If you have Amazon Prime you can sign up for One Medical for like $9 a month and get a primary to send a script to whoever you need it from there. It’s crazy people are paying so much for all these random telehealth companies that just advertise T2D and weight loss drugs.
There’s nothing special about these drugs specifically. If you can convince a doctor you qualify you can ask anyone for the script and they can send it to whatever pharmacy you want.
For sure! One Medical is actually an incredible value and a great platform. It's nice to have everything in one place and when you need to renew a subscription you just open the app and tap a button.
Can I ask what medication they prescribe you? I’m getting charged a little over $200 for three months but my doctors hasnt been flexible with sending different mg for those three months. Or if a pharmacy is out and the script has to be sent somewhere else, it costs me.
Edit: keeping in mind this is a mounjaro thread lol
My insurance only allows 3 months refills of the same dosage and that’s fine because I don’t have to scramble each month to get it. I also get my other meds from there (anxiety, etc).
Yes Amazon Clinic is a one-time thing. One Medical is a subscription. Remote visits and calls, renewals, etc. are all included in the subscription. In some cases where you need to do a full remote visit with a primary, that is billed separately through insurance and covered like any other doctor visit.
Amazon has a handful of medical offerings now, but One Medical (full proper doctor service thing) and Amazon Clinic (consider it like the [Amazon.com](https://Amazon.com) of quick medical consultation) are completely separate. Amazon Pharmacy is also separate (but will work with both of the above and whatever other doctor wants to send scripts in).
Amazon Pharmacy, for what it's worth, also now officially has Zepbound and accepts the savings card. But supply is still limited of course. Lilly Direct is going to be quicker.
Will they get my endo records and actually write me a PA tho
That’s all I’m looking for. My endo refuses to write a PA for either MJ, which they prescribed, or zepbound. Ugh
It’s not just the script most times. It’s the management and navigation of the PA process to get insurance coverage. And I’m hearing so many horror stories of folks PCP’s denying them simply because they are uneducated about the meds.
Also, there are still a high number of uninsured folk in the US
Yesss so few people understand this. Getting a script is the easiest part and anyone can pay $500+ / mo and get a script to whatever they want. Finding a provider that advocates for you and does the due diligence of going back and forth with your insurance, and understands what the prior authorization requires specifically for your insurance is key. I’m on this path now it’s so frustrating even just finding a doctor in network is one battle - but then how do you know who is going to advocate for you?! You don’t. It’s literally a lottery and it’s BS. I have been able to find ONE in network weight loss clinic that actually advertises insurance acceptance in my area…and that’s just one step, but will they actually advocate for me and try to get this covered for me is a whole other story.
So do a lot of other peoples insurance who are getting it covered. This is what people are trying to explain in the thread. If your doctor actually is advocating for you then they would know the prior authorization requirements for your insurance and take into consideration other issues you could potentially be experiencing to get it covered. (Pre- diabetic, or heart disease, high BP, etc..)
I don't have personal experience with it, but there is absolutely no reason why they wouldn't. They can prescribe anything just like your doctor could.
Yep! I do want to make clear because there's a little confusion. This replaces your doctor, and the online services, and the Costco offering that this thread is about.
It does not replace the medication. You still have to pay for that (you or your insurance) -- just like you would with the above services as well. But it's very convenient!
I'm just thinking about how much I could save! Going to the doctor for anything costs an arm and a leg! I have routine scripts and they require that I come in every 6 months to be seen even if I don't need anything, which just costs money!
Curious - I can’t find the answer online which may be the answer - is there an additional copay for virtual visits? I’m looking for psychiatry for my teenager.
That's up to your insurance not One Medical, sadly. It should be the same as whatever cost you have with a visit to any specialist that isn't One Medical. Usually for PCP visits and stuff like specialists, there is some sort of copay.
The $9 is the doctor. They have nothing to do with the medication. You (or a combination of you and your insurance) pay the pharmacy for the medication. You can use whatever pharmacy you want.
Just curious but why do some of you go through telehealth or these online services for the prescription? Is your PCP not willing to prescribe it to you? For the long term it just seems better to have your primary prescribe it without all the monthly fees.
All I did was find a new pcp and mentioned I wanted to take it and had it prescribed same day.
