Post by firedancer10288 on Oct 26, 2022 13:44:24 GMT -5
Two Questions- 1. Has anyone used GoodRx for their prescription? I saw they have the coupon right on their website. My local pharmacy has been a pain to deal with.
2. Do those of you taking mounjaro notice you stink? I don’t feel like I’m sweating anymore than usually, but my armpits are stinky! I’ve used the same deodorant for like 20 years. Maybe I need to change it up.
My doctor actually suggested looking into my insurance coverage for these drugs (not ozempic, because I have no hints of diabetes). I didn’t ask, she just mentioned it when I was complaining about how I’m doing diet and exercise with almost no results. I love that her reaction to me was “well, we know weight loss is more complex that just diet and exercise.”
Suffice to say, no insurance coverage. And she mentioned that the coupons are mostly gone. But I see people are still finding coupons. So maybe I’ll look around.
edit: well, she said I wouldn’t qualify for anything for diabetes, which looks like is ozempic and mounjaro. So I guess just Wegovy. And that one is no covered at all and the coupons look like it’s $200 off $1300. 🥴 Ozempic is the only one my insurance will cover.
My doctor actually suggested looking into my insurance coverage for these drugs (not ozempic, because I have no hints of diabetes). I didn’t ask, she just mentioned it when I was complaining about how I’m doing diet and exercise with almost no results. I love that her reaction to me was “well, we know weight loss is more complex that just diet and exercise.”
Suffice to say, no insurance coverage. And she mentioned that the coupons are mostly gone. But I see people are still finding coupons. So maybe I’ll look around.
edit: well, she said I wouldn’t qualify for anything for diabetes, which looks like is ozempic and mounjaro. So I guess just Wegovy. And that one is no covered at all and the coupons look like it’s $200 off $1300. 🥴 Ozempic is the only one my insurance will cover.
I'm here too - My PCP recommended Saxenda or Wegovy. My (usually great) insurance covers neither.
I reached out to Novo Nordisk about the coupon/savings cards. Their case consultant recommended trying for a prior authorization from my PCP to my insurance. They said they see about 50/50 success rate with that route. So I guess I'll try that next.
I was so hopeful for this medication and it's so frustrating to think a tool is out there to help. My insurance is happy to cover my blood pressure medication & specialist visits (and any other possible issues I could face down the line that are obesity related) but they won't throw money at something that could potentially prevent these issues.
My doctor actually suggested looking into my insurance coverage for these drugs (not ozempic, because I have no hints of diabetes). I didn’t ask, she just mentioned it when I was complaining about how I’m doing diet and exercise with almost no results. I love that her reaction to me was “well, we know weight loss is more complex that just diet and exercise.”
Suffice to say, no insurance coverage. And she mentioned that the coupons are mostly gone. But I see people are still finding coupons. So maybe I’ll look around.
edit: well, she said I wouldn’t qualify for anything for diabetes, which looks like is ozempic and mounjaro. So I guess just Wegovy. And that one is no covered at all and the coupons look like it’s $200 off $1300. 🥴 Ozempic is the only one my insurance will cover.
I'm here too - My PCP recommended Saxenda or Wegovy. My (usually great) insurance covers neither.
I reached out to Novo Nordisk about the coupon/savings cards. Their case consultant recommended trying for a prior authorization from my PCP to my insurance. They said they see about 50/50 success rate with that route. So I guess I'll try that next.
I was so hopeful for this medication and it's so frustrating to think a tool is out there to help. My insurance is happy to cover my blood pressure medication & specialist visits (and any other possible issues I could face down the line that are obesity related) but they won't throw money at something that could potentially prevent these issues.
I’m with you. My insurance pays for Lipitor with no copay. Which surprised me, but yeah. No copay because they know it reduces their costs overall. I’m actually due to see my cardiologist tomorrow, and he is the one that ordered me to lose weight. And I know some cardiologists will prescribe the weight loss meds (ok, I know one who does). But I’m hoping that between the PCP and cardiology, they can do something. And thanks for giving me another name to check (saxenda). Off to check my pharmacy benefits for that one.
edit - surprising no one, saxenda is not covered either. 🤬
My doctor actually suggested looking into my insurance coverage for these drugs (not ozempic, because I have no hints of diabetes). I didn’t ask, she just mentioned it when I was complaining about how I’m doing diet and exercise with almost no results. I love that her reaction to me was “well, we know weight loss is more complex that just diet and exercise.”
