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

[Anonymous]

Anonymous wrote:

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.

diabetics can use insulin. it's not like they really need ozempic. in most cases they insist on it to lose weight (most diabetics are overweight) while pretending they would die without it.

Lol. The gastroparesis will be very well-earned in your case.

[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.

Why is that? Using your ( mean) words, most type 2 diabetics are also lazy fatties who progressed on to diabetes. Why are they more deserving in your mind?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What, pray tell, is “marginally pre-diabetic?”

If you want to lose 50, eat less and move more and cut down on carbs. That will do a lot to help your glucose too. You don’t need Ozempic.

my A1c is outside the normal range, but only a little.

yes, I do need Ozempic. I have been on a diet for the past 40 years.

See an endocrinologist. Expect to spend six months on Metformin first and be told to lose 20 before they will consider putting you on a medication that costs thousands

Go eat rocks. I’m not the PP but you are seriously not well.

NP: I don't understand your angry reaction to PP's comment. I didn't read any snark in their comment, and they're likely not wrong with their advice! Metformin is often the first step. There is a max amount of weight usually experienced with Metformin, and then you're moved to another medication. And yes and Endocrinologist is appropriate doctor for this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What, pray tell, is “marginally pre-diabetic?”

If you want to lose 50, eat less and move more and cut down on carbs. That will do a lot to help your glucose too. You don’t need Ozempic.

my A1c is outside the normal range, but only a little.

yes, I do need Ozempic. I have been on a diet for the past 40 years.

See an endocrinologist. Expect to spend six months on Metformin first and be told to lose 20 before they will consider putting you on a medication that costs thousands

Go eat rocks. I’m not the PP but you are seriously not well.

NP: I don't understand your angry reaction to PP's comment. I didn't read any snark in their comment, and they're likely not wrong with their advice! Metformin is often the first step. There is a max amount of weight usually experienced with Metformin, and then you're moved to another medication. And yes and Endocrinologist is appropriate doctor for this.

Because she’s Veruca Salt as are most of the semaglutiders here. They need a quick revenge on all of the men they presume rejected them due to weight, but especially need to vanquish the thinner women they’ve been in one-way battle with over life. What are you even trying to say, go to an endo IRL and manage your health responsibly, who wants to do that?

[Anonymous]

Anonymous wrote:Hey op, I’m diabetic and take ozempic and have lost 20 pounds in 8 months. I started taking it to lower my a1c, not lose weight. I could have lost weight faster on WW. Some people don’t even lose weight. I hope you get on ozempic and lose nothing. Have a great Sunday!

Lol

[Anonymous]

Wegovy is on back order. Ozempic is the exact same drug and the logical and appropriate substitute. Substituting a medicine is perfectly normal but insurance companies are happy to have an excuse to not pay for it in this case.

OP, pay out of pocket until Wegovy is in stock.

This reasonable post will be buried by trolls on seconds though. Half this thread is trolls.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What, pray tell, is “marginally pre-diabetic?”

If you want to lose 50, eat less and move more and cut down on carbs. That will do a lot to help your glucose too. You don’t need Ozempic.

my A1c is outside the normal range, but only a little.

yes, I do need Ozempic. I have been on a diet for the past 40 years.

See an endocrinologist. Expect to spend six months on Metformin first and be told to lose 20 before they will consider putting you on a medication that costs thousands

Go eat rocks. I’m not the PP but you are seriously not well.

NP: I don't understand your angry reaction to PP's comment. I didn't read any snark in their comment, and they're likely not wrong with their advice! Metformin is often the first step. There is a max amount of weight usually experienced with Metformin, and then you're moved to another medication. And yes and Endocrinologist is appropriate doctor for this.

Because she’s Veruca Salt as are most of the semaglutiders here. They need a quick revenge on all of the men they presume rejected them due to weight, but especially need to vanquish the thinner women they’ve been in one-way battle with over life. What are you even trying to say, go to an endo IRL and manage your health responsibly, who wants to do that?

What You've gone down the rabbit hole with this one. Way too much energy spent trying to defend your hateful position. Go outside and get some fresh air.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What, pray tell, is “marginally pre-diabetic?”

If you want to lose 50, eat less and move more and cut down on carbs. That will do a lot to help your glucose too. You don’t need Ozempic.

my A1c is outside the normal range, but only a little.

yes, I do need Ozempic. I have been on a diet for the past 40 years.

See an endocrinologist. Expect to spend six months on Metformin first and be told to lose 20 before they will consider putting you on a medication that costs thousands

Go eat rocks. I’m not the PP but you are seriously not well.

NP: I don't understand your angry reaction to PP's comment. I didn't read any snark in their comment, and they're likely not wrong with their advice! Metformin is often the first step. There is a max amount of weight usually experienced with Metformin, and then you're moved to another medication. And yes and Endocrinologist is appropriate doctor for this.