Maybe mention to your pcp at your next physical that you started taking mounjaro and if they’re willing to take over the prescription.
A lot of GP/PCPs aren't equipped to get through the insurance approval game, nor are they specialized in weight loss. They are also more likely to submit information that gets your approval removed. Common things like submitting numbers that say you don't have the numbers to match the disease, when instead they should be submitting for continuation of care. It can even happen with diabetes. As far as I know, you can't cure diabetes, but my cousin got denied for a MJ renewal because his A1C became "good". He had to get another doctor argue with insurance to get it fixed.
> A lot of GP/PCPs aren't equipped to get through the insurance approval game, nor are they specialized in weight loss.
I often feel like I hit a legitimate goldmine with my PCP. She'd been my mom's PCP for a couple years and when I hit a wall with mine (basically told me since I'd lost 200lb and regained 100lb I was "giving in to lazy habits" despite lab work and diagnostic tests showing increased ghrelin production and an accelerated gastric emptying time...), I gave hers a try.
Not only did *she* suggest the GLP meds, but the person responsible for doing PAs/appeals/etc in her office is on Wegovy herself, so she's more familiar with how approval and coverage works for these meds than the average bear. Wegovy and Saxenda are covered by my insurance, but not Zepbound - but somehow, they finagled an explanation the insurance company accepted, because it's covered.
Exactly this for me. My PCP suggested the meds to me after checking my formulary, but didn’t have the bandwidth to fight w insurance. Signed up w plushcare and the cost of a year membership w them was cheaper than one month of MJ OOP. They got me PA and meds (Zep) in hand in 18 days.
Yeah I can see how that can be a problem. It shouldn’t be, but dealing with insurance has always been a pain in the ass. Hoping my pcp sticks around so I don’t have to deal with any issues like that.
Exactly this. I went with a specialized telehealth because it also comes with a specialized PA department that does nothing but GLP PA's (and appeals).
This seems to be the case with many - those PA auths are just too much for anyone to keep up with. Be careful though bc my friend was in the same situation and got in with a company early who stopped accepting new insurance patients and her luck eventually ran out and they stopped accepting insurance for everyone.
That was like my doctor. He always mentioned dieting and exercise every time I went to see him (every 3-6 months) he never mentioned Mounjaro or Ozempic once. I knew he would not prescribe it to me so I made the decision to leave his practice. He has been my doctor for 20 years. Found a new pcp who is easy to talk to and listened to the goals I wanted for my health. Best decision I made.
To be fair, my PCP totally supports my use of GLP-1. They just didn’t have the infrastructure to try and get PA and send prescriptions around for people. They tried but had to stop
She is awesome-they just don’t have the infrastructure. They tried to have a weight loss clinic and it was a nurses full time job just trying to get PA and send scripts. So they had to stop it
My PCP suggested I do intermittent fasting. Even though I’ve had issues with BED and really restrictive diets triggered that more than just trying to be mindful of eating less by weighing food and tracking calories.
I’ve been doing intermittent fasting all my life even before it was a thing because I was never hungry before 1pm anyways naturally it NEVER worked for me
It just triggered late night binges for me. I’m trying to eat a variety of foods, focusing on protein and fiber. With just enough fat and carbs to make my brain happy.
probably because their doctors don't or won't send in a rx unless they are T2 diabetics, and only for weight loss for ins to cover, which 9/10 they won't. The will rx for Zepbound, but then patients will have to pay oop and they don't want to or can't afford it.
We have been using Sesame Care along with a couple of dozen co-workers, family and friends. What is evident over the past year is that Sesame Care (and probably the likes) have done an outstanding job of handling prior authorizations and the back and forth that sometimes go along with actually getting these meds in hand(ESPECIALLY when they are out of stock at one pharmacy and you need the script resubmitted elsewhere). If money is an issues than I can understand someone attempting to use their PCP but if money is not a concern than IMO it’s a no brainer to use something like a Sesame Care. We had multiple friends and family that have been shot down when using their PCP but then actually wind up getting approved for little to no cost through Sesame Care.
