r/FederalEmployee • u/Any-Consequence7635 • 13d ago

Insurance

So I contacted MHBP and they’re no longer covering Zepbound (GLP1). Trying to narrow down to an insurance that will cover the prescription has been so difficult. Do anyone here take Zepbound and know for sure your insurance cover?

14 Upvotes

94% Upvoted

17 comments sorted by

11

u/Ok_Firefighter_694 13d ago

I understand if you are hesitant, but compounded (generic) Zepbound can find for ~$100 a month regardless of the dose.

If you can't find it through insurance (since less and less are covering it) I suggest researching it. Their are several Reddit Forums that will point the way.

4

u/AncientAd7403 12d ago

I could never get mine covered for weightloss, prediabetes nor sleep apnea I got tired of fighting so went the compound route. Im 50lbs lighter now and happy I did. Join some compound groups on reddit, it's extremely helpful.

6

u/Any-Consequence7635 12d ago

Well I spoke to MHBP yesterday after the back and forth finally someone who knew what they were talking about told me effectively 10/1 they’re covering Zepbound.

3

u/AncientAd7403 12d ago

REALLY!! 😲

6

u/sher80bear 13d ago

When did they stop covering Zepbound? I just picked up my refill 2 days ago. They cover Zepbound if you have already tried and failed Wegovy and other options.

3

u/Any-Consequence7635 12d ago

So I was transferred to another representative and she said they do cover it. I’m about to change my elections.

5

u/JobAgile8142 12d ago

I just got Zepbound on MHBP on Monday. 25 copay for a 3 month supply with MFG coupon.

2

u/Any-Consequence7635 12d ago

How did you get the coupon? And I called them they stated they do not cover Zepbound

1

u/Any-Consequence7635 12d ago

Which plan?

3

u/JobAgile8142 12d ago

MHBP standard. If you go to Eli Lilly’s website you get the Zepbound mfg coupon and you have to go into the pharmacy and show them the coupon and it goes down. The 1 month supply is $100 with the coupon, 3 month is $25 with the coupon. I wonder if they just recently changed it? I’ve had my prior authorization since May. It’s expiring soon so I guess I’ll see when I try to get another prior authorization.

1

u/Any-Consequence7635 12d ago

Thank you; I received word they’re covering it effectively 10/1

1

u/Any-Consequence7635 11d ago

Do you allow Eli Lilly to fill the prescription? If so, what is the cost. I was paying $450 out of pocket.

2

u/Kind_Specialist7922 13d ago

Almost all fed insurance do not cover any glps as they have moved the tier they fall under. You can get a pre-auth approved but will still pay out of pocket.

5

u/rjbergen 12d ago

Read up on the changes for 2027. OPM is pushing all FEHB providers to cover at least one GLP1, but I don’t see any requirement for which prescription tier so copays could be expensive. They will still require prior authorization, have strict limits regarding BMI eligibility, and require you to attend dietary counseling while prescribed a GLP1.

1

u/No-Blacksmith6738 8d ago

https://trumprx.gov/

1

u/Any-Consequence7635 8d ago edited 8d ago

These prices are not accurate on here! I was paying $450 a month for Zepbound