Suffice to say, no insurance coverage. And she mentioned that the coupons are mostly gone. But I see people are still finding coupons. So maybe I’ll look around.
edit: well, she said I wouldn’t qualify for anything for diabetes, which looks like is ozempic and mounjaro. So I guess just Wegovy. And that one is no covered at all and the coupons look like it’s $200 off $1300. 🥴 Ozempic is the only one my insurance will cover.
I’m confused because I believe Ozempic and Wygovy are the same med just at different doses. I don’t have diabetes, but am on Ozempic which was approved by my insurance. If your insurance will cover Ozempic, why not start there?
I'm here too - My PCP recommended Saxenda or Wegovy. My (usually great) insurance covers neither.
I reached out to Novo Nordisk about the coupon/savings cards. Their case consultant recommended trying for a prior authorization from my PCP to my insurance. They said they see about 50/50 success rate with that route. So I guess I'll try that next.
I was so hopeful for this medication and it's so frustrating to think a tool is out there to help. My insurance is happy to cover my blood pressure medication & specialist visits (and any other possible issues I could face down the line that are obesity related) but they won't throw money at something that could potentially prevent these issues.
I’m with you. My insurance pays for Lipitor with no copay. Which surprised me, but yeah. No copay because they know it reduces their costs overall. I’m actually due to see my cardiologist tomorrow, and he is the one that ordered me to lose weight. And I know some cardiologists will prescribe the weight loss meds (ok, I know one who does). But I’m hoping that between the PCP and cardiology, they can do something. And thanks for giving me another name to check (saxenda). Off to check my pharmacy benefits for that one.
edit - surprising no one, saxenda is not covered either. 🤬
Check out the Mounjaro subreddit. There are people there getting it covered by the savings cards who don't have T2.
My doctor actually suggested looking into my insurance coverage for these drugs (not ozempic, because I have no hints of diabetes). I didn’t ask, she just mentioned it when I was complaining about how I’m doing diet and exercise with almost no results. I love that her reaction to me was “well, we know weight loss is more complex that just diet and exercise.”
Suffice to say, no insurance coverage. And she mentioned that the coupons are mostly gone. But I see people are still finding coupons. So maybe I’ll look around.
edit: well, she said I wouldn’t qualify for anything for diabetes, which looks like is ozempic and mounjaro. So I guess just Wegovy. And that one is no covered at all and the coupons look like it’s $200 off $1300. 🥴 Ozempic is the only one my insurance will cover.
I’m confused because I believe Ozempic and Wygovy are the same med just at different doses. I don’t have diabetes, but am on Ozempic which was approved by my insurance. If your insurance will cover Ozempic, why not start there?
They are the same medication. Ozempic is approved for treatment of diabetes. Wegovy is approved for treatment of obesity.
Ozempic comes in strengths of 0.25, 0.5, 1, 2mg options Wegovy comes in strength options of 0.25, 0.5, 1, 1.7, 2.4mg.
Insurance will ultimately determine your coverage, option, and strength
I’m confused because I believe Ozempic and Wygovy are the same med just at different doses. I don’t have diabetes, but am on Ozempic which was approved by my insurance. If your insurance will cover Ozempic, why not start there?
They are the same medication. Ozempic is approved for treatment of diabetes. Wegovy is approved for treatment of obesity.
Ozempic comes in strengths of 0.25, 0.5, 1, 2mg options Wegovy comes in strength options of 0.25, 0.5, 1, 1.7, 2.4mg.
Insurance will ultimately determine your coverage, option, and strength
Also, be prepared for Oz to be out of stock. The Oz shortage was what prompted me to go the MJ route. My insurance doesn’t cover MJ, but it was $25 with the coupon the first month and $0 last month. I can’t figure out why it was $0 other than maybe it’s because I’ve met my deductible for the year. This is through the Amazon pharmacy.
I’m confused because I believe Ozempic and Wygovy are the same med just at different doses. I don’t have diabetes, but am on Ozempic which was approved by my insurance. If your insurance will cover Ozempic, why not start there?