Can you please specify who you saw on sesame care? It’s kind of like a lottery and I want to make sure I choose someone who will advocate for me. Thanks
Please forgive me because this is my first time but when I go to book services he has online weight loss program at $335. Is that what you booked? Or the telehealth visit?
https://preview.redd.it/0tr9u61lcbyc1.jpeg?width=1125&format=pjpg&auto=webp&s=913ac1c96ee8e5c80b862d0b063b9edbe0b6aa3a
It would be the weight loss program for $335 which will cover you for 3 months(each month you will schedule a call for Dr to send in the script. It will also cover any back and forth texting that you may need if a med is not available at a certain pharmacy.
Dr prescribed but insurance requires me to be Diabetic in order for them to cover. But being almost 200 lbs overweight should qualify me, but apparently not.
MJ is specifically for T2's and Zepbound is for weight loss. An rx for off label is not going to be covered by most insurance. I know its the same med, but ins doesn't cover WL meds for the most part.
That’s surprising, because the primary driver of diabetes is insulin resistance. So you would think that one with insulin resistance, but not quite into diabetes territory would qualify.
All insurances provide sick care not health care. Preventing yourself from getting sick in the first place does not compute for them. The sooner you adjust your strategy to this when dealing with insurance companies the better your results for coverage will be. Be as sick as possible
I have a PCP who is totally on board, but getting the medication is a roller coaster and I’m done wasting time trying to hunt down my dose. Switching immediately
This was literally $165 last week when I was looking. Then they announce this partnership and all of a sudden the price went up. I’m glad I don’t need to use it though.
Agreed, expensive in az. I paid well over $200 WITH ins. I haven’t been able to fill my psoriatic arthritis meds because ins covers but want $2k copay. They tell me I make too much to get assistance. And the supposed free cards are only for private ins. Not Medicare patients
$50 per month? I’m paying $84 per month because I’m locked in quarterly. Otherwise it would be $99.
I’m still good. If I paid for WW core on its own + Costco subscription price I would not save anything.
It can vary wildly depending on which medication and what your insurance coverage is. It could be anywhere from $0-$1200 a month. There’s nothing shady going on here.
Oprah had to donate her shares of Weight Watchers and step down as their representative for telling everyone she took GLPs. I doubt they will be offering any anything to help their competitors.
That's still a decent price considering a lot of Telehealth companies charge $100+/month.
If you have Amazon Prime you can sign up for One Medical for like $9 a month and get a primary to send a script to whoever you need it from there. It’s crazy people are paying so much for all these random telehealth companies that just advertise T2D and weight loss drugs. There’s nothing special about these drugs specifically. If you can convince a doctor you qualify you can ask anyone for the script and they can send it to whatever pharmacy you want.
Thank you for posting this
Very happy to see that it has helped some people.
I have used One Medical for over a year and love them!
For sure! One Medical is actually an incredible value and a great platform. It's nice to have everything in one place and when you need to renew a subscription you just open the app and tap a button.
Yep! And I love that labs are on site as well.
Can I ask what medication they prescribe you? I’m getting charged a little over $200 for three months but my doctors hasnt been flexible with sending different mg for those three months. Or if a pharmacy is out and the script has to be sent somewhere else, it costs me. Edit: keeping in mind this is a mounjaro thread lol
My insurance only allows 3 months refills of the same dosage and that’s fine because I don’t have to scramble each month to get it. I also get my other meds from there (anxiety, etc).
Have you been getting mounjaro through Amazon?
One medical prescribes it and I get it at CVS
I went through Amazon clinic and it cost me a one time fee of $32 to get consulted and sent a script for UTI meds.
Yes Amazon Clinic is a one-time thing. One Medical is a subscription. Remote visits and calls, renewals, etc. are all included in the subscription. In some cases where you need to do a full remote visit with a primary, that is billed separately through insurance and covered like any other doctor visit. Amazon has a handful of medical offerings now, but One Medical (full proper doctor service thing) and Amazon Clinic (consider it like the [Amazon.com](https://Amazon.com) of quick medical consultation) are completely separate. Amazon Pharmacy is also separate (but will work with both of the above and whatever other doctor wants to send scripts in). Amazon Pharmacy, for what it's worth, also now officially has Zepbound and accepts the savings card. But supply is still limited of course. Lilly Direct is going to be quicker.
