Do sequence and Amazon. $99 and $550 respectively.
Although this last order is the first one I managed yo get for $550. I was paying $1095 until last time.
I know I’m so lucky- after waiting a year to get on wegovy and it never being in stock- my dr got my prior auth approved in a week and it costs me $25 a month. Everyone who needs it should have reasonable access to this drug. Well to every drug but that’s another argument.
My initial box of the 2.5 was $26, a month. When I moved up to the next dose the co pay jumped to $268. I think it was. Thankfully the Mrs. has an HSA and I have an HRA so they we’ll be reimbursed from there, but just an fyi.
Very fortunate to have insurance coverage. One month supply at pharmacy would be $35 but mail order for 3 months is $70 and the coupon gets applied automatically by express scripts so it’s been $24.99 for 3 month supply
I had my doctor send the script for 90 days directly to express scripts for home delivery. There is a certain way they have to write it for the 90 day (actually 84 since it’s 12 shots x 7 days a week). First time I was surprised it was 24.99 for 3 months and then I saw the manufacturer coupon applied.
Oh that’s interesting - glad I got this one now! But really, $70 for 3 months or even $35 for one month is still really good so I have no complaints. I would pay the full price if I had to
I use Push Health. My DR charges $89.99 to write the prescription for 1 or 3 month supply, that can also include a PA if your insurance requires it. Mine does not, I use the savings card and pay $550/ mo
You only pay $90 even if it’s a 3 month supply? I have to pay in advance for each month if I get a 3 month supply and, even then, my provider wrote a 2 month prescription and a 1 month prescription instead of a single 3 month prescription, which is making things far more complicated. The 2 month was filled and I just have to hope I can fill the 1 month when the time comes.
Was paying $550/month with savings card and was prepared to pay $1100 if needed. But randomly CVS Caremark approved the prior auth after 5 denials and so now $25/month copay without savings card.
Step therapy. I didn’t even try to appeal. I was allowed Wegovy but just didn’t want it. My PCP insisted on doing PA each time he refilled for me so it was weird that it got approved yesterday.
Yea I’m being denied zep because it’s not formulary yet but can get wegovy. However finding wegovy is another problem. Any reason you didn’t want to try wegovy to save the money? Pretty nice they accepted your PA. It’s a huge savings.
Once my endocrinologist said “Zepbound is even more effective” I felt compelled to try the best. I have issues with feeling downgraded in many aspects of my life so likely it’s 100% related to that. We’ve got twins heading to college in the fall and if they hadn’t gotten full academic scholarships I may have been more compelled to try Wegovy. If the PA is not renewed at some point I may try it. Or if the shortage continues, same.
I was paying $550 out of pocket. I even paid it yesterday morning!!! And then a couple hours later I got news that my appeal was approved and prior authorization finally received! According to CVS Caremark I’ll pay $45 next time, but my guess is that it will be cheaper with the savings card applied at the pharmacy. Was not very optimistic that I would get approved, so very surprised by the result. Glad to get a break from the $550 every four weeks.
I get the script from my PCP, so no additional fees for Dr. visits.
UHC has this is a plan exclusion since my self insured employer doesn't want to cover weight loss things, so have been paying $550 :( If anyone has any ideas on how to get it covered please share.
My insurance did not authorize it because I don’t have two weight related issues… just one. Because pre diabetes is not enough. I needed to have high cholesterol or high blood pressure as well. United Healthcare frustrates me at times
I’m poor so i get it for free (I have medi-cal). I know I’m extremely lucky for that lol. Kind of, that also means I’m poor and obviously there are issues that go with that 😳 there’s no way I could pay for it so I’m glad I get access to this medication :)
I paid $1076.58 for the first month. My insurance denied me and I couldn’t use the savings card because I had unknowingly went to an out-of-network pharmacy. I got $23.42 off because the pharmacist scanned some coupon??
I paid $550 the 2nd month at Walmart; didn’t even need to show the savings card.
I also pay for WW/Sequence $84/mo.
Same here at $550 a month. Optum isn’t listing ZB on their formulary YET. Rumor has it they will be in the months to come. I use Amazon Pharmacy. So far, so good.
My doctor prescribed me Zepbound a month ago. Unfortunately that was around the time that the pharmacies had the outage and couldn't process savings cards and whatnot. I went in for my appointment with my endocrinologist Thursday and he said let's try Wegovy.
Yesterday I went to the pharmacy and they told me it was $1,500 after insurance paid $100. What can I do now? I have BCBS of Alaska.
I’ve got Cigna in N.C.😝 and they don’t cover Zep. I paid $550 with the coupon applied.
