So that people like the one that ask the question further understand, my personal situation is that I’m on Medicare (over 65) and by law my Part D cannot cover weight loss medication. Nor can any supplemental/gap plan, or any Advantage plan, as they are basically insurance companies working for the government. I also am not eligible for discounts that were offered by the manufacturers. I did pay full price ($1100/month) for several months, and then went to a reputable Telehealth company that uses reputable compounding pharmacy. For Membership and medication that is about $400/mo. Huge difference- still not an insignificant amount each month for sure, but for my improved health well worth it. I am using it only for obesity/ weight management . Most PCPs and even endocrinologists, and obesity MDs with focused practices have not “accepted” compounding pharmacies. I will stay with compounded tirzepatide for the remainder of of my journey as it makes the most financial sense for me. And a bonus - there are no shortages. ❤

I never take a thing for granted when it comes to Mounjaro. Thankful for my amazing pharmacy and my insurance coverage. It is constantly in the back of my mind to have a Plan B in case the worst happens. It is saving my life in more ways than just weight loss and getting my Diabetes under control. Hopefully once the "fad" of it wears off and the next big thing comes along it is easier for everyone, no matter the reason you need it.

I asked my Dr last year for GLP1 med. I was pre-diabetic. BMI 43+ severe sleep Apnea. Cardiac issues. 3 times denied. Dec she put me on Metformin. In March 2024 dr said I am now t2 Diabetic. So I asked her to send it in again. 2 prior Authorizations and finally approved for mounjaro.

I feel extremely fortunate here in the UK diabetic Patients like myself receive Mounjaro for free from our National Health Service. It literally saved my life I really feel so badly about people going through this awful situation in the States. Its not fair people who need this medication should be able to Access it fairly

I am blessed but I wait for the shoe to drop. First a shortage, now insurance gets to tell my doctor what’s best for me! Aaaaurrrgh! Thank you for letting insurance know they are a piece of our health solutions. Act like we mean something to you! WE ARE HIMANS! Care for us!!!!! I AM NOT A NUMBER!!!! Thank you so much Alli!!!!!

Thank you for this clear and honest information. I never had any support for insurance, and my PCP will not write to a compounding pharmacy. They see it as risky. I pay the $550 with coupon, but I am looking for a compounding pharmacy I can trust.

They can and they will.Insurance don't care.great info.So thankful.

I am very grateful to have coverage. If they change the rules, no way can I afford it. Not even compound. I'm grateful and wish everybody good luck.

I wish Oprah would do another special, on these meds needing to be more affordable for people.

I’m in Australia 🇦🇺. I started on Ozempic . Private insurance won’t pay for it . But here it’s only $200 a month. My doctor won’t prescribe it anymore. So has put me on Saxenda which is $400 a month. Almost at my goal weight and currently cutting my dosage down to save money and see if I can maintain my weight. My doctor is happy to prescribe Wegovy because it actually for weight loss. But not available here yet. And Mounjaro here is soo expensive. Anyone that is saying this is the easy way out, is crazy. Your videos are always so informative 💜

I wonder if the person trying to approved prior authorization is tired and just keep denying. Or they were told to deny them.

🧡🧡 very well explained, ty!

I went to my pcp for high blood pressure , high cholesterol and obesity, he put me on blood pressure the same day then told me diet and excercise can help get my blood pressure down, Guess what? Blood pressure meds free but no help for obesity. I had to go thru telehealth for help, The doctor even offered to take over my bp meds and send a monitor to login daily, go figure 🙄🤦🏾‍♀️

I lost over 70# on Mounjaro but now the prior auth is not getting done. I am now gaining back the weight. I have a commercial plan and paid $550 for my last box of Mounjaro 15mg.. so is paying 550 for 60mg total a good price??

I actually have the same question very early into the my journey. I was just not very familiar with telehealth companies in general.😊

I was just talking to a co worker and she said her doctor prescribed her Zepbound and the insurance came back and said she would need to be on a diet plan for 6 months. It looks like they are starting that process now for new prescription and this is BCBS Texas so now I’m wondering if it’s going to be BCBS all around the board not just BCBS Michigan. Her doctor did send back that she has been dieting for a year.

hi Alie

What video was it that you talked about the telehealth company?

I really think doctors need to be more selective about who they prescribe too. I really think for awhile they were prescribing to people who don't qualify. You should either be diabetic or have a BMI over 30 or a BMI of 28 with a comorbidity period. When everyone and there whole family is on an expensive medication with no restrictions this was guaranteed to happen. I pay out of pocket and I'm fortunate that I can afford to pay out of pocket. The only benefit is I can get mounjaro or zepbound whatever available.