Wegovy/Saxenda for weight loss?

[Anonymous]

Anonymous wrote:

Anonymous wrote:This thread is very informative.

Question: Is it likely that Ozempic would be prescribed for someone who is prediabetic? According to my latest bloodwork, I am in that category. Rather than going through Callibrate, I’m wondering if my primary doctor could prescribe it (which could then be covered by insurance). I need to lose 30 lbs.

Or do you have to actually have diabetes to get it prescribed?
Thanks.

Your primary care doctor can prescribe it, but insurance may not pay for it if you aren’t diabetic.

Thanks. The question I should’ve asked is: Has anyone who is prediabetic been prescribed Ozembic AND had it covered by their insurance?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This thread is very informative.

Question: Is it likely that Ozempic would be prescribed for someone who is prediabetic? According to my latest bloodwork, I am in that category. Rather than going through Callibrate, I’m wondering if my primary doctor could prescribe it (which could then be covered by insurance). I need to lose 30 lbs.

Or do you have to actually have diabetes to get it prescribed?
Thanks.

Your primary care doctor can prescribe it, but insurance may not pay for it if you aren’t diabetic.

Thanks. The question I should’ve asked is: Has anyone who is prediabetic been prescribed Ozembic AND had it covered by their insurance?

Yes, lots of people, usually requires pre-authorization. Just depends on your insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This thread is very informative.

Question: Is it likely that Ozempic would be prescribed for someone who is prediabetic? According to my latest bloodwork, I am in that category. Rather than going through Callibrate, I’m wondering if my primary doctor could prescribe it (which could then be covered by insurance). I need to lose 30 lbs.

Or do you have to actually have diabetes to get it prescribed?
Thanks.

Your primary care doctor can prescribe it, but insurance may not pay for it if you aren’t diabetic.

Thanks. The question I should’ve asked is: Has anyone who is prediabetic been prescribed Ozembic AND had it covered by their insurance?

Yes, lots of people, usually requires pre-authorization. Just depends on your insurance.

Thanks! I think I’m going to try that first (versus starting with Calibrate).

[Anonymous]

With supply chain issues now with Wegovy, has anyone looked into Qsymia or Contrave?

[Anonymous]

I’ve been fighting for a month with my insurance to get Wegovy or Ozempic covered.

I am 95 pounds overweight and even though all I hear from society is that I’m de facto unhealthy because of my obesity, I’m too healthy for a medication that would treat it.

[Anonymous]

I don't have diabetes and am not prediabetic and my insurance pays for Ozempic. Not sure if this is because of Calibrate though. I am obese but otherwise healthy. Start with your primary and see what happens.

[Anonymous]

Anonymous wrote:I don't have diabetes and am not prediabetic and my insurance pays for Ozempic. Not sure if this is because of Calibrate though. I am obese but otherwise healthy. Start with your primary and see what happens.

It just depends on your insurance.

[Anonymous]

Call your insurance company/prescription plan to see (a) if it's on the formulary and (b) what type of preauthorization is required. Some companies require you to try other/cheaper drugs first, some just require you to be obese.

My insurance covered for $25/month but I had TERRIBLE side effects and had to stop taking it.

[Anonymous]

I’m a PP whose insurance refuses to cover Ozempic without a T2 diabetes diagnosis. Got some blood work back and my A1C is normal but my insulin resistance is horrific because of my PCOS, or maybe just because I’m so fat, to a point where I’m kind of freaked out. This medicine would really help me! My PCP is going to keep working on it for me but doesn’t seem hopeful. I straight up asked her if she would just diagnose me with diabetes and she said “well, that would be fraud.” Oops! Sorry doc.

I think I’m going to try to get it from a Canadian pharmacy. It’s still expensive but about a quarter of the cost here.

[Anonymous]

Anonymous wrote:I’m a PP whose insurance refuses to cover Ozempic without a T2 diabetes diagnosis. Got some blood work back and my A1C is normal but my insulin resistance is horrific because of my PCOS, or maybe just because I’m so fat, to a point where I’m kind of freaked out. This medicine would really help me! My PCP is going to keep working on it for me but doesn’t seem hopeful. I straight up asked her if she would just diagnose me with diabetes and she said “well, that would be fraud.” Oops! Sorry doc.

I think I’m going to try to get it from a Canadian pharmacy. It’s still expensive but about a quarter of the cost here.

Have you tried metformin for your insulin resistance? If not, it’s a no brained to do it first before rolling out the big guns.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m a PP whose insurance refuses to cover Ozempic without a T2 diabetes diagnosis. Got some blood work back and my A1C is normal but my insulin resistance is horrific because of my PCOS, or maybe just because I’m so fat, to a point where I’m kind of freaked out. This medicine would really help me! My PCP is going to keep working on it for me but doesn’t seem hopeful. I straight up asked her if she would just diagnose me with diabetes and she said “well, that would be fraud.” Oops! Sorry doc.

I think I’m going to try to get it from a Canadian pharmacy. It’s still expensive but about a quarter of the cost here.

Have you tried metformin for your insulin resistance? If not, it’s a no brained to do it first before rolling out the big guns.

Yes I’ve been on 1000 mg for quite a while. Seen no weight loss and fasting insulin is still creeping up. When I try to increase the dose the side effects are too much (constant, life-interfering diarrhea).

[Anonymous]

I think I’m going to try to get it from a Canadian pharmacy. It’s still expensive but about a quarter of the cost here.

I assume you still need a prescription right? So the issue is your doctor will prescribe but insurance wont pay? I've heard that calibrate can help work through the red tape.

[Anonymous]

Anonymous wrote:

I think I’m going to try to get it from a Canadian pharmacy. It’s still expensive but about a quarter of the cost here.

I assume you still need a prescription right? So the issue is your doctor will prescribe but insurance wont pay? I've heard that calibrate can help work through the red tape.

Sure, but then you still have to pay for the monthly cost to Calibrate ($149/month, yes?). This is in addition to the prescription.

[Anonymous]

Yes but Calibrate will guarantee you get the prescription for $25 or less and in the rare instance Calibrate isn't successful then you are out of your one year contract with Calibrate. So if you can't get it done with your primary and insurance in your own I highly recommend Calibrate (which does more than dispense medication).

[Anonymous]

Anonymous wrote:

I think I’m going to try to get it from a Canadian pharmacy. It’s still expensive but about a quarter of the cost here.

I assume you still need a prescription right? So the issue is your doctor will prescribe but insurance wont pay? I've heard that calibrate can help work through the red tape.

Yes, my PCP has no problem prescribing and is going to continue fighting with my insurance but like I said she’s not hopeful she can do anything without the T2 diagnosis. I reached out to Calibrate and there’s nothing they can do either with my particular insurance.