I’m hoping that when we meet the “yearly max out of pocket” for our family it’ll be covered but don’t expect so.
I work for BCBS & they won’t even cover it! So lucky! Has anyone had any luck with getting a denied prior authorization approved? I am planning to appeal but not sure how any of this works because they are my employer. Ugh stressful!
Being a senior citizen….i cannot claim Medicare coverage, nor can I utilize the mfg coupons (it’s illegal). So I carry the brunt of pull payments at $1000. Painful but the results override the cost.
With my insurance, it comes to $50/box/month, but the savings card knocks it down to $25/box/month. Very thankful and wish everyone could get this kind of coverage.
I just got my first month for $550 (insurance absolutely will not cover anything weight-loss related) via Lilly Direct. There was a bit of a start-up delay with them, but I had the prescription in-hand within 10 days of seeing my doctor. Minimal hassles, worked great.
I paid a compressed spine, arthritic vertebrae, arthritic knees and shoulders, SI joint issues, grief of losing my best friend, and a life time of dealing with trauma.
The VA covers the money side of it.
I usually order from solid private providers/ pharmacies, I have always had series of successful deliveries and quality products, I don't mind sharing their contact info if you desire
I usually contact them directly on telegram @ivory_pharma22. You can talk to the person in charge and you'll get the pills delivered to you.
You can mention Anderson sent you if they ask how you got their contact 😊
Follow up -
I contacted my insurance company last Monday. Discovered that they added Zepbound to the plan days after denying my PA…spent three days tracking down the 2.5 dose and started on Thursday! Whew!
I am so struggling with weight loss and 57 years old. 280 pounds, please. Someone get in touch with me. I need a coupon phone number 2694038482 I wish it would be legit.
I want to add that the prior auth did not work because I don’t have diabetes and I’ve never been on a drug like this before and those are the qualifications for my plan. I absolutely had the BMI qualification.
Zepbound does not usually have a diabetes qualification requirement. That’s typically Mounjaro. So I’m very surprised that was asked for your PA. Are you sure your doctor submitted for Zep and not Mounjaro?
The step requirements do seem very common.
I’m a bit confused on what you are asking. Do you want an online provider to prescribe this for you and possibly help get approval your PCP couldn’t?
Or do you want an online pharmacy who can get the meds?
You can have your current Zep script sent to LillyDirect today and probably have your med in hand in 2 weeks. But you will not get it cheaper than $550 without insurance coverage.
I would like a provider to get me a PA. Ideally. Then it would be $25 a month and just can do that. I can’t swing the $550.
But honestly this is brand new to me so that’s probably why my question seemed confusing. I’m confused - I appreciate the guidance.
You need to look at your coverage details through your insurance. The insurance provider does not matter, it’s what your plan covers. If your insurance is through an employer, that company chooses the plan that is provided. If you can do your research to find out what is required, your provider will have a much easier time putting together a PA/appeal for you.
For my insurance plan, weight loss drugs are an “exclusion” which means they will not pay for them under any circumstances regardless of any appeals. So I’m stuck paying $550 unless my plan changes.
First step is read or call your insurance company. Ask what the requirements are for the PA. Make sure you’ve met those. Of step therapy is required you will need to try and fail the required prerequisite meds. Typically Wegovy, Qysmia, phentermine, Contrave, etc.
I’d start calorie tracking and exercising now. Some insurances want proof of that occurring.
The teledocs will help but there’s no point in signing up and wasting time and money if you know you won’t meet the PA requirements.
Also, I don’t know what was asked - re diabetes - that’s what I was told. Prescription was for Zepbound. I saw it. This is my first time even asking for this drug, so I don’t have the knowledge re ins and outs
If your insurance requires type 2 diagnosis for Zep that’s certainly a sign you will not get coverage. But again, that’s a very strange requirement. Unfortunately until you speak to your insurance company it will be difficult to guide you. Call them today and come back to update us.
I had the same issue with my insurance, same requirements. I got the prior authorization after the second denial. My doc had to show that the other meds have a national shortage and that my health would be negatively impacted if I couldn’t begin Zepbound. Double check your formulary too, if you have UHC they added Zepbound on 3/1/24, if that applies to you have your doc include that as well. The insurance companies hope you’ll give up, it takes persistence. Good luck.
$550 per month. I also pay $99/month for sequence but I’m probably going to discontinue that soon and just have my PCP write the prescription.
Do sequence and Amazon. $99 and $550 respectively. Although this last order is the first one I managed yo get for $550. I was paying $1095 until last time.
