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ForumsMarketplace & ListingsTelehealth provider directory — need advice Page 2

Telehealth provider directory — need advice

sophie_paris Thu, May 30, 2024 at 7:00 PM 63 replies 3,076 viewsPage 2 of 13
anders_CPH
Senior Member
1,567
7,234
Feb 2024
Copenhagen, DK
Jun 1, 2024 at 6:39 AM#6
SarahChen_PharmD said:
sophie_paris said: ...my insurance denied cost and coverage coverage because...

I read this differently from SarahChen_PharmD, on substance rather than tone. 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.

Ask again with the specifics and you will get a better answer than this one.

24 19CryptoCarl, MariaRD, AussieAnna and 21 others
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dave_SLC
Member
345
1,567
Aug 2024
Salt Lake City, UT
Jun 1, 2024 at 8:54 PM#7
sophie_paris 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$52$82$0
Monthly Follow-up$32Included$52
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.

23 18NicoleRaleigh, james_edin, FranDenver and 20 others
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pete_nash
Member
312
1,345
Aug 2024
Nashville, TN
Jun 2, 2024 at 11:10 AM#8
anders_CPH said:
The affordability discussion here usually stops at individual tactics.

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.

22 17mike_mod, SarahChen_PharmD, sarah.morrison and 19 others
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JakeBK_lifts
Member
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Jul 2024
Brooklyn, NY
Jun 3, 2024 at 1:26 AM#9

A narrower follow-up, since the general answer is now clear:

What would you measure differently if you were starting again?

Last edited: Jun 3, 2024 at 3:26 AM
21 16kate.chem, DataDave, Dr.GutHealth and 18 others
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sophie_paris
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Nov 2024
Paris, FR
Jun 5, 2024 at 9:56 PM#10

Closing the loop on my own question.

Follow-up — getting the denial reason in writing was the step that mattered. It named the criterion, and the criterion was a document I already had.

3 1BethLabQueen, ChrisMacros, KetoKyle
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