking a short cut or breaking the rules. I 💯 percent guarantee I work harder and eat less than 90 percent of you.

Nobody needed your life story but wouldn’t HRT have done this? It’s an estrogen imbalance that causes midsection weight gain in menopause.

No. The point of my story is that there are people like myself on weight loss drugs who work out, eat healthy and aren’t lazy. I find it ironic that this thread is full of diabetics ( likely because of lifestyle) angry that overweight people benefit from the same drug. It’s like the pot calling the kettle black.

FACTS! All these diabetics have some nerve, with their equally unhealthy a$$! Give me a f'ing break.

Yes. Sorry you live in denial that somehow the lifestyle diabetic is more deserving than the lifestyle obese individual. They are both equally deserving or undeserving as any rational person would see it. But the diabetic whiner, “ but you are taking MY medicine away from me” is clearly not rational.

It is when people like OP try to get a drug indicated for diabetes when the one for obesity isn’t available. I realize they’re the same formulary but from a rationing perspective, yeah, they are laying claim to drugs allocated to a different population who are, in fact, more deserving of the therapy than lazy fatties.

But what’s the difference really? Aren’t diabetics (the diabetics diagnosed from lifestyle) the same as your “lazy fatties”. I’m not sure if you were being sarcastic.

[Anonymous]

Anonymous wrote:Insurance companies decide what is covered. Not your doctor, OP. You can get a prescription, no one is stopping you. But you won’t have it covered so stop complaining, or else eat more bad food so you get full blown diabetes and then it will be covered.

insurance company does cover both ozempic and wegovy. so they already decided they would do it.

and my doctors think i need them. it's weird to me that there the company needs to make additional approval to cover the medicine they already decided to cover. if they don't want to cover wegovy, fine. but why second guess my doctor? why would they know better what i need?