Reply to Prescription for Wegovy but $1500?!?!

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[quote=Anonymous][quote=Anonymous]My dr sent in a prescription for Wegovy for me but Cigna is denying coverage and it’s over $1500 a month. I have PCOS and have been on metformin for years with no luck. Any suggestions? Thanks so much.[/quote]

Denying coverage for what reason? What does your pharmacy formulary say- is it covered, requires PA, or covers a different Rx? If it says requires prior auth then your doctor needs to submit a PA stating that youve tried other meds. Just metformin may not be enough. This is why it is helpful to know if other meds with similar mechanisms are covered- trulicity, ozempic, mounjaro, etc.

Cigna and UHC were the first two insurances to cover mounjaro according to my endo. I have UHC and Mounjaro is covered with Prior auth.

I would also see if your A1C qualifies you for pre-diabetes, diabetes II. You also need to know the ICD code that your provider is using to submit the medication. Sometimes insurance will only cover medications for specific codes. [/quote]

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