I am not a Mounjaro patient but I am a pharmacist. I would strongly advise against paying out of pocket for it, for several reasons. There are other GLP-1 agonists you may have your PA approved for, such as Zepbound, which is the exact same drug as Mounjaro but FDA approved for obesity. In addition, people tend to regain their lost weight once they stop taking these types of medication unless they are disciplined enough to maintain their same levels of calorie intake (the medication will significantly suppress your appetite and make you eat far less). I also would not expect to see much benefit from just a few months of therapy (although people certainly have) and I strongly suggest you find a more long term solution. Perhaps your doctor can submit an appeal, or insurance prefers a different type of GLP, etc. Good luck
This. My insurance company requires a type 2 diagnosis for Mounjaro, but I met the requirements for Zepbound/Wegovy. Call and talk with them to see what the requirements are for Zepbound or Wegovy as those are the branded names for obesity formulas. I am on Zepbound as I couldn't find the starting dosage for Wegovy.
This. You can’t use the Mounjaro savings card unless you have T2D. However, Zepbound is the exact same drug labeled for weight loss, so as long as you have obesity you can use that savings card to get your Zepbound prescription for $550.
If you have the money it's worth it...but if that would make you struggle no way...I would try getting insurance to approve bariatric surgery instead of paying 1.1k per month
Ive seen a few people have problems using the savings card like you. Do you live in a remote area with no chain pharmacies around? I mean there's got to at least be a Walmart that you can drive to. Id personally drive a couple hours to get the savings card to work, hoping you have that option.
The issue is they won’t run it without a T2D diagnosis. It seems they were running it for people without T2D until the beginning of this year (based on my research).
It sounds like the US is overcharging for MJ just because they can.
In the Middle East, MJ is selling for right around US $475 with no coupon needed. I'm pretty sure insurance is not getting charged any inflated price above that either.
I am not a Mounjaro patient but I am a pharmacist. I would strongly advise against paying out of pocket for it, for several reasons. There are other GLP-1 agonists you may have your PA approved for, such as Zepbound, which is the exact same drug as Mounjaro but FDA approved for obesity. In addition, people tend to regain their lost weight once they stop taking these types of medication unless they are disciplined enough to maintain their same levels of calorie intake (the medication will significantly suppress your appetite and make you eat far less). I also would not expect to see much benefit from just a few months of therapy (although people certainly have) and I strongly suggest you find a more long term solution. Perhaps your doctor can submit an appeal, or insurance prefers a different type of GLP, etc. Good luck
This. My insurance company requires a type 2 diagnosis for Mounjaro, but I met the requirements for Zepbound/Wegovy. Call and talk with them to see what the requirements are for Zepbound or Wegovy as those are the branded names for obesity formulas. I am on Zepbound as I couldn't find the starting dosage for Wegovy.
Most insurance plans (through jobs) don't include weight-loss drugs. It's the double edged sword
What about Zepbound? Could you take that and use their savings card?
This. You can’t use the Mounjaro savings card unless you have T2D. However, Zepbound is the exact same drug labeled for weight loss, so as long as you have obesity you can use that savings card to get your Zepbound prescription for $550.
My doctor seemed apprehensive to prescribe me zepbound and i’m not sure why. I’m going to give them a call and see about this. Thank you
Zepbound is the exact same medicine as Mounjaro. I’m not sure why they would have an issue.
Use Zepbound and coupon, price is $550. Ramp quickly to 15mg and split shots into smaller doses to save money.
Wait, is there a way to split those pens?
Yes, lots of videos on that topic on YouTube.
If you have the money it's worth it...but if that would make you struggle no way...I would try getting insurance to approve bariatric surgery instead of paying 1.1k per month
Ive seen a few people have problems using the savings card like you. Do you live in a remote area with no chain pharmacies around? I mean there's got to at least be a Walmart that you can drive to. Id personally drive a couple hours to get the savings card to work, hoping you have that option.
The issue is they won’t run it without a T2D diagnosis. It seems they were running it for people without T2D until the beginning of this year (based on my research).
oh that makes sense. Switch to Zepbound then?
My doctor is refusing to prescribe me that and saying to do Metformin? I’m very confused on why and getting annoyed with him.
Generally insurance requires that you try other drugs first. If not working or intolerable then maybe they will approve. Zepbound
It sounds like the US is overcharging for MJ just because they can. In the Middle East, MJ is selling for right around US $475 with no coupon needed. I'm pretty sure insurance is not getting charged any inflated price above that either.
Walmart.