Getting coverage for GLP-1 agonist medication

Posted by michellejack1 @michellejack1, Oct 19, 2023

Fatty Liver
Asthma
Sleep apnea
Obese
Deceased parent diabetes
3 current siblings with diabetes
Why is insurance only covering 12 injections of wegovy? I hate insurance companies. Do I need doctors to write a letter? Very frustrating

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If you have diabetes, why aren't you getting Ozempic? That drug has been approved for diabetes and your insurance company may cover all of those? Good luck.

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I haven’t been diagnosed with diabetes.

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My apologies...I see it is your family members. If it makes you feel any better, my insurance did okay the prescription, but it is out of stock in every pharmacy around me.

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Mostly in ky it’s the starting dose, that’s out of stock! I think there’s more to it, that we’re not hearing about! So why would you have the other in stock? If my insurance would have came through for me, I wouldn’t need starting dose. Oh well

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I understand your disappointment. I was hoping that the Wegovy would be successful, so I wouldn't have to get bariatric surgery. In my area, it is also the starting dose that is out of stock. I do have a friend who has been taking Ozempic for diabetes control, but hasn't had it for two weeks because it is out if stock (he was using the larger dose.) I pray the company who manufactures Semiglutide can start keeping up with the demand.

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Insurance co generally approve 12 weeks at a time

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@michellejack1

Mostly in ky it’s the starting dose, that’s out of stock! I think there’s more to it, that we’re not hearing about! So why would you have the other in stock? If my insurance would have came through for me, I wouldn’t need starting dose. Oh well

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The only doses of Wegovy available in US right now are the 1.7 and 2.4. This is because Norvo stopped making the smaller dose pens so doctors would stop putting new patients on it so Norvo could provide doses to patients already taking it. This will stay that way until they can catch up. (I work in pharmacy). Also some insurance companies only approve 90 days supply at a time (84 days in case of a weekly shot) of weight loss medication so they can see if it is helping you. If nothing happens within first 3 months then they have a reason to deny a refill. It is expensive, about $1300 per month, so insurance wanto to make sure that first 3 months you are giving it you all to lose with the shot, diet changes and exercise.

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I appreciate your comment. I know most of facts you gave me. However I lost 19 pounds in 3 months, had a coupon through pharmaceutical. So I’m sure insurance had a break, I’m sure it didn’t cost them 1300.00.
I think insurance companies should and still do a communication regarding what cost is and how long they’re going to cover it! Not until I was done with injections, did they say that’s it!! Not covered anymore this calendar year! Stupidity! Now next year you can get 12 more injections. Well let’s see. I can take one a month?

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I tried Ozempic and I was nauseous and vomited daily for 3 weeks. I don’t know if that would’ve passed, but I couldn’t take it. I did lose about 15 pounds, although I was taking it for diabetes.

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I’m sure everyone is different, but I heard drink or eat protein about 30 min before injection and give it somewhere other than stomach .

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