Because she’s Veruca Salt as are most of the semaglutiders here. They need a quick revenge on all of the men they presume rejected them due to weight, but especially need to vanquish the thinner women they’ve been in one-way battle with over life. What are you even trying to say, go to an endo IRL and manage your health responsibly, who wants to do that?

What You've gone down the rabbit hole with this one. Way too much energy spent trying to defend your hateful position. Go outside and get some fresh air.

Go back to telling people to eff themselves when metformin and seeing a doctor are recommended, sweetie. Might burn a calorie or two.

[Anonymous]

Anonymous wrote:Wegovy is on back order. Ozempic is the exact same drug and the logical and appropriate substitute. Substituting a medicine is perfectly normal but insurance companies are happy to have an excuse to not pay for it in this case.

OP, pay out of pocket until Wegovy is in stock.

This reasonable post will be buried by trolls on seconds though. Half this thread is trolls.

Op doesn't want to. It's easier to complain.

Op I'm diabetic. My insurance company won't cover Ozempic because another drug, (not metformin) combined with mostly a proper diet and exercise, is keeping my blood sugar in check.

Keep complaining though.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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?

My doctor prescribed me Ozempic, but my insurance company is very clear they only cover it for full diabetes, not pre diabetes. It may be a dumb policy but it is clearly the policy. I pay out of pocket. Your insurance company isn't saying you can't use Ozempic, they are just saying that they aren't covering it for you being overweight.

but what i am saying is that it is a dumb policy. many people here are supporting this policy.

Well, if *you* say it’s dumb policy ….

(Hint, it’s not dumb policy).

[Anonymous]

Anonymous wrote:Wegovy is on back order. Ozempic is the exact same drug and the logical and appropriate substitute. Substituting a medicine is perfectly normal but insurance companies are happy to have an excuse to not pay for it in this case.

OP, pay out of pocket until Wegovy is in stock.

This reasonable post will be buried by trolls on seconds though. Half this thread is trolls.

Or get any one of the other semiglutides such as Trulicity.

[Anonymous]

I’m type 1.5 (LADA) which is adult onset type 1 diabetes. I’m taking ozempic until my pancreas stops working in 5-6 years and I need insulin. This isn’t a lifestyle choice, I’m not fat, and it’s genetic. But I guess op is fine with people like me struggling to get my medication because despite just people want to say, there is a shortage of the 2mg dose. It’s had to find because people are getting that dose, so they can save money paying out of pocket, when they’re prescribed a lower dose.

You kind of suck op. I don’t really have an issue with people wanting ozempic to lose weight, but op is so entitled, I hope she has to pay full price.

Also, good luck getting a pharmacist to fill your prescription, so try to get it online. Pharmacists are gate keeping this medication. More than one person at Walgreens and CVS have told me they are making sure the people who actually need this medication are getting it.

[Anonymous]

I am diabetic and want Mounjaro, but my insurance will only cover ozempic. It’s not all about you, op. Even diabetics can’t just get whatever diabetes medicine they want!

[Anonymous]

Anonymous wrote:I’m type 1.5 (LADA) which is adult onset type 1 diabetes. I’m taking ozempic until my pancreas stops working in 5-6 years and I need insulin. This isn’t a lifestyle choice, I’m not fat, and it’s genetic. But I guess op is fine with people like me struggling to get my medication because despite just people want to say, there is a shortage of the 2mg dose. It’s had to find because people are getting that dose, so they can save money paying out of pocket, when they’re prescribed a lower dose.

You kind of suck op. I don’t really have an issue with people wanting ozempic to lose weight, but op is so entitled, I hope she has to pay full price.

Also, good luck getting a pharmacist to fill your prescription, so try to get it online. Pharmacists are gate keeping this medication. More than one person at Walgreens and CVS have told me they are making sure the people who actually need this medication are getting it.[/quote]

That’s good to read. But according to OP and the other truffle hunters who have been treated in singularly cruel ways by the world at large, patients like you don’t exist.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What, pray tell, is “marginally pre-diabetic?”

If you want to lose 50, eat less and move more and cut down on carbs. That will do a lot to help your glucose too. You don’t need Ozempic.

my A1c is outside the normal range, but only a little.

yes, I do need Ozempic. I have been on a diet for the past 40 years.

See an endocrinologist. Expect to spend six months on Metformin first and be told to lose 20 before they will consider putting you on a medication that costs thousands

Go eat rocks. I’m not the PP but you are seriously not well.

NP: I don't understand your angry reaction to PP's comment. I didn't read any snark in their comment, and they're likely not wrong with their advice! Metformin is often the first step. There is a max amount of weight usually experienced with Metformin, and then you're moved to another medication. And yes and Endocrinologist is appropriate doctor for this.

Because she’s Veruca Salt as are most of the semaglutiders here. They need a quick revenge on all of the men they presume rejected them due to weight, but especially need to vanquish the thinner women they’ve been in one-way battle with over life. What are you even trying to say, go to an endo IRL and manage your health responsibly, who wants to do that?