Reply to Wegovy moving Tiers on BCBS FEP

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[quote=Anonymous][quote=Anonymous]What is the price difference? I pay $24.99 with coupon now, and I think it would be $60 withiut coupon. How much will it be in 2025?[/quote]

Hard to say for sure. But I have BCBS Fep Standard, and my Wegovy is moved from a Tier 2 to a Tier 3 drug, and will require 50% coinsurance. I'm not sure what that means ... because I will be responsible for 50% of ... what price? The retail price? Or a price negotiated by BCBS? I think someone posted on another forum somewhere that their eob had it listed at like $1300. So if that is the amount (which is a big if), then I'd be responsible for $650 per month in 2025. The coupon, which has brought it down to $24.99 for me as well, is not only limited to 13 fills, it is also limited in amount of savings -- specifically $225. So, subtract $225 from $650, and my out-of-pocket per month would be $425 per month in 2025.

But in order to get the 50% coinsurance from BCBS, I would have to go to a preferred pharmacy, which I haven't been doing because the coupon got it down to $24.99 no matter where I went ... so I have been going to Costco because they had it. So now I won't be able to do that. So that is a wrinkle (although this week, for the first time, Costco didn't have it either).

Bottom line for most of us regarding how much our Wegovy will cost in 2025 with FEP BCBS -- a lot more. [/quote]

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