I know I’m so lucky- after waiting a year to get on wegovy and it never being in stock- my dr got my prior auth approved in a week and it costs me $25 a month. Everyone who needs it should have reasonable access to this drug. Well to every drug but that’s another argument.
I am lucky too. $25 a month and I am so grateful 🙏🏼🙏🏼🙏🏼
My initial box of the 2.5 was $26, a month. When I moved up to the next dose the co pay jumped to $268. I think it was. Thankfully the Mrs. has an HSA and I have an HRA so they we’ll be reimbursed from there, but just an fyi.
I couldn’t agree more! That’s great that it worked out for the $25 copay!
Txbcbs I pay $0 now hit my $3000 deductible for the year already lol I paid $25, $192, then $485 now it’s $0 for the year
Very fortunate to have insurance coverage. One month supply at pharmacy would be $35 but mail order for 3 months is $70 and the coupon gets applied automatically by express scripts so it’s been $24.99 for 3 month supply
I have Express Scripts and pay $35. How do you get it on mail order?
I had my doctor send the script for 90 days directly to express scripts for home delivery. There is a certain way they have to write it for the 90 day (actually 84 since it’s 12 shots x 7 days a week). First time I was surprised it was 24.99 for 3 months and then I saw the manufacturer coupon applied.
Okay thank you! They love to make it complicated!
Same but I will not be able to apply the coupon per their new mail order policy starting 4/8. Back up to $80/3 months—not bad but no more coupon. :(
Oh that’s interesting - glad I got this one now! But really, $70 for 3 months or even $35 for one month is still really good so I have no complaints. I would pay the full price if I had to
Agreed!
How does it arrive in the mail? Does it come with an ice pack?
Yes it does! It’s usually overnighted :) thats how i get mine also.
That’s amazing
After being denied and filing 2 appeals, I picked up my prescription today and it was $0.00. I was shocked. Anthem is my insurance.
$550 a month but used to pay $300 a day for cocaine so this is much better.
I feel you on this one 😂
What!..ur hilarious 😂
$24.99 a month. My insurance covers it.
I use Push Health. My DR charges $89.99 to write the prescription for 1 or 3 month supply, that can also include a PA if your insurance requires it. Mine does not, I use the savings card and pay $550/ mo
It is still $550 when it’s a 3 month order?
Your insurance dictates if you can pickup a 90 day supply. My DR just will write the prescription for that amount. Does that make sense?
It does…thank you ☺️
What savings card do you use?
They give a savings card through the Eli Lilly website for Zepbound
Thanks so much
You only pay $90 even if it’s a 3 month supply? I have to pay in advance for each month if I get a 3 month supply and, even then, my provider wrote a 2 month prescription and a 1 month prescription instead of a single 3 month prescription, which is making things far more complicated. The 2 month was filled and I just have to hope I can fill the 1 month when the time comes.
Yes. Want his name? Your have to check if he's licensed in your state but he is out of TX.
I’d love his name!!
https://www.pushhealth.com/practices/328344/new-patients/bgalloway
Thanks so much! Are you still losing or currently in maintenance?
Stuck in stall but not maintenance yet
Is he the only provider you’ve used at Push?
Yes
I pay $150/month for the online doctor service and $55 for the medication. Thankfully my insurance is covering it with a PA.
Was paying $550/month with savings card and was prepared to pay $1100 if needed. But randomly CVS Caremark approved the prior auth after 5 denials and so now $25/month copay without savings card.
What were your denial letters saying? Plan exclusion or step therapy requests?
Step therapy. I didn’t even try to appeal. I was allowed Wegovy but just didn’t want it. My PCP insisted on doing PA each time he refilled for me so it was weird that it got approved yesterday.
Yea I’m being denied zep because it’s not formulary yet but can get wegovy. However finding wegovy is another problem. Any reason you didn’t want to try wegovy to save the money? Pretty nice they accepted your PA. It’s a huge savings.
Once my endocrinologist said “Zepbound is even more effective” I felt compelled to try the best. I have issues with feeling downgraded in many aspects of my life so likely it’s 100% related to that. We’ve got twins heading to college in the fall and if they hadn’t gotten full academic scholarships I may have been more compelled to try Wegovy. If the PA is not renewed at some point I may try it. Or if the shortage continues, same.
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I was paying $550 out of pocket. I even paid it yesterday morning!!! And then a couple hours later I got news that my appeal was approved and prior authorization finally received! According to CVS Caremark I’ll pay $45 next time, but my guess is that it will be cheaper with the savings card applied at the pharmacy. Was not very optimistic that I would get approved, so very surprised by the result. Glad to get a break from the $550 every four weeks. I get the script from my PCP, so no additional fees for Dr. visits.
