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Discontinuation of Mounjaro
I have been doing excellent on Mounjaro. When I began my A1C was 10.8 and now has dropped to 5.4 after being on it for a year. I also have heart issues and ckd. This year I am having to change insurance due to mine leaving our state. There are only two plans available for my area and doctors. Unfortunately upon research I have learned that I will be dropped from Mounjaro because the a1c of 5.4 is no longer considered diabetic. So, praise God that is much better. Now, I am terrified that the a1c will skyrocket again when it's discontinued in January. I am also concerned that the 25 pounds I lost will return. Is there any way to keep the a1c under control and the weight off when this is stopped? Previously I was on Metformin, Jardiance, Insulin and Glipizide before starting Mounjaro. Any advice from anyone?
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@happilyalive
I don't know of any medication that was not covered. I get a bi-yearly osteoporosis injection and it costs $458 and I don't pay for that. When you're a senior you pay $4.11 cents per prescription if you have 2 or 3 medications you will pay $12.33(4×$4.11). So price is negligible. We're lucky to live in a country that doesn't bankrupt you dealing with your health. I really do feel for you in your situation.
@happilyalive
Glad to hear you got back on Mounjaro. Some insurance companies just say no automatically but can be reasoned with - it's not even reason, really, they just filter out claims by making you jump through hoops.
Even going back up to A1C of 6.3 for a few months is not terrible. Were you still on those other drugs, or just doing it by diet and exercise?
Asking for a friend ...
Hi carbcounter - The way that I kept it at 6.3 and not letting it go higher is that I also have chronic kidney disease and stick to an extremely strict renal diet. Since I am a caregiver 24/7 and 365 days then I am constantly moving. Unfortunately my insurance company had also taken away my Jardiance so that also contributed to more damage while off of it. My doctors gave me nothing to help keep it low while we were battling through the appeals process. So, all of my meds to control the A1c were gone for the five weeks along with a blood pressure med that I needed. My body complained in every possible way. At the end of the fourth month everything was back. I just think though that there is absolutely no reason to get people onto meds to only yank them away through insurance companies who want to give what they believe the patient needs instead of what their doctors prescribe. It can definitely be frustrating beyond measure.
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1 ReactionHi straiton - Thank you for letting me know how it works in Canada. I'm very glad that you get your bi-yearly osteoporosis injection for the $4.11 cents per prescription. That must help tremendously with finances. Are the taxes reasonable in your country to help pay for the healthcare? Have a great day and thanks for your response.
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Has anyone had denials from HeathSpring?
We pay a certain amount off our salary(everybody pays the same amount) every pay cheque. So that pays for our Healthcare, eg: giving birth in hospital: no bill, any heart surgery: no bill. That means no stress having to pay thousands of dollars for any surgery or hospital stay. We might have to wait a wee bit longer than you guys in the US but I can live with that.
Thanks for your reply. I used to think that Canadians waited longer for surgery but after my husband's recent triple bypass I'm not certain anymore. By the time that all of the testing was done, prior authorizations were given and the go ahead from insurance it took a little over three months from diagnosis to surgery date. It beats his dying but the wait is excruciating when life is hanging in the balance. Are emergency surgeries and hospitalizations done immediately if needed? Either way, I'm thankful that your insurance is good. Have a blessed day.