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ForumsInsurance & AccessTricare GLP-1 coverage for military families — 12 month update Page 3

Tricare GLP-1 coverage for military families — 12 month update

wendy_avl Fri, Jul 11, 2025 at 2:23 PM 46 replies 2,274 viewsPage 3 of 10
Dr.CardioMD
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Jul 13, 2025 at 6:15 AM#11
VanRx_Mike said:
PeptideChemSF said: ...my insurance denied cost and coverage coverage because...

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$67$97$0
Monthly Follow-up$47Included$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.

3 3kim_atl_prep, sarah_TO, wendy_avl
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NurseAsh_DET
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Jul 13, 2025 at 11:35 PM#12
JakeSmashed95 said:
Dr.PeteFamMed said: ...compounded vs brand cost and coverage...

That reframing is the part I needed.

Last edited: Jul 14, 2025 at 5:35 AM
2 2ricardo_MIA, BrianDallas92
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pete_nash
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Jul 14, 2025 at 4:56 PM#13
VanRx_Mike said:
PeptideChemSF said: ...my insurance denied cost and coverage coverage because...

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

  • Groceries: SAVED $247/month (eating less)
  • Restaurants: SAVED $177/month (fewer meals out)
  • Alcohol: SAVED $127/month (stopped drinking)
  • Life insurance: Premium REDUCED by $37/month (lower BMI)
  • Copays: SAVED $77/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.

1 1mike_mod
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bri_stats
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Jul 15, 2025 at 10:17 AM#14
wendy_avl 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…
wendy_avl said:
...regarding the discontinuation data for cost and coverage...

I want to reframe the discontinuation narrative. We don't say "insulin fails because blood sugar rises when you stop it." We don't say "antihypertensives fail because BP goes up without them."

Why do we apply different logic to anti-obesity medications? The answer is stigma. We still, unconsciously, believe obesity is about willpower rather than biology. The discontinuation data actually PROVES it's a chronic biological condition requiring ongoing treatment.

This reframing isn't semantic — it has implications for insurance coverage, treatment duration, and patient expectations.

50 0JessicaM_2024, TomFromTexas, mike.trainer_LA and 47 others
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mike_mod
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Jul 16, 2025 at 3:38 AM#15

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. Tagging this one for the weekly digest.

49 24PurityPaulOR, MaxMetOK, MounjBrad and 46 others
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