It's frequently a decision (to cover GLP 1s or no) from the employer.

https://www.healthsystemtracker.org/brief/perspectives-from-employers-on-the-costs-and-issues-associated-with-covering-glp-1-agonists-for-weight-loss/#Percentage%20of%20large%20firms%20whose%20largest%20plan%20includes%20coverage%20for%20GLP-1%20agonists%20when%20used%20primarily%20for%20weight%20loss,%20by%20firm%20size,%202025

I'm on Wegovy from my endocrinologist and have Carefirst. I was approved and pay $10 for 4 shots. No issues with refills.

I'm on Wegovy via CareFirst mail order. I got a prescription from my primary care doctor, and had to pay about $340/month at CVS for the 0.25, 0.50, and 1.5 mg doses. Then he sent the scrip for 1.7 mg to CareFirst Mail Order, which charges $250 for 3 month supply. Same for 2.4 mg if I move up.

Anonymous wrote:

Anonymous wrote:I tried this and it said that you had to join a separate 'Noom Med' program to get the meds, but they still weren't covered by CareFirst. Unless I'm doing something wrong? I do have a prescription for Wegovy, but Noom didn't ask about pre-existing prescriptions ....

I am on Wegovy via CareFirst/Noom. You need to make an appointment with a Noom provider and have a video call. They will be the new prescribed.
If you are having an issue, perhaps call CareFirst and have a representative talk and guide you through the signup.

Thank you!

I also have carefirst, and had a prescription from my Primary care doctor. I called Carefirst and they told me I had to join Noon Med. Once in the program, I got a prescription for metformin for 12 weeks, so I ended up signing up with Gobymeds and paid a 3-month compounded semiglutide. So far, I have lost 14 pounds in 8 weeks of treatment.

Anonymous wrote:I tried this and it said that you had to join a separate 'Noom Med' program to get the meds, but they still weren't covered by CareFirst. Unless I'm doing something wrong? I do have a prescription for Wegovy, but Noom didn't ask about pre-existing prescriptions ....

I am on Wegovy via CareFirst/Noom. You need to make an appointment with a Noom provider and have a video call. They will be the new prescribed.
If you are having an issue, perhaps call CareFirst and have a representative talk and guide you through the signup.

I have a small employer plan with Carefirst. Plan only allows GLP1s for diabetes but I was able to get approved for metabolic syndrome via multiple appeals. I’m on my third year of coverage.

I tried this and it said that you had to join a separate 'Noom Med' program to get the meds, but they still weren't covered by CareFirst. Unless I'm doing something wrong? I do have a prescription for Wegovy, but Noom didn't ask about pre-existing prescriptions ....

Call CareFirst; I just had this issue after being on for a few months. They are making folks join Noom (for free) and go through Noom to get an rx now.

Anonymous wrote:Can you swing getting through LillyDirect? It starts at 299/month for the initial dose.

Sorry, getting zepbound

Can you swing getting through LillyDirect? It starts at 299/month for the initial dose.

Anonymous wrote:Oh maybe ... is that without insurance? Can I ask where/how you get started with compounding it?

Yes without insurance. It was super simple to get a prescription. I uploaded a picture of me and put in my stats. There's lots of companies online that are similar, but I did Gobymeds. No issues. You have to be able to inject yourself (painless) and you use the same vial until it's gone.

Oh maybe ... is that without insurance? Can I ask where/how you get started with compounding it?

Could you do compounded? It's much cheaper now- I pay $350 for 3 months supply. I've seen it on sale for $300

Has anyone gotten their GLP1 covered through CareFirst? My doctor wrote me a prescription (I'm obese and have high cholesterol) and it was denied. She tried two different meds.