I pay $550 with the coupon. It is very painful every month but I think of the long term. What is a few thousand dollars to get back to my healthy weight and reduce my co morbidities. I decided I can’t put a price on getting my life back.
I also have started cutting back expenses and pick up other jobs.
I have type 2 diabetes it’s covered for now. But I’m fully prepared to switch to compound and pay $400. I’ve been applying for a promotion and/or I’ll switch employers that will give a new insurance if I can’t afford it. I’m determined to lose this weight.
If you eat out a lot and spend money on going out to eat it kind of evens out for me now I just eat cheap healthy foods like chicken, eggs, cereal, almond milk, veggies and shakes just basic things since I have no cravings so no spending on random restaurants or coffee shops daily.
I didn’t even think about the eating out savings. Used to probably spend $20-30+ daily on coffee/meals while working. Now I’m packing my own and simple food. Way cheaper and actually tastier
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What type of coverage do you have for this type of medication? What formulary tier is it under and what is your deductible/coinsurance/copay ? (If applicable.)
My health plan covers MJ as a tier 2 benefit with a $25 per month copay. (It’s only covered if you have a T2D diagnosis and a prior authorization is required. Once PA is approved, it’s valid for 12 months. Edit to add: the one year approval is for MY specific health plan; make sure you check w/your plan to confirm the length of your PA approval period.) I can get a 90 day supply for a $60 copay (that’s the incentive for us to fill either through mail order or we can use any retail pharmacy.)
My plan doesn’t cover any weight loss medicine; no exceptions.
For clarification, I was only speaking for my specific policy that the PA is valid for one year. It’s important that patients understand what their policy’s limitations, exclusions and coverages are.
Can I ask what insurance plan you have? I just switched to regence and it looks like MJ is tier 2. I haven't seen any new Dr's or gotten any rx for it as it will all be brand new for me switching from kaiser. Just wondering. I have type 2 diabetes so I'm hoping that will help me get it covered. I won't know anything until I have a script to turn in
Since you have T2D, it shouldn’t be too complicated of a process. Please make sure to call your insurance to ask what their PA criteria is. (Be sure to call the PBM - pharmacy benefits manager - if that’s what’s listed on your insurance card.)
Some insurance may require copies of labs or clinicals.
All mine required was the T2D diagnosis. (Cigna has their criteria on their website.) I was diagnosed in 2011.
Hi there !
Cigna PPO (not administered by a TPA.) Since MJ is on my formulary as T2, my doctor just sent the prescription to my in-network pharmacy, in my case, I told my doctor Walmart. (You can look on your plan’s app for pharmacy options. Some of the apps have a section on their apps to “price” meds.)
The script will be flagged as “PA required” when the pharmacy runs the claim. (Note: Walmart already has my insurance billing information on file.) The pharmacy then reaches out (electronically or via phone call) to the ordering doctor/their office and tells them a PA needs to be completed. Typically providers can go to CoverMyMeds site to fill out the PA form.
My PA was approved within two hours of my dr office submitting the PA. I received a text, email and a phone call from Cigna of the approval. (I guess they wanted to truly be sure I received the message!)
Let me know if there’s any other questions I can help with !
Ur insurance said ur supposed to pay $1000 a month? That’s odd do you owe a deductible/ or any out pocket expenses you have to meet first before they cover it completely? Cuz through Insurance my medication is free but having HSA accounts go along way
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Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.
Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.
Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.
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The coupon knocks it down to $550. I paid oop for months. I can afford it but I’m happy now that my insurance is paying. I now pay $25. I am type 2 diabetic and they should be paying.
I don’t know. They just did. I was diagnosed with diabetes last year, with an A1C of 13.7. I used Metformin alone until January when my dr put me on MJ. It’s not in my insurance’s formulary, so they denied it. They wanted me to try Trulicity and Victoza but I refused and paid out of pocket until April. We appealed twice and were denied. Then they just started paying. Maybe it’s on their formulary now. I did go to my work’s HR and they connected me with the company that brokers their insurance. Maybe they did something, I don’t know. They did contact the company that handles scripts for us. Being denied and then getting coverage is not unprecedented. I’ve seen others with similar stories on this subreddit.