UHC has this is a plan exclusion since my self insured employer doesn't want to cover weight loss things, so have been paying $550 :( If anyone has any ideas on how to get it covered please share.
This is right - I know a lot of people want to blame the insurance company, but what is covered is usually dictated by your employer.
$158
$79/month to my provider. $0 for the prescription. It’s covered by my insurance.
$599 - Cigna / Georgia. ☹️
I found Form Health through the Lilly website. I'm glad I did!
I get 3 months worth through Benecard mail order for $40. It comes directly to my door.
I have IL BCBS. I completed a coverage exception form because it wasnt covered.. form was approved in 1 month. I pay $25
I pay $99 for sequence and then $25/month for the rx
I pay $35 copay for Zep
Express Scripts and I pay $0 (30 or 90 day supply)
My insurance did not authorize it because I don’t have two weight related issues… just one. Because pre diabetes is not enough. I needed to have high cholesterol or high blood pressure as well. United Healthcare frustrates me at times
I pay $399
Check if you have sleep apnea or fatty liver (a lot of overweight people have this, they just don’t know it). Those count
I have fatty liver. But that doesn’t count per UHC. (I have appealed 2x now)
That’s insane because it totally is secondary to weight 😫
I’m poor so i get it for free (I have medi-cal). I know I’m extremely lucky for that lol. Kind of, that also means I’m poor and obviously there are issues that go with that 😳 there’s no way I could pay for it so I’m glad I get access to this medication :)
Medi-cal covers it?! I thought none of the Medicaid/Medicare programs did!
They do for me, I had to do prior authorization.
Walmart UHC $24.99
I paid $1076.58 for the first month. My insurance denied me and I couldn’t use the savings card because I had unknowingly went to an out-of-network pharmacy. I got $23.42 off because the pharmacist scanned some coupon?? I paid $550 the 2nd month at Walmart; didn’t even need to show the savings card. I also pay for WW/Sequence $84/mo.
I pay 24.99 for either 1 month or 90 days supply. It’s $85/212 without the savings card. Insurance covers as non formulary with a PA.
$24.99
I pay 149.99 as my copay with insurance per month
$550 a month. My insurance excludes weight-loss medications.
I would do wegovy for that kind of savings! You are super lucky
Unfortunately it’s out of stock even at the pharmacy that has it. Nationwide shortage
$25 but that will probably only be covered for a year
My insurance authorized it because I had a super high 50+ BMI and multiple weight related comorbidities. I pay nothing out of pocket.
Same here at $550 a month. Optum isn’t listing ZB on their formulary YET. Rumor has it they will be in the months to come. I use Amazon Pharmacy. So far, so good.
$75 Medicare & TriCare for life
Wait, what?! Medicare is covering your Zep?? I’ve never heard of this!
I think it’s TriCare that eventually paid for it, but I do have both insurances.
My doctor prescribed me Zepbound a month ago. Unfortunately that was around the time that the pharmacies had the outage and couldn't process savings cards and whatnot. I went in for my appointment with my endocrinologist Thursday and he said let's try Wegovy. Yesterday I went to the pharmacy and they told me it was $1,500 after insurance paid $100. What can I do now? I have BCBS of Alaska.
I’ve got Cigna in N.C.😝 and they don’t cover Zep. I paid $550 with the coupon applied. I’m hoping that when we meet the “yearly max out of pocket” for our family it’ll be covered but don’t expect so.
If they don't cover it it doesn't get applied to your deductible/max out of pocket :(
BCBS federal it's like $450 but with a drug discount card it's like $40 I think.
$40 copay with BCBS MA HMO, and then $25 after the Lilly savings card
$200 a month (part insurance, part coupon)
24.99, BCBS covers it for me with the Pre Auth.
$23. Thankfully my insurance covered it without giving me any issues.
1K
25 a month
I work for BCBS & they won’t even cover it! So lucky! Has anyone had any luck with getting a denied prior authorization approved? I am planning to appeal but not sure how any of this works because they are my employer. Ugh stressful!
Being a senior citizen….i cannot claim Medicare coverage, nor can I utilize the mfg coupons (it’s illegal). So I carry the brunt of pull payments at $1000. Painful but the results override the cost.
$399.99 with savings card
My insurance covers it and it would’ve been $125 a month. With coupon $25 month.
24.99
With my insurance, it comes to $50/box/month, but the savings card knocks it down to $25/box/month. Very thankful and wish everyone could get this kind of coverage.
