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Getting insurance to cover weight loss medications is awful. Anyone have any tips for someone who can’t afford to pay for the online ones?

A MyObesityTeam Member asked a question in GLP-1s group 💭
Guilford, CT
March 7
 · 
Be the first to react
A MyObesityTeam Member

My insurance refuses to cover anything GLP-related so I have to pay out of pocket. Luckily, I am in a situation where I can.

May 19
A MyObesityTeam Member

Insurance companies are truly out of control. Offering as little as possible to consumers. It's an enraging situation

April 18
A MyObesityTeam Member

Obesity! The disease no one cares about! I couldn’t get my insurance to pay and I’m categorized class 3 obesity, BMI 59 with comorbidity factors of hypertension, asthma, high cholesterol, sleep apnea and more. The Pill, WEGOVY cost less than the injections $299. A month with manufacturer coupon and I pay it myself. I would like a class action lawsuit against insurance companies for discriminating against obesity!!! Good luck on your journey and fight.

April 17
MyObesityTeam

How can you get insurance to cover weight loss medications when you can't afford to pay out-of-pocket?

Getting insurance coverage for weight loss medications can definitely be frustrating, but there are several strategies that might help:

Work with your doctor to strengthen your case
- Ask for a Letter of Medical Show Full Answer

How can you get insurance to cover weight loss medications when you can't afford to pay out-of-pocket?

Getting insurance coverage for weight loss medications can definitely be frustrating, but there are several strategies that might help:

Work with your doctor to strengthen your case:
- Ask for a Letter of Medical Necessity that explains why the medication is essential for your health
- Document all your previous weight-loss attempts (diet programs, exercise routines, other medications)
- Make sure your doctor includes your medical history and any related health conditions like high blood pressure or type 2 diabetes

Check your insurance coverage carefully:
- Review your plan's formulary to see which GLP-1 medications are covered
- Some plans cover medications like Wegovy, Saxenda, or Zepbound if you meet specific criteria (usually BMI of 30+ or BMI of 27+ with related health conditions)
- If one medication isn't covered, ask your doctor about alternatives that might be

If you're denied coverage:
- Appeal the decision with additional documentation from your doctor
- Provide detailed explanations of medical necessity Look for financial assistance programs:
- Check directly with drug manufacturers for patient assistance programs or copay cards
- The manufacturer of medications like Ozempic (Novo Nordisk) offers savings cards that can help reduce costs
- Search online for charitable patient assistance foundations

Consider other options:
- Ask your doctor about other FDA-approved weight loss medications that might be more affordable
- Speak with a patient advocate who can help navigate insurance issues
- If possible, compare different insurance plans during open enrollment for better medication coverage

A MyObesityTeam member emphasized the importance of not ignoring these financial challenges and working with someone who can help advocate for you, whether that's a family member, friend, or professional advocate.

March 7

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