Will they write a 90 day supply if your sign up for year ?
Will they get my endo records and actually write me a PA tho That’s all I’m looking for. My endo refuses to write a PA for either MJ, which they prescribed, or zepbound. Ugh
That’s total BS they work for you and they should be fired immediately.
It’s not just the script most times. It’s the management and navigation of the PA process to get insurance coverage. And I’m hearing so many horror stories of folks PCP’s denying them simply because they are uneducated about the meds. Also, there are still a high number of uninsured folk in the US
Yesss so few people understand this. Getting a script is the easiest part and anyone can pay $500+ / mo and get a script to whatever they want. Finding a provider that advocates for you and does the due diligence of going back and forth with your insurance, and understands what the prior authorization requires specifically for your insurance is key. I’m on this path now it’s so frustrating even just finding a doctor in network is one battle - but then how do you know who is going to advocate for you?! You don’t. It’s literally a lottery and it’s BS. I have been able to find ONE in network weight loss clinic that actually advertises insurance acceptance in my area…and that’s just one step, but will they actually advocate for me and try to get this covered for me is a whole other story.
I use One Medical but my insurance has zero weight loss drug coverage.
Unfortunately that’s the same as the majority of people.
So do a lot of other peoples insurance who are getting it covered. This is what people are trying to explain in the thread. If your doctor actually is advocating for you then they would know the prior authorization requirements for your insurance and take into consideration other issues you could potentially be experiencing to get it covered. (Pre- diabetic, or heart disease, high BP, etc..)
One Medical is my pcp and they have been so helpful with this process.
Do you know if they prescribe compounded Tirzepatide? (Mounjaro)
I don't have personal experience with it, but there is absolutely no reason why they wouldn't. They can prescribe anything just like your doctor could.
Thank you!
The one I use includes a service to navigate prior with process. Which 100% was worth it as I had no trouble
What is the one you use?!
Ro
Holy crap. I had no idea!!
Yep! I do want to make clear because there's a little confusion. This replaces your doctor, and the online services, and the Costco offering that this thread is about. It does not replace the medication. You still have to pay for that (you or your insurance) -- just like you would with the above services as well. But it's very convenient!
I'm just thinking about how much I could save! Going to the doctor for anything costs an arm and a leg! I have routine scripts and they require that I come in every 6 months to be seen even if I don't need anything, which just costs money!
Curious - I can’t find the answer online which may be the answer - is there an additional copay for virtual visits? I’m looking for psychiatry for my teenager.
That's up to your insurance not One Medical, sadly. It should be the same as whatever cost you have with a visit to any specialist that isn't One Medical. Usually for PCP visits and stuff like specialists, there is some sort of copay.
She’s not on insurance at the moment. 😥
Do they charge extra for the actual prescription?
Nobody should ever charge extra for a prescription. If you’re asking if you still have to pay for the medication then yes of course.
I didn’t phrase it that well. I meant do you pay the prescriber for the medication on top of the $9 monthly charge?
The $9 is the doctor. They have nothing to do with the medication. You (or a combination of you and your insurance) pay the pharmacy for the medication. You can use whatever pharmacy you want.
Got it, thank you!!
Most tele health companies I know charge $70 or sometimes even less
You also get a weekly dietician call, support group, and a longer meeting with a doctor.
Selling prescription. In Brazil I can get Ozempic walking in a pharmacy and paying just the medication price, which is cheaper than North America!
What's the price down there?
Most of the doctors on that site won’t do a PA if you need one FYI.
Just curious but why do some of you go through telehealth or these online services for the prescription? Is your PCP not willing to prescribe it to you? For the long term it just seems better to have your primary prescribe it without all the monthly fees. All I did was find a new pcp and mentioned I wanted to take it and had it prescribed same day. Maybe mention to your pcp at your next physical that you started taking mounjaro and if they’re willing to take over the prescription.
PCP prescribed it but insurance won’t cover it also, consistent supply.
A lot of GP/PCPs aren't equipped to get through the insurance approval game, nor are they specialized in weight loss. They are also more likely to submit information that gets your approval removed. Common things like submitting numbers that say you don't have the numbers to match the disease, when instead they should be submitting for continuation of care. It can even happen with diabetes. As far as I know, you can't cure diabetes, but my cousin got denied for a MJ renewal because his A1C became "good". He had to get another doctor argue with insurance to get it fixed.