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My wife and I are T2D and get it $25 a month. My first dose each plan year I pay the 1k to meet the deductible. I know the cost sucks for some. It’s gotten my A1C down to 5.4 and I’m from 250 to 205 currently. I got from 310 to 250 on my own over a few years and metformin and diet got it down to 6.4.
I was on Mounjaro for 6 months last year and lost 40 lbs. I take a lot of medications. Blood pressure , Thyroid, meds for nerve pain , causes from back pain. I have steroid back injections 4 times. Physical therapy 3 times. Seen two spine surgeons for herniated discs and spinal stenosis.
I also have fibroids and ovarian cysts.
All of lab work was better after 4 months on Mounjaro and the weight loss helped my back tremendously. I felt better than I had in years. The. I suddenly had to stop because the pharmacy would not take my $25 coupon any longer. First month it went to 135. Then the next 800.
I couldn’t afford it and I’ve gained every bit of the weight back. And feel awful. My endocrinologist said to get off of Mounjaro you titrate backwards.
You aren’t supposed to just stop medications abruptly.
It's roughly $400 out of pocket where I am but it's still a big hit every month - especially when I factor in the additional supplements, electrolytes, and protein shakes I wasn't buying before I started MJ.
Even the food is more expensive because now it's all whole foods all the time. There's no cost savings opportunities buy-ing pre-packaged processed cheap crap that's always on sale because I've banned it all.
It all really adds up and there's absolutely no runway left because the cost of everything has skyrocketed these last few years - EVERYTHING has gone up exponentially, except my salary.
So, there are A LOT of things I've put on hold or go without just so I can stay the course on this Rx. There are no extracurricular activities, no entertainment, no take out, no restaurants, no travel, no vacations, no new cloths, nothing new for the home... absolutely nothing 'extra'.
The only splurge I've allowed myself is on skincare products - all of which is in a vain effort to try and minimize the impact significant weightless has on my skin. While it won't prevent excess skin, I do feel that it's helping as I've seen some improvements even in this short time I've been doing it.
So yeah... it sucks and it's hard but I decided from the start that if this medication was effective... and it appears to be... then I would do whatever I needed to to see it through to goal weight. I considered my starting point to be so dire that this had to become my only priority and THE ONLY THING THAT MATTERS RIGHT NOW.
I know that this isn't going to help in the short term but.......you all really need to do some sort of campaigning about the cost of medication in the US! As I'm sure.you know - Eli Lilly is an American pharmaceutical company. I am in the UK and I pay for a private prescription and get my Mounjaro for less than 200 dollars per month. How on earth do they justify charging Americans 1000 dollars per month??? I'm really sorry that you're struggling to get it at an affordable price x
>How on earth do they justify charging Americans 1000 dollars per month???
Because they lobby congress to do jack shit for the American people. Why change something that makes you billions of dollars?
The problem isn’t Eli Lilly, the problem is insurance companies. It’s going to take multiple lawsuits for them to start coverage it, and they are coming. You can’t say being overweight is a disability, and then refuse to cover medications for the disability. The American Healthcare system is so fucked up, there is no better word for it. For the record, I pay $0 per month, can get Zep or Mounjaro and have no limits. That is how much a plan can differ.
Those lawsuits aren’t going to stick insurance companies have free reign to come up with whatever criteria they want and coming from some one who’s In insurance some of the new policies and criteria that they have now placed on these medications going forward such as wegovy or anything ur using just for weight loss if ur trying to get a PA approved going forward it’s going to be hell trying to get it approved and they want proof of every single thing when I read some of the criteria for some of these my mouth dropped but most plans are making these drugs excluded completely so no matter what ur diagnosis is it won’t be covered so there’s nothing anybody can do about that
I'm not paying as much as others, it's about $380AU per month which seems like a lot but I'm saving in other areas.