They are the same medication. Ozempic is approved for treatment of diabetes. Wegovy is approved for treatment of obesity.
Ozempic comes in strengths of 0.25, 0.5, 1, 2mg options Wegovy comes in strength options of 0.25, 0.5, 1, 1.7, 2.4mg.
Insurance will ultimately determine your coverage, option, and strength
Oh ok. I don’t have diabetes, got prescribed Ozempic, and my insurance covers it (I pay $10 a pen). I was told even tho I don’t have diabetes, I have other risk factors that will allow the approval of Ozempic and apparently my insurance agreed.
FWIW, I did ask if maybe it was worth checking my A1C again. It’s been 3 years, and holy shit have I been through medical shit in the last 3 years. Last tested when I had my stroke, which lead to cancer, which lead to thyroid issues. I have blood work coming up in a few weeks. Not that I want it to be higher, but… My primary is not one to really go off label.
They are the same medication. Ozempic is approved for treatment of diabetes. Wegovy is approved for treatment of obesity.
Ozempic comes in strengths of 0.25, 0.5, 1, 2mg options Wegovy comes in strength options of 0.25, 0.5, 1, 1.7, 2.4mg.
Insurance will ultimately determine your coverage, option, and strength
Oh ok. I don’t have diabetes, got prescribed Ozempic, and my insurance covers it (I pay $10 a pen). I was told even tho I don’t have diabetes, I have other risk factors that will allow the approval of Ozempic and apparently my insurance agreed.
Right. We use medications off-label all the time. Point remains that Ozempic is approved for diabetes. Is it used for weight management? Absolutely. Will all insurance cover it for weight management? No.
Also, Ozempic and Wegovy are literally the exact same drug made by the SAME company. By approving and marketing Wegovy for obesity, it's ensuring Novo Nordisk makes even more money.
There are supply issues that have been making it difficult for patients to obtain the medication. When I was in the Middle East earlier this month I was going to stock up (it's super cheap and you can buy pretty much anything OTC) but they haven't had stock for over 3 months. NN hasn't been able to keep up with demand
Eil Lily manufactures Mounjaro, which is a separate drug (tirzepatide) and as of right now, only approved for DM2 treatment. Fast Track approval for treatment should be completed by next year when they have both of their study results completed.
Oh ok. I don’t have diabetes, got prescribed Ozempic, and my insurance covers it (I pay $10 a pen). I was told even tho I don’t have diabetes, I have other risk factors that will allow the approval of Ozempic and apparently my insurance agreed.
Right. We use medications off-label all the time. Point remains that Ozempic is approved for diabetes. Is it used for weight management? Absolutely. Will all insurance cover it for weight management? No.
Got it. I was trying to understand PP’s post saying, “Ozempic is the only one my insurance will cover.” If that’s the case, I’d take that! Now if your doctor doesn’t want to prescribe it, that’s another issue. Good luck PP. I’ve had success on Ozempic, and I hope you get what you need.
Right. We use medications off-label all the time. Point remains that Ozempic is approved for diabetes. Is it used for weight management? Absolutely. Will all insurance cover it for weight management? No.
Got it. I was trying to understand PP’s post saying, “Ozempic is the only one my insurance will cover.” If that’s the case, I’d take that! Now if your doctor doesn’t want to prescribe it, that’s another issue. Good luck PP. I’ve had success on Ozempic, and I hope you get what you need.
Yes. That is correct in what I meant. They will only pay of ozempic, and my primary doctor said no, you don’t have diabetes. But, I’m deep diving and there is something about increased risk of cardiovascular issues. Which I *do* have (in fact, I’m on lipitor profolactically, not because i of elevated cholesterol). So, I think I need to work with cardio when I go in tomorrow (which is why I am looking into it today. I’ve been sitting on it for a couple weeks).
whee Ruby, just let all your medical info hang out 😂
edit: oooooooo. Weigh loss medications are covered under my health plan starting Jan 2023. So, I suppose maybe I just wait it out 2 months and maybe the shortage will be better by then?
Right. We use medications off-label all the time. Point remains that Ozempic is approved for diabetes. Is it used for weight management? Absolutely. Will all insurance cover it for weight management? No.