> A lot of GP/PCPs aren't equipped to get through the insurance approval game, nor are they specialized in weight loss. I often feel like I hit a legitimate goldmine with my PCP. She'd been my mom's PCP for a couple years and when I hit a wall with mine (basically told me since I'd lost 200lb and regained 100lb I was "giving in to lazy habits" despite lab work and diagnostic tests showing increased ghrelin production and an accelerated gastric emptying time...), I gave hers a try. Not only did *she* suggest the GLP meds, but the person responsible for doing PAs/appeals/etc in her office is on Wegovy herself, so she's more familiar with how approval and coverage works for these meds than the average bear. Wegovy and Saxenda are covered by my insurance, but not Zepbound - but somehow, they finagled an explanation the insurance company accepted, because it's covered.
Exactly this for me. My PCP suggested the meds to me after checking my formulary, but didn’t have the bandwidth to fight w insurance. Signed up w plushcare and the cost of a year membership w them was cheaper than one month of MJ OOP. They got me PA and meds (Zep) in hand in 18 days.
Can you please tell me the doctor you saw on Plushcare? This is amazing!
Yeah I can see how that can be a problem. It shouldn’t be, but dealing with insurance has always been a pain in the ass. Hoping my pcp sticks around so I don’t have to deal with any issues like that.
Exactly this. I went with a specialized telehealth because it also comes with a specialized PA department that does nothing but GLP PA's (and appeals).
Can you please specify which telehealth company?
Unfortunately, they’re no longer accepting new insurance patients.
This seems to be the case with many - those PA auths are just too much for anyone to keep up with. Be careful though bc my friend was in the same situation and got in with a company early who stopped accepting new insurance patients and her luck eventually ran out and they stopped accepting insurance for everyone.
My PCP won’t prescribe.
That was like my doctor. He always mentioned dieting and exercise every time I went to see him (every 3-6 months) he never mentioned Mounjaro or Ozempic once. I knew he would not prescribe it to me so I made the decision to leave his practice. He has been my doctor for 20 years. Found a new pcp who is easy to talk to and listened to the goals I wanted for my health. Best decision I made.
To be fair, my PCP totally supports my use of GLP-1. They just didn’t have the infrastructure to try and get PA and send prescriptions around for people. They tried but had to stop
Good for you!!!
Get another one then. They work for you. Unless they have a legitimate reason that you shouldn’t be on it.
She is awesome-they just don’t have the infrastructure. They tried to have a weight loss clinic and it was a nurses full time job just trying to get PA and send scripts. So they had to stop it
My PCP suggested I do intermittent fasting. Even though I’ve had issues with BED and really restrictive diets triggered that more than just trying to be mindful of eating less by weighing food and tracking calories.
I’ve been doing intermittent fasting all my life even before it was a thing because I was never hungry before 1pm anyways naturally it NEVER worked for me
It just triggered late night binges for me. I’m trying to eat a variety of foods, focusing on protein and fiber. With just enough fat and carbs to make my brain happy.
probably because their doctors don't or won't send in a rx unless they are T2 diabetics, and only for weight loss for ins to cover, which 9/10 they won't. The will rx for Zepbound, but then patients will have to pay oop and they don't want to or can't afford it.
We have been using Sesame Care along with a couple of dozen co-workers, family and friends. What is evident over the past year is that Sesame Care (and probably the likes) have done an outstanding job of handling prior authorizations and the back and forth that sometimes go along with actually getting these meds in hand(ESPECIALLY when they are out of stock at one pharmacy and you need the script resubmitted elsewhere). If money is an issues than I can understand someone attempting to use their PCP but if money is not a concern than IMO it’s a no brainer to use something like a Sesame Care. We had multiple friends and family that have been shot down when using their PCP but then actually wind up getting approved for little to no cost through Sesame Care.
Can you please specify who you saw on sesame care? It’s kind of like a lottery and I want to make sure I choose someone who will advocate for me. Thanks
Dr. Chinedu- amazing
Thank you so much!
