Reply to Wegovy moving Tiers on BCBS FEP

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]Hey all. (I know we have bigger things on our minds right now w/ the new administration.)

I'm on Wegovy since last year. With the new year, they are increasing price - I'm ok with that. That said, they previously communicated it would be $125/month via mail-order.

I tried moving from CVS retail (now $643/mo) to CVS Caremark for a 3 months supply (which is $125/mo). Of course, CVS Caremark says they don't have stock and haven't in 6 months.

I'm willing to pay the $125/month copay but it seems horribly bait-and-switch to say "you must use CVS Caremark mail order" when it's been out of stock for months. We would have made a different choice at open enrollment if we knew it was going to be like this.

This seems like a way for them to say they are offering it but not really offer it.

With the popularity of BCBS FEP, has anyone else found way around this? (other than the tier exemptions?) Does the unavailability of CVS Caremark allow for us to get the $125 rate from CVS Retail? What's the magic here?

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I'm really glad the PP got Caremark to honor the mail rx rate, I hope that works. I left BCBS because it was clear last year that the mail rx option was not happening in real life. I really think it's fraud that they displayed it during open season as if it would be an option. [/quote]

Update: I will get my Wegovy for $0!!!  I am still in shock and will go get it tomorrow morning.  Thanks to persistence and this blog and my skill at firing off a gazillion written pleas and phone calls (hours!!!), I discovered that if your insurance plan advertises on your plan website after you login that your meds are available for $125 via its mail in pharmacy but you know that is a fraud as it has never been available or hasn’t been in forever (even without shortages), you can have your insurance company escalate your issue about false advertising to the mail in pharmacy provider—all with you in the phone—who will then do an override so you can get mail in pricing at your local pharmacy.  So with that I can get 1-3 Wegovy pens filled at one time for just $125.  And since I had already had my local pharmacy apply the manufacturer coupon to my account (removing up to $225 if your insurance covers the drug—which mine did but still left me with more than $400 per single pen), $125-225 equals ZERO!

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