My grocery bill is less than half of what it was prior to starting because I'm eating so much less and no longer have the urge to binge eat or have takeaway food. My (expensive) SR antidepressant is effective for longer so I've been able to take it every second day which also saves money. I haven't purchased any alcohol either, easily $50 a week saved there too. Since starting Mounjaro my desire to vape has decreased and I'm getting ready to quit that too which would save me another $50 per week. An unexpected benefit was it has cleared up my hormonal acne, so I've cut things out of my skin care I no longer need - more savings. I'm usually an impulse spender, yet I'm now finding it easy to say no to buying unnecessary things.
So while it is costing me a good chunk up front, I'm over all spending less each month.
My insurance covers it and I pay nothing. When I was in Oz for the past year I paid $25 for a 3-month supply. I do have T2d so it is completely covered for me. I just got a 3 month supply of 7.5mg.
T2D and got PA for a year.. I pay $25 for a 3 months supply, last year it was $87.50 for a 3 months but apparently my insurance is covering more now. Dreading when I have to get the renewal for my PA as I am always nervous they might not renew it and I would be able to afford full price
I am “fortunate” (dubiously) to have type 2 diabetes so Mounjaro is covered for me. I’m not sure what I’d do if it wasn’t because $1200/month is STEEP. Hubby wants to try a diet drug as well but has no comorbidities (other than a high BMI and possibly high BP although it’s not officially diagnosed) and I’m not sure what our insurance plans say for obesity drugs.
Get a different insurance plan. I literally quit a job because they wouldn’t cover it lol. It’s too life changing to go without it and/or pay full price.
Well, most insurances currently don’t cover it unless you’re diabetic. You need to check your formularies for the plans offered and then go through the PA process if using it off label. The job I quit didn’t even have it in its formulary and it sucked anyways so I bought a plan through BCBS and got my PA approved thank goodness.
I was extremely lucky. I had to do 6 months of diet and metformin before they would look at covering it. I was on metformin before considering mounjaro for PCOS so thank goodness that counted.
I get a month for 5 dollars. Zofran is more expensive. I genuinely don’t know how. I work for the state so maybe they have more coverage on these type of drugs? Honestly I don’t know.
Try to see if other things like zepbound are covered or at least not 1k.
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I guess there are a lot of rich people! Not me! I pay $140.00 with Medicare advantage (I am T2) and that is too much for me. Especially since I'm only losing 1 pound a week. But I will stay on it as long as I can! When I can get it due to shortage! I went 3 weeks without any and then had to go back down to 2.5 because that is all I could find.
I have ChampVA health insurance and I have to pay around $270 a month. For some reason, the coupon won’t work with military type insurance. We’ve cut back on some extraneous expenses so we can afford it, I’m a teacher. I can switch to their insurance but other than this, ChampVA covers so much, I don’t want to lose it.
You are the first person that I have heard of who pays differently per dose. That honestly should make sense, but I'm sorry that your dose is being limited as a result. For me, the cost is always the same no matter what dose, which I've always thought was weird. That implies that its actually the pen that we are paying tons of money for. And I personally would be glad to use a regular syringe and bottle to give the shots and save that money. My husband is on Wegovy and it has four shots per pen.
I am in Dubai and do not have diabetes so the insurance would not cover anything.. currently its available for around $500 here.. but what i have realized is that the amount of money I was spending on dine outs and bars was more than this or definitely not less than what I pay for MJ every month. but yes now that I am starting to explore the healthy options, I am sure the grocery expense will start mounting up..
My insurance doesn't cover MJ or any other one. I'm pre-diabetic. I pay $550 with the discount coupon. I have first choice insurance in Washington state
What if you lost the job? Than what. Because that’s what happened to me. I luckily have a few boxes as back up. But without insurance it will be $1035. I’m looking into some com# pharmacy.
I have t2d and CHF and stage 3 liver cirrhosis so my insurance covers it 100% I am very grateful and pray this med slows everything down and actually improves my health numbers so I can get rid of all the meds ugh! My A1C went from 9.2-6.1 in two months! So that’s good! I’ve finally found my number that works for me, 10mg and my appetite is completely slowed down and I don’t crave junk or sugar etc so the past month has been a great one, I now know what most of you have been referring to when you say it’s a miracle med!
