🍪 CompoundTalk uses cookies to improve your experience, analyze traffic, and personalize content. By continuing to use this site, you agree to our Cookie Policy.
Evidence-based GLP-1 & peptide discussion since 2023
ForumsInsurance & AccessHow is this not covered but my coworker gets Viagra no questions asked — my results so far Page 2

How is this not covered but my coworker gets Viagra no questions asked — my results so far

mike_nyc Tue, Mar 18, 2025 at 6:20 PM 14 replies 1,462 viewsPage 2 of 3
SandraNC_45
Member
312
1,345
Sep 2024
Charlotte, NC
Mar 18, 2025 at 9:10 PM#6

UPDATE: PA submitted yesterday, approved this morning. Less than 24 hours. I've been fighting for coverage for 14 months and it took less than a day once it was actually on formulary.

My new cost: $25/month with the Zepbound savings card stacking on top of my $50 specialty copay. Down from $549/month.

I'm going to save $6,288 this year. I genuinely cannot stop smiling.

46 23FranDenver, Dr.BariatricHTX, LindaRN_retired and 43 others
Reply Quote Save Share Report
NurseAsh_DET
Member
356
1,567
Sep 2024
Detroit, MI
Mar 18, 2025 at 9:27 PM#7

Love seeing this! And for anyone whose employer currently excludes GLP-1s, here's what you can do:

  1. Write a professional letter to your HR/benefits department requesting the exclusion be reviewed
  2. Include data on cost-effectiveness (JPMorgan's internal analysis showed net savings within 2 years of adding GLP-1 coverage)
  3. If your company does an annual benefits survey, advocate loudly for GLP-1 coverage
  4. Connect with other employees who want coverage — there's strength in numbers

Most employer plans renew annually. Changes requested now could take effect at the next plan year. Don't give up — the trend is clearly moving toward coverage.

Last edited: Mar 19, 2025 at 3:27 AM
28 6ricardo_MIA, BrianDallas92, labquiet_amy and 25 others
Reply Quote Save Share Report
MariaRD
Member
823
4,567
Jun 2024
New Mexico
Mar 18, 2025 at 9:44 PM#8

Pharmacy side update: we've been seeing a FLOOD of new Zepbound PA approvals through UHC this week. Our pharmacy filled more Zepbound prescriptions yesterday than in the entire previous month.

Heads up: there may be short-term supply pressure as demand spikes. If your pharmacy is out of stock, ask them to check other locations or consider the mail-order option through OptumRx (UHC's pharmacy benefit manager). Mail order has been more reliable for supply in my experience.

Also: make sure you enroll in the Zepbound savings card BEFORE your first fill at the new copay. It's free to enroll and could save you $25-50 per fill depending on your copay tier.

32 14maria_elpaso, anders_CPH, Dr.NutriCornell and 29 others
Reply Quote Save Share Report

Janoshik Analytical — Independent Testing

Trusted third-party HPLC & mass spectrometry analysis. Verify peptide purity with the lab the community relies on. Independent. Accurate. Transparent.

Verify Your Peptides
LipidDoc_ATL
Senior Member
1,123
5,678
Apr 2024
Atlanta, GA
Mar 18, 2025 at 10:01 PM#9

Happy for those of you who got coverage. Genuinely.

I took the advice and emailed our benefits team. They said they'll "bring it up at the Q3 benefits review." It's not a no. Small progress.

In the meantime, I'm staying on compounded tirzepatide at $199/month. It's working great for me (down 43 lbs) and honestly, even if my employer adds coverage tomorrow, I might stick with compounded. No PA hassles, no formulary changes, no pharmacy games. There's something to be said for simplicity.

40 2DebRD_ATL, KristenIndy, MarkLI_maint and 37 others
Reply Quote Save Share Report

Similar Threads

Prior authorization success: step-by-step guide with templates5 replies
Cigna now covering Zepbound — how I got approved13 replies
Appeal letter template — denied PA for GLP-1 medications4 replies
Mounjaro savings card — manufacturer program changes 202610 replies
Medicare Part D GLP-1 coverage — what's covered in 202610 replies
ForumsNewTrendingMembersAccount

Log In

Forgot password?
No account? Register