Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Does United Health Care cover Ozempic?

OMG. You guys are such idiots. You need to talk to your HR. They negotiate coverages with insurance companies. If your insurance plan doesn't cover it, it's because your employer said no.

You are the idiot. Some of us are self-employed and must buy health insurance through the exchange.

And we're all idiots to enrich health insurance executives rather than having nationalized health plans.

Which would also be an enormous incentive to do more preventive care like weight loss medication.

Lol at calling weight loss medication preventive care. Preventive care would be to not get to a place of needing this medication in the first place.

Anonymous wrote:

Anonymous wrote:I am overweight but not pre-diabetic and my insurance covers Ozempic, which my doctor prescribes for weight loss.

You are taking Wegovy.

Yes, they are the same drug.

My prescription is for Ozempic and I use Ozempic, not Wegovy.

My doctor doesn’t medicate for pre-diabetes. Maybe it’s not considered necessary? Or maybe they only cover metaforfin? It’s cheaper.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Does United Health Care cover Ozempic?

OMG. You guys are such idiots. You need to talk to your HR. They negotiate coverages with insurance companies. If your insurance plan doesn't cover it, it's because your employer said no.

You are the idiot. Some of us are self-employed and must buy health insurance through the exchange.

And some of us have small group plans. Those employers can't negotiate from what I understand.

Anonymous wrote:

Anonymous wrote:I am overweight but not pre-diabetic and my insurance covers Ozempic, which my doctor prescribes for weight loss.

You are taking Wegovy.

No, PP is likely taking Ozempic. I also am taking Ozempic purely for weight loss and insurance covers it.

I’m also on Carefirst and I was able to get covered for Ozempic.

The caveat is that I had to have completed step therapy by using metformin first. I had labs and have no kidney issues so Dr was good with prescribing metformin. Once I filled the metformin I had no additional requirements for Ozempic.

I chose to instead use Mounjaro to treat my obesity and metabolic syndrome. It took several attempts to get it approved and insurance wanted me on Ozempic instead.

Please check your policy and ask your insurance for a copy of your prescription formulary or look it up on the portal. My formulary clearly stated that for Ozempic, a prior authorization (PA) was required if step therapy was not done.

New policies are coming out though regarding Ozempic and similar medicines where access will be restricted to type 2 diabetics primarily. You can still file a request for a PA but it will be harder to get approved

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Does United Health Care cover Ozempic?

OMG. You guys are such idiots. You need to talk to your HR. They negotiate coverages with insurance companies. If your insurance plan doesn't cover it, it's because your employer said no.

You are the idiot. Some of us are self-employed and must buy health insurance through the exchange.

And we're all idiots to enrich health insurance executives rather than having nationalized health plans.

Which would also be an enormous incentive to do more preventive care like weight loss medication.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Does United Health Care cover Ozempic?

OMG. You guys are such idiots. You need to talk to your HR. They negotiate coverages with insurance companies. If your insurance plan doesn't cover it, it's because your employer said no.

You are the idiot. Some of us are self-employed and must buy health insurance through the exchange.

And we're all idiots to enrich health insurance executives rather than having nationalized health plans.

Anonymous wrote:

Anonymous wrote:Does United Health Care cover Ozempic?

OMG. You guys are such idiots. You need to talk to your HR. They negotiate coverages with insurance companies. If your insurance plan doesn't cover it, it's because your employer said no.

You are the idiot. Some of us are self-employed and must buy health insurance through the exchange.

Supposedly the federal plans cover it for pre diabetics. My Carefirst plan does not.

Anonymous wrote:Does United Health Care cover Ozempic?

OMG. You guys are such idiots. You need to talk to your HR. They negotiate coverages with insurance companies. If your insurance plan doesn't cover it, it's because your employer said no.

Anonymous wrote:OP here. I guess I just have crap insurance (Carefirst).

It's not the insurance plan, it's the plan your employer negotiated with the insurance company. I had a Cigna PPO under my previous employer and they covered wegovy. I have a Cigna PPO under my new employer and they do not cover Wegovy.

Anonymous wrote:I am overweight but not pre-diabetic and my insurance covers Ozempic, which my doctor prescribes for weight loss.

You are taking Wegovy.

FEHB requires Tx of obesity. That varies between plansFEHB is push them to be covered like any medication for chronic conditions. For BMI 25-30 plus one weight related illness (hypertension, high cholesterol, pre diabetes) or BMI 30+ with no co-morbid condition, Wegovy is covered. On the standard plan, it’s about $360 a month, but there is a one year, $250 per month coupon. So, $110. Once I’m on a stable dosage, o AP an mail order for a $90 co-pay (I can’t tell if that’s 28 or 84 day supply).

Pre-authorization took less than 2 days.

We pay roughly $900/month for our employer sponsored CareFirst plan. I am pre-diabetic and the plan won’t cover Wegovy or any of the others for me. It’s much too expensive for us to afford out of pocket.

Irony- my spouse is a health care provider and this is the insurance that is offered to employees. It’s terrible. Our out of network deductible is 20k!