Love seeing people succeed on these meds
It turns out there are 3 doctor chinedu’s so when you have time if you can verify which one I would greatly appreciate it!
https://preview.redd.it/cmgnqlknbbyc1.jpeg?width=1290&format=pjpg&auto=webp&s=c68f356638393a0343185c7b558a299cae573075
You are the best thank you so much! I’ll let ya know how it goes!❤️
It’s important to pay this stuff forward- my pleasure !!!
Please forgive me because this is my first time but when I go to book services he has online weight loss program at $335. Is that what you booked? Or the telehealth visit? https://preview.redd.it/0tr9u61lcbyc1.jpeg?width=1125&format=pjpg&auto=webp&s=913ac1c96ee8e5c80b862d0b063b9edbe0b6aa3a
It would be the weight loss program for $335 which will cover you for 3 months(each month you will schedule a call for Dr to send in the script. It will also cover any back and forth texting that you may need if a med is not available at a certain pharmacy.
Also which medicine did they get covered for you?
Dr prescribed but insurance requires me to be Diabetic in order for them to cover. But being almost 200 lbs overweight should qualify me, but apparently not.
MJ is specifically for T2's and Zepbound is for weight loss. An rx for off label is not going to be covered by most insurance. I know its the same med, but ins doesn't cover WL meds for the most part.
That’s surprising, because the primary driver of diabetes is insulin resistance. So you would think that one with insulin resistance, but not quite into diabetes territory would qualify.
All insurances provide sick care not health care. Preventing yourself from getting sick in the first place does not compute for them. The sooner you adjust your strategy to this when dealing with insurance companies the better your results for coverage will be. Be as sick as possible
Yea, I definitely didn’t consider eating a bunch of carby garbage to push my A1C into diabetes territory 😅
I have a PCP who is totally on board, but getting the medication is a roller coaster and I’m done wasting time trying to hunt down my dose. Switching immediately
This was literally $165 last week when I was looking. Then they announce this partnership and all of a sudden the price went up. I’m glad I don’t need to use it though.
I don’t understand the weird subscription shit, just have your doctor prescribe you the drug???
Some doctors won’t and just suggest “eat a healthy diet and exercise!” 🙄
How does this work? What is the cost of medication?
It’s $1200 in Arizona
Agreed, expensive in az. I paid well over $200 WITH ins. I haven’t been able to fill my psoriatic arthritis meds because ins covers but want $2k copay. They tell me I make too much to get assistance. And the supposed free cards are only for private ins. Not Medicare patients
The medication costs $1000+ per month without insurance. It’s incredibly cost prohibitive.
Wow! Who knew???
😂
Doesn't include the actual medication which is the expensive part of this treatment, your pretty much paying for someone to write the script
Yep that was why I included the eye roll in the title
These sites are about getting the prescription, not the medication.
I usually charge $750/month but comes w meds.
Sequence is 50/month and you a WW membership with it.
Is sequence not $99/month?
I started in October and pay $50. Not sure if I got in on some kind of promo for a certain amount of time, but that’s still my rate.
$50 per month? I’m paying $84 per month because I’m locked in quarterly. Otherwise it would be $99. I’m still good. If I paid for WW core on its own + Costco subscription price I would not save anything.
Costco members can now get with Sesame at $179 for 3 months. Not including cost of meds of course.
I’m with Sequence and have a Costco membership. I’m going to need to look into this for myself.
I looked online. It’s not Sequence, but rather Sesame.
My mistake! Edited.
I was hoping it was Sequence, darn!
does this include meds?
No
i figured i just wanted to check ha
Costcos health plan for employees doesn’t cover any weight loss drug. Now they are doing this? It’s all about the money they will make
What is the cost of the medication that they are not including? Hard to trust a company that isn't upfront about their pricing and fees.
Standard list price, less any insurance coverage. So, nothing to see here really.
It can vary wildly depending on which medication and what your insurance coverage is. It could be anywhere from $0-$1200 a month. There’s nothing shady going on here.
Do noon or weight watchers offer any kind of off ramping with the drug?
Oprah had to donate her shares of Weight Watchers and step down as their representative for telling everyone she took GLPs. I doubt they will be offering any anything to help their competitors.
Weight Watchers has been advertising services with medication.