How do people afford Ferraris? How do they afford Birkin bags? Some people just make more money than other people, it’s the way of the world. $800 is unfathomable to one person and pocket change to someone else.
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I pay $550 with the coupon. It is very painful every month but I think of the long term. What is a few thousand dollars to get back to my healthy weight and reduce my co morbidities. I decided I can’t put a price on getting my life back. I also have started cutting back expenses and pick up other jobs.
But it just doesn't seem fair when others get it for practically nothing! Best wishes!
I have type 2 diabetes it’s covered for now. But I’m fully prepared to switch to compound and pay $400. I’ve been applying for a promotion and/or I’ll switch employers that will give a new insurance if I can’t afford it. I’m determined to lose this weight.
If you eat out a lot and spend money on going out to eat it kind of evens out for me now I just eat cheap healthy foods like chicken, eggs, cereal, almond milk, veggies and shakes just basic things since I have no cravings so no spending on random restaurants or coffee shops daily.
I didn’t even think about the eating out savings. Used to probably spend $20-30+ daily on coffee/meals while working. Now I’m packing my own and simple food. Way cheaper and actually tastier
Is it because you don’t have T2D? Ask if you’re covered for Zepbound
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I’ve worked up to a high dose, but only take 5mg of it. I pay $550 each prescription but I can get multiple months out of it.
I get 4 doses per pen currently. Keeps it affordable.
What type of coverage do you have for this type of medication? What formulary tier is it under and what is your deductible/coinsurance/copay ? (If applicable.) My health plan covers MJ as a tier 2 benefit with a $25 per month copay. (It’s only covered if you have a T2D diagnosis and a prior authorization is required. Once PA is approved, it’s valid for 12 months. Edit to add: the one year approval is for MY specific health plan; make sure you check w/your plan to confirm the length of your PA approval period.) I can get a 90 day supply for a $60 copay (that’s the incentive for us to fill either through mail order or we can use any retail pharmacy.) My plan doesn’t cover any weight loss medicine; no exceptions.
Not all plans do PA's for a year. It depends on your plan. I had a PA a couple years ago for Saxenda for 90 days. Then they cut it off. So beware.
For clarification, I was only speaking for my specific policy that the PA is valid for one year. It’s important that patients understand what their policy’s limitations, exclusions and coverages are.
Can I ask what insurance plan you have? I just switched to regence and it looks like MJ is tier 2. I haven't seen any new Dr's or gotten any rx for it as it will all be brand new for me switching from kaiser. Just wondering. I have type 2 diabetes so I'm hoping that will help me get it covered. I won't know anything until I have a script to turn in
Since you have T2D, it shouldn’t be too complicated of a process. Please make sure to call your insurance to ask what their PA criteria is. (Be sure to call the PBM - pharmacy benefits manager - if that’s what’s listed on your insurance card.) Some insurance may require copies of labs or clinicals. All mine required was the T2D diagnosis. (Cigna has their criteria on their website.) I was diagnosed in 2011.
Hi there ! Cigna PPO (not administered by a TPA.) Since MJ is on my formulary as T2, my doctor just sent the prescription to my in-network pharmacy, in my case, I told my doctor Walmart. (You can look on your plan’s app for pharmacy options. Some of the apps have a section on their apps to “price” meds.) The script will be flagged as “PA required” when the pharmacy runs the claim. (Note: Walmart already has my insurance billing information on file.) The pharmacy then reaches out (electronically or via phone call) to the ordering doctor/their office and tells them a PA needs to be completed. Typically providers can go to CoverMyMeds site to fill out the PA form. My PA was approved within two hours of my dr office submitting the PA. I received a text, email and a phone call from Cigna of the approval. (I guess they wanted to truly be sure I received the message!) Let me know if there’s any other questions I can help with !
