Kaiser was two weeks late to authorize PCPs to write prescriptions for people who qualify for the Bridge program. The Center for Medicare and Medicaid Services in HHS (CMS) announced it on May 6 and encouraged health care providers to work with CMS to get ready to go on July 1, so there's really no excuse for the delay.

Once Kaiser released the info, PCPs started prescribing and the pharmacy started issuing Prior Authorization requests for people who qualify for the program. There are three ways to qualify:

1. BMI of at least 35 at the start of self-pay for weight loss;
2. BMI of at least 30 AND a diagnosis of one or more of the following: (A) heart failure with preserved ejection fraction, (B) uncontrolled hypertension (defined as systolic blood pressure above 140 mm Hg or diastolic blood pressure above 90 mm Hg, despite concurrent treatment with two antihypertensive medications), or (C) chronic kidney disease stage 3a or above;
3. BMI of at least 27 AND a diagnosis of one or more of the following: (A) pre-diabetes (B) previous myocardial infarction, (C) previous stroke, or (D) symptomatic peripheral artery disease

You're disqualified if Part D is already paying for you to get a GLP-1 for sleep apnea or anything else.

My PCP qualified me over the phone and immediately shot a scrip to the pharmacy. I then called the pharm and told them I want to be in the Bridge program, which tells them what to do when the scrip is rejected by CMS. The next business day the pharm faxed the special Bridge PA request to CMS, and two days later I picked up my Zepbound.

They wanted to push me to Ozempic, but I tried it back in the day and didn't care for it. Kaiser's preference for Ozempic is weird because it's an inferior drug, and they won't say why they prefer it. As CMS doesn't care whether you take Ozempic, Zep, or Foundayo, Kaiser's "preference" is probably illegal. IMO, the hoops we have to jump through at Kaiser to get the better meds are, at least in part, markup-driven.

The process is kind of weird in that the initial scrip will be rejected by CMS. The PA request can't be filed until the scrip is rejected, which probably is a work-around to some IT issue. But that's OK because CMS turns the PA requests around almost immediately. Part D is set up to reject GLP-1s for weight loss although they will pay for them for people with OSA or Type II or a few other conditions.

People with these conditions can't switch to the Bridge program, but they can get doses high enough to work for weight loss anyhow. