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ForumsInsurance & AccessEmployer wellness programs covering GLP-1 — a growing trend

Employer wellness programs covering GLP-1 — a growing trend

amy_econ_NJ Fri, May 29, 2026 at 3:33 AM 10 replies 446 viewsPage 1 of 2
amy_econ_NJ
Member
567
2,567
May 2024
Princeton, NJ
May 29, 2026 at 3:33 AM#1

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 the outside.

What I am trying to establish is what actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work.

Not looking for reassurance. Looking for the part I have got wrong.

46 16Dr.SportsMedIN, amy_econ_NJ, bbq_ray_KC and 43 others
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Dr.LipidDallas
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14,567
Dec 2023
Dallas, TX
May 29, 2026 at 6:02 AM#2
amy_econ_NJ 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…

Telehealth prescriber review for cost and coverage: I've used 3 different telehealth platforms to get my GLP-1 prescription. Comparison:

FeaturePlatform APlatform BPlatform C
Initial Consult$70$80$0
Monthly Follow-up$30Included$55
Prescription SpeedSame day24-48 hoursSame day
Lab MonitoringRequiredOptionalRequired

I settled on the one that required labs — it shows they care about safety, not just prescribing volume.

Last edited: May 29, 2026 at 8:02 AM
45 15wei_SG, cory_ATX, lori_vegas and 42 others
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Dr.PathRoch
Member
456
2,123
Jun 2024
Rochester, MN
May 29, 2026 at 8:32 AM#3
Dr.LipidDallas said:
Telehealth prescriber review for cost and coverage: I've used 3 different telehealth platforms to get my GLP-1 prescription.

Financial impact of cost and coverage weight loss beyond medication cost:

  • Groceries: SAVED $206/month (eating less)
  • Restaurants: SAVED $156/month (fewer meals out)
  • Alcohol: SAVED $106/month (stopped drinking)
  • Life insurance: Premium REDUCED by $36/month (lower BMI)
  • Copays: SAVED $76/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.

44 14WendyG_ATL, SaraMom3, Dr.MetabolicMD and 41 others
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paige_pharma
Member
289
1,234
Sep 2024
Omaha, NE
May 29, 2026 at 11:02 AM#4
amy_econ_NJ 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…

Can confirm. Same sequence, different timescale. Posting only so the count is not one.

Last edited: May 29, 2026 at 12:02 PM
43 13lisa_labSD, adam_van, Dr.SurgeonPGH and 40 others
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julia.endo
Senior Member
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9,012
Feb 2024
Cincinnati, OH
May 30, 2026 at 2:00 AM#5

Clinical perspective, offered as context rather than as advice.

My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.

Last edited: May 30, 2026 at 8:00 AM
42 12chris_chi24, tampaLisa73, KarenAZ_mom and 39 others
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