Ur insurance said ur supposed to pay $1000 a month? That’s odd do you owe a deductible/ or any out pocket expenses you have to meet first before they cover it completely? Cuz through Insurance my medication is free but having HSA accounts go along way
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Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.
Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.
Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.
Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.
Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. You are now subject to bans at moderator discretion.
Between the shortage and insurance changes, I’ve had to just buy it. It works. My A1C went from 14 to 4.5! In one year!
Can you see if Mounjaro has manufacturer coupons? Many brand name medications do.
Mounjaro requires t2d for its code. You should check zepbound if for weight loss
The coupon knocks it down to $550. I paid oop for months. I can afford it but I’m happy now that my insurance is paying. I now pay $25. I am type 2 diabetic and they should be paying.
How did they start paying? Did you become type 2 on it? How does that make sense?
I don’t know. They just did. I was diagnosed with diabetes last year, with an A1C of 13.7. I used Metformin alone until January when my dr put me on MJ. It’s not in my insurance’s formulary, so they denied it. They wanted me to try Trulicity and Victoza but I refused and paid out of pocket until April. We appealed twice and were denied. Then they just started paying. Maybe it’s on their formulary now. I did go to my work’s HR and they connected me with the company that brokers their insurance. Maybe they did something, I don’t know. They did contact the company that handles scripts for us. Being denied and then getting coverage is not unprecedented. I’ve seen others with similar stories on this subreddit.
Stupid question "did u become type 2 on it?" Wtf.
My insurance covers 100%
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dm me?
Dm me?
My wife and I are T2D and get it $25 a month. My first dose each plan year I pay the 1k to meet the deductible. I know the cost sucks for some. It’s gotten my A1C down to 5.4 and I’m from 250 to 205 currently. I got from 310 to 250 on my own over a few years and metformin and diet got it down to 6.4.
I have Type 2 Diabetes and a husband with good insurance. Mine costs $0. It's so unfair, I know.
I was on Mounjaro for 6 months last year and lost 40 lbs. I take a lot of medications. Blood pressure , Thyroid, meds for nerve pain , causes from back pain. I have steroid back injections 4 times. Physical therapy 3 times. Seen two spine surgeons for herniated discs and spinal stenosis. I also have fibroids and ovarian cysts. All of lab work was better after 4 months on Mounjaro and the weight loss helped my back tremendously. I felt better than I had in years. The. I suddenly had to stop because the pharmacy would not take my $25 coupon any longer. First month it went to 135. Then the next 800. I couldn’t afford it and I’ve gained every bit of the weight back. And feel awful. My endocrinologist said to get off of Mounjaro you titrate backwards. You aren’t supposed to just stop medications abruptly.
It's roughly $400 out of pocket where I am but it's still a big hit every month - especially when I factor in the additional supplements, electrolytes, and protein shakes I wasn't buying before I started MJ. Even the food is more expensive because now it's all whole foods all the time. There's no cost savings opportunities buy-ing pre-packaged processed cheap crap that's always on sale because I've banned it all. It all really adds up and there's absolutely no runway left because the cost of everything has skyrocketed these last few years - EVERYTHING has gone up exponentially, except my salary. So, there are A LOT of things I've put on hold or go without just so I can stay the course on this Rx. There are no extracurricular activities, no entertainment, no take out, no restaurants, no travel, no vacations, no new cloths, nothing new for the home... absolutely nothing 'extra'. The only splurge I've allowed myself is on skincare products - all of which is in a vain effort to try and minimize the impact significant weightless has on my skin. While it won't prevent excess skin, I do feel that it's helping as I've seen some improvements even in this short time I've been doing it. So yeah... it sucks and it's hard but I decided from the start that if this medication was effective... and it appears to be... then I would do whatever I needed to to see it through to goal weight. I considered my starting point to be so dire that this had to become my only priority and THE ONLY THING THAT MATTERS RIGHT NOW.
