Price went up $50 this month with no warning - switching vendors — anyone have experience?

BariatricNurseD said:

My insurance denied my PA related to cost and coverage.

Same pattern here, and in the same order.

josh_phd_bmore said:

paige_pharma said: ...my insurance denied cost and coverage coverage because...

Insurance update relevant to cost and coverage: I just got my prior auth approved through UnitedHealthcare after 1 attempts.

What finally worked: a letter from my endocrinologist documenting BMI history (>3 years), failed diet attempts, comorbidities (PCOS + insulin resistance), and referencing the SELECT trial data.

If your PA keeps getting denied, don't give up. Request a peer-to-peer review between your doctor and the insurance medical director. That's what finally broke through for me.

josh_phd_bmore said:

paige_pharma said: ...my insurance denied cost and coverage coverage because...

Thank you for spelling out the reasoning rather than just the conclusion.

From the other side of the consultation, briefly.

Insurance coverage hack for cost and coverage: if your insurance denies brand Wegovy/Ozempic, consider these alternatives:

1. Prior authorization appeal with peer-to-peer review
2. Manufacturer copay card (for commercial insurance)
3. Patient assistance programs (Novo Nordisk, Eli Lilly)
4. Compounded medication from a 503B pharmacy ($149/month)
5. Canadian pharmacy (requires prescription, ~40-60% savings)

Don't let cost prevent access to effective treatment. There are options at every price point.

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