Dr.ObesityLA said:Insurance coverage hack for cost and coverage: if your insurance denies brand Wegovy/Ozempic, consider these alternatives: Prior authorization appeal…
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The affordability discussion here usually stops at individual tactics. At list price this class is out of reach for most of the people who would benefit, and no amount of appeal strategy changes that — it is a pricing problem wearing a paperwork costume.
I would rather be corrected than agreed with, if it comes to it.
CanadaChris said:The list price and the price I actually pay differ by a factor of six depending on which of four routes I use, and none of that is transparent from…
My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.
BenResearch_OR said:The affordability discussion here usually stops at individual tactics.
Financial impact of cost and coverage weight loss beyond medication cost:
- Groceries: SAVED $245/month (eating less)
- Restaurants: SAVED $155/month (fewer meals out)
- Alcohol: SAVED $105/month (stopped drinking)
- Life insurance: Premium REDUCED by $35/month (lower BMI)
- Copays: SAVED $65/month (fewer BP/cholesterol meds)
Net impact after medication cost: approximately BREAKING EVEN. The medication pays for itself through reduced food spending and healthcare costs. This surprised me.
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Browse GL BiochemOne thing that is still open after A1cHero_PHX’s answer:
How long did you give it before you decided it was working?
OP back with an update, since a thread like this is useless without one.
Update: approved on the third attempt after a peer-to-peer. Nothing about my case changed; only who was doing the talking.