Got it. I was trying to understand PP’s post saying, “Ozempic is the only one my insurance will cover.” If that’s the case, I’d take that! Now if your doctor doesn’t want to prescribe it, that’s another issue. Good luck PP. I’ve had success on Ozempic, and I hope you get what you need.
one thing to note; if you do get your PCP to prescribe this for diabetes, which you do not have, it will be listed on your medical record as having diabetes and could become an issue in the future for various things like switching health insurance, life insurance, etc.
I've been seeing articles pop up about how tiktok has been spreading word on the medications now and it's making the shortage worse for diabetics that need it.
Got it. I was trying to understand PP’s post saying, “Ozempic is the only one my insurance will cover.” If that’s the case, I’d take that! Now if your doctor doesn’t want to prescribe it, that’s another issue. Good luck PP. I’ve had success on Ozempic, and I hope you get what you need.
one thing to note; if you do get your PCP to prescribe this for diabetes, which you do not have, it will be listed on your medical record as having diabetes and could become an issue in the future for various things like switching health insurance, life insurance, etc.
I absolutely do *not* want someone to list me as diabetic when I haven’t been diagnosed. If off label was possible and didn’t contribute to shortage, then I’d maybe consider it. Hell, I’m pissed at my cardiologist who put in high blood pressure from one reading taken while the nurse was rapid fire questioning me.
I saw my endocrinologist today and she both gave me a sample and Rx for mounjaro and was also like, welp lets do some bloodwork and hope you are diabetic because in the spring the cost of this is going up to 1K a month. So, fingers crossed I'm diabetic? We talked a lot about how it makes no sense, because I'm PRE-diabetic so like, if this gets my levels back to normal its not like suddenly my body is going to be like, oh that insulin resistance? That's not a problem any more. She said it's been a real issue with her patients who end up back in "normal" ranges with it or other drugs and insurance companies are like, you're cured!
I’ve been bumped up to the 40 dose. My blood sugars are so much better! Instead of 135 fasting, I’m getting 104 or lower.
I’m not sure I like to higher dose, it’s making my GI tract super slow, and it wasn’t fast to begin with. I’m starting to incorporate more foods to help me go. Lol. Breakfast is oatmeal with berries, and some pears on the side. Lunch is tuna with rice cakes (I just like the crunch and flavor of them) and mandarin oranges. Snacks are grapes and maybe nuts. Dinner is just what everyone else eats, with smaller portions and extra veggies.
I’m down about 31 pounds now though. My BP is better too. I’m happy with results overall, and glad my health is doing better.
I just did my forth 7.5mg shot of Monjauro. I'm down 25lbs since I started at the end of Aug! I've barely had any side effects on the 7.5 so I'm staying on that dosage. Alpha put in my refill last thur and I haven't heard from my pharmacy yet that its ready so I'm getting nervous. Hoping it will still work with the $25.
I also wanted to share my experience here and thank everyone for adding to the conversation. I started Mounjaro at the end of August after learning about it from this post.
This med has been life changing for me. I'm down about 20lbs, unsure of the exact number because I was too scared to step on a scale prior to, or even the first week or so after starting it. Today I weighed myself and my BMI finally moved from obese to overweight.
The changes to my face, body and mood have been incredible. I ended up buying some Eli Lily stock because this really feels like a miracle to me. Now when I look in a mirror the reflection matches what I see in my head, I have more energy, I've almost completely stopped the negative self talk that was on a constant loop in my mind.
I did see my primary care doctor for a physical a few weeks after getting the Mounjaro prescription through Alpha, just so I could get some labs done so I'd have a baseline to compare to in the future. My doctor prescribed Welbutrin for some some ongoing stress that I haven't been coping with very well, and I know Welbutrin can also have a weight-loss effect. Between these two meds I feel more like myself than I have in years and there's zero chance I would have even gone to the doctor if it wasn't for this thread and Mounjaro.
Sorry to throw this question in here, but I've never really dealt with various health insurance options (been on DH's for 11 years) and I'm trying to think through something.
I am currently covered through DH's health insurance. His employer does not cover any weight loss meds - specifically the Wegovy or Saxenda that my PCP recommended. Without insurance, the monthly RX would be $1000-$2000/month.
