Anyone on Medicare been prescribed Zepbound for sleep apnea

Perhaps the clinical presentation is that someone's abdomen is large and pushes up against the diaphragm and causes sleep apnea.....perhaps Zepbound was to encourage weight loss to improve the apnea.

I also have Wellcare and they denied it several times but I had my endocrinologist as well as my GP send in narratives and I also had a back up with my pulmonary doctor who did the sleep apnea test but it turned out I didn't need him to send in a narrative. Just be persistent and hopefully they will relent.

I am not sure why losing weight will help with sleep apnea but most doctor's think being even a little overweight can contribute to having that medical condition. I did get approval from my insurance to get the Zepbound which I was very surprised that they allowed. It was rejected several times prior as the medication is expensive but for some reason they approved it this time so I just started on the Zepbound last week. We will see what happens. Thank you for responding.

I’m 73 and have WellCare part D.
For 5mg the pharmacy (Costco) is billing $452 , and Eli Lilly direct would be $499.
Are you on Medicare, and did WellCare cover the entire cost?

I was prescribed Zepbound for Idiopathic Hypersomnia with Moderate OSA. But I have been paying out of pocket for this medication.

Yes, I am on Medicare and am taking Zepbound for sleep apnea. ( covered by Medicare) I have been on it for several months and have lost about 15 pounds - I am overweight. I also have PMR and am very pleased that this Rx has helped my inflammation tremendously. I am moving better, sleeping better - better oxygen level. I have no significant side effects. I don’t know if I will ever be able to stop the cpap machine, but am thankful for the weight loss and increased energy.

@maryro I am on Medicare and I signed up for the Medicare plan with my prescription insurance so I only have a $2,000.00 out of pocket per year for my prescriptions. I didn't sign up for that plan until August of this year so that $2,000.00 will be divided into the remaining months of the year and that will be what I will pay per month. All of my covered prescriptions go towards that $2,000.00 maximum so I will hit it this month. Wellcare did not cover the total cost. The first month I bought it direct from Lilly and paid $400.00 for 2.5mg. The second month I got it through Wellcare and it was around $680.00 The third month it was the same but from now on it will be 100% covered. If you can sign up for that Medicare program it is worth it. Next year it will be much better for me as I will be starting in January and my prescription costs will be divided throughout the whole year. I hope this helps.