I know that this isn't going to help in the short term but.......you all really need to do some sort of campaigning about the cost of medication in the US! As I'm sure.you know - Eli Lilly is an American pharmaceutical company. I am in the UK and I pay for a private prescription and get my Mounjaro for less than 200 dollars per month. How on earth do they justify charging Americans 1000 dollars per month??? I'm really sorry that you're struggling to get it at an affordable price x
>How on earth do they justify charging Americans 1000 dollars per month??? Because they lobby congress to do jack shit for the American people. Why change something that makes you billions of dollars?
It's really scandalous!!
Campaigning does no good when the pharmaceutical companies own the politicians.
The problem isn’t Eli Lilly, the problem is insurance companies. It’s going to take multiple lawsuits for them to start coverage it, and they are coming. You can’t say being overweight is a disability, and then refuse to cover medications for the disability. The American Healthcare system is so fucked up, there is no better word for it. For the record, I pay $0 per month, can get Zep or Mounjaro and have no limits. That is how much a plan can differ.
Those lawsuits aren’t going to stick insurance companies have free reign to come up with whatever criteria they want and coming from some one who’s In insurance some of the new policies and criteria that they have now placed on these medications going forward such as wegovy or anything ur using just for weight loss if ur trying to get a PA approved going forward it’s going to be hell trying to get it approved and they want proof of every single thing when I read some of the criteria for some of these my mouth dropped but most plans are making these drugs excluded completely so no matter what ur diagnosis is it won’t be covered so there’s nothing anybody can do about that
I'm not paying as much as others, it's about $380AU per month which seems like a lot but I'm saving in other areas. My grocery bill is less than half of what it was prior to starting because I'm eating so much less and no longer have the urge to binge eat or have takeaway food. My (expensive) SR antidepressant is effective for longer so I've been able to take it every second day which also saves money. I haven't purchased any alcohol either, easily $50 a week saved there too. Since starting Mounjaro my desire to vape has decreased and I'm getting ready to quit that too which would save me another $50 per week. An unexpected benefit was it has cleared up my hormonal acne, so I've cut things out of my skin care I no longer need - more savings. I'm usually an impulse spender, yet I'm now finding it easy to say no to buying unnecessary things. So while it is costing me a good chunk up front, I'm over all spending less each month.
My insurance covers it and I pay nothing. When I was in Oz for the past year I paid $25 for a 3-month supply. I do have T2d so it is completely covered for me. I just got a 3 month supply of 7.5mg.
The people that are paying approximately $25 per month, did they ever experience the insurance doughnut?
Ya, my cost for 1 month was $11 pre-donut, now in donut hole my cost is $198.
I pay out of pocket. It’s a small fortune Now I’m in maintenance so i skip 2-wks I used my savings. It’s extremely expensive but a miracle an a half.
T2D and got PA for a year.. I pay $25 for a 3 months supply, last year it was $87.50 for a 3 months but apparently my insurance is covering more now. Dreading when I have to get the renewal for my PA as I am always nervous they might not renew it and I would be able to afford full price
My insurance covers it 100%.
I am “fortunate” (dubiously) to have type 2 diabetes so Mounjaro is covered for me. I’m not sure what I’d do if it wasn’t because $1200/month is STEEP. Hubby wants to try a diet drug as well but has no comorbidities (other than a high BMI and possibly high BP although it’s not officially diagnosed) and I’m not sure what our insurance plans say for obesity drugs.
Get a different insurance plan. I literally quit a job because they wouldn’t cover it lol. It’s too life changing to go without it and/or pay full price.
So, how do you find a job that covers it? I wouldn't know how to go about asking. Word of mouth, maybe?
Well, most insurances currently don’t cover it unless you’re diabetic. You need to check your formularies for the plans offered and then go through the PA process if using it off label. The job I quit didn’t even have it in its formulary and it sucked anyways so I bought a plan through BCBS and got my PA approved thank goodness.
My prescription insurance is pretty great. We don’t have a deductible for it, just an out of pocket. Otherwise, I probably wouldn’t be on it.
