I have UHC, BMI 35, pre diabetic, and UHC wouldn’t cover Ozempic. I believe I would have to have diabetes to get coverage.

Is your plan fully insured or self insured? What does your formulary cover?

Hmmm my dr prescribed Zepbound which UHC denied of course. I wonder if I should have tried Wegovy.

Using compounded Zepbound. I was feeling a little under the weather before I started last week so I can’t tell if I have side effects.

Anonymous wrote:Is it. Monthly prescription? What happens if you take it for a month, but it sis t available after that?

Amd if it’s approved only for a year, won’t you gain the weight back?

My doctor wrote prescriptions for the first three dosage levels, and I did not start until I knew I could get all three.
The higher doses are more readily available.
If I am losing sufficient weight, my insurance will renew the authorization every six months.

Anonymous wrote:Is it. Monthly prescription? What happens if you take it for a month, but it sis t available after that?

Amd if it’s approved only for a year, won’t you gain the weight back?

I think you can get some doses for three months. However, when you're starting out, they typically assess how you're doing and adjust dosage, so you'd want to do month-by-month if possible. And yes, it's a problem when you can't find it and have to stop. That's the reason, though, that (at least for a while, perhaps still) the company prioritized the higher doses rather than the starting doses-- so the people who'd already started wouldn't be disrupted.

Is it. Monthly prescription? What happens if you take it for a month, but it sis t available after that?

Amd if it’s approved only for a year, won’t you gain the weight back?

I’ve got prior authorization for wegovy from UHC but no pharmacy has wegovy. I hope to get it before the authorization expires this summer.

Thank you for this info. I assume Wegovy would be fine. I’ve taken Ozempic in the past but assume my doctor would be ok with either.

I have GEHA/United. I got Wegovy approved with an elevated BMI and another health condition. The process was a bit of a PITA. They denied the prior auth, then wouldn't accept an appeal from my doctor w/o a form from me authorizing my doctor to appeal. They told me this by a letter in the MAIL, in the year 2024. I called a couple of times to figure out what was going on/what I needed to do, and got different answers from different reps. Ultimately, they did approve it, and the approval is for a year so that's great!

*so

I think I got ozempic at pre diabetic levels (I have geha/united) but I also had high blood pressure regulated by meds. When there were shortages however, I could not get it for over a week. Once I was officially diabetic, I have never had to wait for it. I think I was originally given wegovy but could not get it due to shortages do was switched to ozempic.

Unless you are diabetic, you won’t get Ozempic approved, you will get Wegovy.

What has your experience been getting Ozempic covered by United Healthcare, especially if you're in the category of BMI of 27 plus with other health conditions?