Susan Maria Leach
Glow Weight Loss
glowweightloss.com
Founder of Bariatric Eating
Author Before and After - Living & Eating Well After Weight Loss Surgery (HarperCollins Publishers)
If you have a diagnosis of Type 2 diabetes (NOT just pre diabetic), one of these two more popular and recent brand name medications are likely to be covered by your Health Insurance. So if you have Health Insurance let’s begin there!
Remember that Ozempic (which is Semaglutide) and Mounjaro (which is Tirzepatide) were developed and tested for Type 2 Diabetes management.
So, if you have Type 2 Diabetes, check with your insurance carrier as to whether or not either or both Ozempic or Mounjaro are approved by your plan and if so what you have to do to have it covered, how much of the cost is covered with consideration to your deductible, copays and maximum out of pocket.
Here is a list of specific insurance questions to help you. Call the 800 number on your insurance card and ask the following:
1. Does my insurance plan cover Ozempic and or Mounjaro since I have Type 2 Diabetes? (If you legit have Type 2 diabetes as there is no faking it)
2. If so, are step therapies using other medications required first or can I start with my doctors recommendation of Ozempic or Wegovy?
3. Are there any specific steps my doctor needs to take before my coverage can be approved, such as submitting a Prior Authorization (known as a PA) form?
4. What is my insurance plan’s deductible (the amount you need to pay in healthcare costs before your insurance plan starts paying)
5. Are you able to tell me how much I will pay?
Many people who are covered by insurance for Ozempic and Wegovy are required to pay full price until they have met their deductible. Fortunately, both drug companies who made the meds, have coupons on their website that help defray costs. This is how some people are able to pay $25 a month for their medications.
Here are links to both drug websites where you can scroll to find the button for ‘Get Savings Card’ to ‘Save on Ozempic’ and follow the instructions for a coupon to save to your phone or print out for your pharmacy. We have discovered that Walmart and CVS are more familiar with the use of the codes on the coupons in order to apply them. Some smaller local pharmacies will go the extra mile to help as well.
Click to open in new window:
Ozempic website
Mounjaro website
Your old familiar bariatric best friends have a new group on Facebook to help people who are stuck in Bariatric Surgery Mode find their way out of the hole! Read some of the blog posts to give yourself a base and then ask away.
Click to Join GLOW Bariatric Chat for Zepbound™, Mounjaro ™, Ozempic™, & Wegovy™ on Facebook.