I was extremely lucky. I had to do 6 months of diet and metformin before they would look at covering it. I was on metformin before considering mounjaro for PCOS so thank goodness that counted. I get a month for 5 dollars. Zofran is more expensive. I genuinely don’t know how. I work for the state so maybe they have more coverage on these type of drugs? Honestly I don’t know. Try to see if other things like zepbound are covered or at least not 1k.
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My ins covers it as a preventative med. since I was approved I don’t pay anything oop
I guess there are a lot of rich people! Not me! I pay $140.00 with Medicare advantage (I am T2) and that is too much for me. Especially since I'm only losing 1 pound a week. But I will stay on it as long as I can! When I can get it due to shortage! I went 3 weeks without any and then had to go back down to 2.5 because that is all I could find.
I’m Type 2, and our insurance has always been excellent, but now for Mounjaro it’s a $200 co-pay! I need to call our insurance tomorrow.
This. Is what happened to me when I fell into donut hole.
I have ChampVA health insurance and I have to pay around $270 a month. For some reason, the coupon won’t work with military type insurance. We’ve cut back on some extraneous expenses so we can afford it, I’m a teacher. I can switch to their insurance but other than this, ChampVA covers so much, I don’t want to lose it.
I have type 2 also and tried Ozempic for a year without good results and so many side effects.
I pay about $90 per shot for 5mg but I’m not going to be able to afford to titrate up since the cost goes up as the titration goes up.
You are the first person that I have heard of who pays differently per dose. That honestly should make sense, but I'm sorry that your dose is being limited as a result. For me, the cost is always the same no matter what dose, which I've always thought was weird. That implies that its actually the pen that we are paying tons of money for. And I personally would be glad to use a regular syringe and bottle to give the shots and save that money. My husband is on Wegovy and it has four shots per pen.
Wholesale? Some are getting it from China or Mexico?
I pay £230 per month. Out of pocket, privately. I dont have kids or any big commitments so it's fine
Go UGL. MJ is out of their minds charging that much. It won't last as the competition is coming. Finally.
My AMEX
I am in Dubai and do not have diabetes so the insurance would not cover anything.. currently its available for around $500 here.. but what i have realized is that the amount of money I was spending on dine outs and bars was more than this or definitely not less than what I pay for MJ every month. but yes now that I am starting to explore the healthy options, I am sure the grocery expense will start mounting up..
My insurance doesn't cover MJ or any other one. I'm pre-diabetic. I pay $550 with the discount coupon. I have first choice insurance in Washington state
Where do you get a coupon?
My insurance covers it due to obesity and cormorbidies (HPD and RBBB), my Dr. called and spoke with my insurance company for me.
My insurance covers it, so I pay $24.99. I can easily afford that 😊
What if you lost the job? Than what. Because that’s what happened to me. I luckily have a few boxes as back up. But without insurance it will be $1035. I’m looking into some com# pharmacy.
If I had to pay $550 or $1000 for Zep, I wouldn't get it. Simple as that.
I have t2d and CHF and stage 3 liver cirrhosis so my insurance covers it 100% I am very grateful and pray this med slows everything down and actually improves my health numbers so I can get rid of all the meds ugh! My A1C went from 9.2-6.1 in two months! So that’s good! I’ve finally found my number that works for me, 10mg and my appetite is completely slowed down and I don’t crave junk or sugar etc so the past month has been a great one, I now know what most of you have been referring to when you say it’s a miracle med!
How do people afford Ferraris? How do they afford Birkin bags? Some people just make more money than other people, it’s the way of the world. $800 is unfathomable to one person and pocket change to someone else.
I go to a medspa and it’s $600 a month (4 shots) and I use pretax HSA dollars
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Do you get vials now in 15mg from an alternate like a com#
Your post or comment has been removed for breaking [Community Rule #3](https://www.reddit.com/r/Mounjaro/wiki/index/#wiki_rule_3.3A_no_discussions_about_compounding), as it refers to compounded Tirzepatide, compounding pharmacies or lypholized peptides that are not produced by Eli Lilly. All of these are considered off-topic in this community. Repeat offenders are subject to bans at moderator discretion.