FEHB and Wegovy

[Anonymous]

On the wegovy subreddit, there is a lot of talk about the MHBP, which uses Aetna and Caremark. I’ve got to price that out.

FYI to the person who asked: $650 is after insurance + coupon as far as I know.

[Anonymous]

I have not heard this. And to be honest, I'm not even sure where to look for this information?
I'm have BCBS basic and get wegovy for $25/month at local pharmacy. My pre-auth is valid until 10/2025.

In 2 months my monthly copay will go from $25 to $600+?? That doesn't seem possible

[Anonymous]

Anonymous wrote:On the wegovy subreddit, there is a lot of talk about the MHBP, which uses Aetna and Caremark. I’ve got to price that out.

FYI to the person who asked: $650 is after insurance + coupon as far as I know.

Just be aware that the MHBP people have made it clear in their presentations that the formulary can change at any time. Definitely a year to fill your FSA up.

Currently trying to figure out how the different HDHPs yearly out of pocket would look, filling at Costco since I try to avoid CVS as much as possible, but I haven’t been able to find any first-hand experiences for that particular scenario yet. At least with an HDHP it doesn’t matter how tiers get moved around since the assumption is on an expensive drug you’ll be hitting the deductible anyway.

[Anonymous]

Anonymous wrote:BCBS standard mail order (assuming it’s actually filled that way) will be $125 for a three month supply or $643 for in-store pickup of one month’s supply. BCBS basic will be $771 for one month. Wow.

They are not doing mail order for Wegovy. That will not be an option.

[Anonymous]

Anonymous wrote:It makes no sense for them to stop paying for it once you are not obese. As soon as you stop, you will be one obese again!

It makes all the sense in the world -- they care about their bottom line, not your weight. And these meds are expensive.

[Anonymous]

Anonymous wrote:I have not heard this. And to be honest, I'm not even sure where to look for this information?
I'm have BCBS basic and get wegovy for $25/month at local pharmacy. My pre-auth is valid until 10/2025.

In 2 months my monthly copay will go from $25 to $600+?? That doesn't seem possible

The 600-something is before coupon. But the max discount on the coupon is $225. So you are still looking at around $400-ish.

[Anonymous]

Does anyone know how much Mounjaro will be under BCBS Basic for 2025?

[Anonymous]

Anonymous wrote:Does anyone know how much Mounjaro will be under BCBS Basic for 2025?

I was wondering this too. I was playing around on the bcbs website and it seemed like Mounjaro would still be $25. Is that correct? I'm currently on Wegovy but my weight loss stalled out after loosing 45 pounds. My doctor prescribed Mounjaro but I was initially denied by bcbs although we're appealing. I still have a fair amount of weight to loose but I think my BMI may have just dropped below obese into overweight. Not sure if that was why I was denied but they recently reauthorized my Wegovy prescription so who knows. Very frustrating!

[Anonymous]

Anonymous wrote:Me either on bcbs. It’s absolutely terrible and hurting people’s health.

The rest of us don't want to pay the premium increases for all the people on these expensive drugs! Insurance is too damn expensive already!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Does anyone know how much Mounjaro will be under BCBS Basic for 2025?

I was wondering this too. I was playing around on the bcbs website and it seemed like Mounjaro would still be $25. Is that correct? I'm currently on Wegovy but my weight loss stalled out after loosing 45 pounds. My doctor prescribed Mounjaro but I was initially denied by bcbs although we're appealing. I still have a fair amount of weight to loose but I think my BMI may have just dropped below obese into overweight. Not sure if that was why I was denied but they recently reauthorized my Wegovy prescription so who knows. Very frustrating!

You have to be diabetic for mounjaro I think

[Anonymous]

Anonymous wrote:

Anonymous wrote:Does anyone know how much Mounjaro will be under BCBS Basic for 2025?

I was wondering this too. I was playing around on the bcbs website and it seemed like Mounjaro would still be $25. Is that correct? I'm currently on Wegovy but my weight loss stalled out after loosing 45 pounds. My doctor prescribed Mounjaro but I was initially denied by bcbs although we're appealing. I still have a fair amount of weight to loose but I think my BMI may have just dropped below obese into overweight. Not sure if that was why I was denied but they recently reauthorized my Wegovy prescription so who knows. Very frustrating!

I only see Wegovy and Saxenda listed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Me either on bcbs. It’s absolutely terrible and hurting people’s health.

The rest of us don't want to pay the premium increases for all the people on these expensive drugs! Insurance is too damn expensive already!

I don't want to pay for your mental health visits or your IVF. Work somewhere you get a high deductible health plan and see how you feel about the cost of insurance.

[Anonymous]

Wegovy costs $24 with our insurance for a month supply.

BCBC (feds btw)

[Anonymous]

Anonymous wrote:Wegovy costs $24 with our insurance for a month supply.

BCBC (feds btw)

You may want to read the first post in this thread. It costs that much NOW, but in 2025....

[Anonymous]

Anonymous wrote:Wegovy costs $24 with our insurance for a month supply.

BCBC (feds btw)

Right, but the point if this thread is that it is going to cost hundreds of dollars more in 2025 because it is being moved to Tier 3.