It's open enrollment at my job. I just checked and my employer would cover these same meds for closer to $25/month. Is it crazy to sign up for the cheapest plan possible ($35/biweekly) to cover just me? If I keep DH's insurance and sign up for insurance through my company, would this considered secondary insurance?
Am I missing something here? It seems to make sense to pay an extra $70 out of my pay + $25 for the RX for a total cost of <$100ish/month to use a med that would otherwise cost $1000+. Of course, I'll be stuck with this additional coverage for the next 12 months until next open enrollment, so I want to be sure it's a good decision.
Sorry to throw this question in here, but I've never really dealt with various health insurance options (been on DH's for 11 years) and I'm trying to think through something.
I am currently covered through DH's health insurance. His employer does not cover any weight loss meds - specifically the Wegovy or Saxenda that my PCP recommended. Without insurance, the monthly RX would be $1000-$2000/month.
It's open enrollment at my job. I just checked and my employer would cover these same meds for closer to $25/month. Is it crazy to sign up for the cheapest plan possible ($35/biweekly) to cover just me? If I keep DH's insurance and sign up for insurance through my company, would this considered secondary insurance?
Am I missing something here? It seems to make sense to pay an extra $70 out of my pay + $25 for the RX for a total cost of <$100ish/month to use a med that would otherwise cost $1000+. Of course, I'll be stuck with this additional coverage for the next 12 months until next open enrollment, so I want to be sure it's a good decision.
Mounjaro has a $25/coupon (4 weeks) that you just have to have commercial insurance to use. Insurance denies it and then you use the coupon, $25.
Sorry to throw this question in here, but I've never really dealt with various health insurance options (been on DH's for 11 years) and I'm trying to think through something.
I am currently covered through DH's health insurance. His employer does not cover any weight loss meds - specifically the Wegovy or Saxenda that my PCP recommended. Without insurance, the monthly RX would be $1000-$2000/month.
It's open enrollment at my job. I just checked and my employer would cover these same meds for closer to $25/month. Is it crazy to sign up for the cheapest plan possible ($35/biweekly) to cover just me? If I keep DH's insurance and sign up for insurance through my company, would this considered secondary insurance?
Am I missing something here? It seems to make sense to pay an extra $70 out of my pay + $25 for the RX for a total cost of <$100ish/month to use a med that would otherwise cost $1000+. Of course, I'll be stuck with this additional coverage for the next 12 months until next open enrollment, so I want to be sure it's a good decision.
Mounjaro has a $25/coupon (4 weeks) that you just have to have commercial insurance to use. Insurance denies it and then you use the coupon, $25.
Double check this. I've been hearing that the coupon is now good for diabetics only.
Mounjaro has a $25/coupon (4 weeks) that you just have to have commercial insurance to use. Insurance denies it and then you use the coupon, $25.
Double check this. I've been hearing that the coupon is now good for diabetics only.
Seems to depend on the pharmacy. My friend filled it at Kroger last night with no issue. I think CVS and Walgreens are mostly requiring the diagnosis code.
Mounjaro has a $25/coupon (4 weeks) that you just have to have commercial insurance to use. Insurance denies it and then you use the coupon, $25.
Double check this. I've been hearing that the coupon is now good for diabetics only.
Yeah, if you go to the manufacturer’s website for the savings card, you need to confirm that you’re diabetic. I’m not diabetic (at this point) and I don’t feel comfortable lying. I was exploring Wegovy and Saxenda based on my PCP’s recommendation.
Double check this. I've been hearing that the coupon is now good for diabetics only.
Seems to depend on the pharmacy. My friend filled it at Kroger last night with no issue. I think CVS and Walgreens are mostly requiring the diagnosis code.
Agree! My insurance was covering it so I didn't have to use the coupon at the beginning. But then when all the insurances added to their formulary they stopped covering but my pharmacy has had no issue/questions applying the coupon. I use Safeway. I figure they might eventually catch on - IDK but for now I'm happy to be able to still get it.
Double check this. I've been hearing that the coupon is now good for diabetics only.
Yeah, if you go to the manufacturer’s website for the savings card, you need to confirm that you’re diabetic. I’m not diabetic (at this point) and I don’t feel comfortable lying. I was exploring Wegovy and Saxenda based on my PCP’s recommendation.
I think the doctor was the one who provided the coupon though. I’d assume they have them from before the change.