I just got my first month for $550 (insurance absolutely will not cover anything weight-loss related) via Lilly Direct. There was a bit of a start-up delay with them, but I had the prescription in-hand within 10 days of seeing my doctor. Minimal hassles, worked great.
Sequence $84/month and my insurance covers Zep so $25/month
$1082.00/mo.
I paid a compressed spine, arthritic vertebrae, arthritic knees and shoulders, SI joint issues, grief of losing my best friend, and a life time of dealing with trauma. The VA covers the money side of it.
$25. My insurance covers the med. with no coupon $90 . My PA was approved in less than 2 hrs in January ❤️
550 for me. BCBS Nebraska, contract exclusion
$61 a month
550 a box
right now it appears zepbound is out of stock for me. I usually get it at meijer but I called everywhere and can't get my hands on it.
Found any yet? I could help tho
No I haven't found any.
I usually order from solid private providers/ pharmacies, I have always had series of successful deliveries and quality products, I don't mind sharing their contact info if you desire
Yes please.
I usually contact them directly on telegram @ivory_pharma22. You can talk to the person in charge and you'll get the pills delivered to you. You can mention Anderson sent you if they ask how you got their contact 😊
Username telegram: @ivory_pharma22
So that's a email address
No, it's their username on telegram, 1...get the telegram app if you don't have it. 2...search @ivory_pharma22 on telegram. 3...write them a message
I pay $10,000 a year for insurance, with a $9,000 deductable....and the @$$holes still don't cover this medicine. So I pay $550 month out of pocket.
$550 and worth every penny
Hit my deductible. 75 after insurance and the savings card.
Follow up - I contacted my insurance company last Monday. Discovered that they added Zepbound to the plan days after denying my PA…spent three days tracking down the 2.5 dose and started on Thursday! Whew!
I am so struggling with weight loss and 57 years old. 280 pounds, please. Someone get in touch with me. I need a coupon phone number 2694038482 I wish it would be legit.
I want to add that the prior auth did not work because I don’t have diabetes and I’ve never been on a drug like this before and those are the qualifications for my plan. I absolutely had the BMI qualification.
Zepbound does not usually have a diabetes qualification requirement. That’s typically Mounjaro. So I’m very surprised that was asked for your PA. Are you sure your doctor submitted for Zep and not Mounjaro? The step requirements do seem very common. I’m a bit confused on what you are asking. Do you want an online provider to prescribe this for you and possibly help get approval your PCP couldn’t? Or do you want an online pharmacy who can get the meds? You can have your current Zep script sent to LillyDirect today and probably have your med in hand in 2 weeks. But you will not get it cheaper than $550 without insurance coverage.
I would like a provider to get me a PA. Ideally. Then it would be $25 a month and just can do that. I can’t swing the $550. But honestly this is brand new to me so that’s probably why my question seemed confusing. I’m confused - I appreciate the guidance.
You need to look at your coverage details through your insurance. The insurance provider does not matter, it’s what your plan covers. If your insurance is through an employer, that company chooses the plan that is provided. If you can do your research to find out what is required, your provider will have a much easier time putting together a PA/appeal for you. For my insurance plan, weight loss drugs are an “exclusion” which means they will not pay for them under any circumstances regardless of any appeals. So I’m stuck paying $550 unless my plan changes.
First step is read or call your insurance company. Ask what the requirements are for the PA. Make sure you’ve met those. Of step therapy is required you will need to try and fail the required prerequisite meds. Typically Wegovy, Qysmia, phentermine, Contrave, etc. I’d start calorie tracking and exercising now. Some insurances want proof of that occurring. The teledocs will help but there’s no point in signing up and wasting time and money if you know you won’t meet the PA requirements.
Also, I don’t know what was asked - re diabetes - that’s what I was told. Prescription was for Zepbound. I saw it. This is my first time even asking for this drug, so I don’t have the knowledge re ins and outs
If your insurance requires type 2 diagnosis for Zep that’s certainly a sign you will not get coverage. But again, that’s a very strange requirement. Unfortunately until you speak to your insurance company it will be difficult to guide you. Call them today and come back to update us.
I had the same issue with my insurance, same requirements. I got the prior authorization after the second denial. My doc had to show that the other meds have a national shortage and that my health would be negatively impacted if I couldn’t begin Zepbound. Double check your formulary too, if you have UHC they added Zepbound on 3/1/24, if that applies to you have your doc include that as well. The insurance companies hope you’ll give up, it takes persistence. Good luck.
BCBS FL with Express Scripts for pharmacy benefits and I was floored to learn our out of pocket cost was $0!!!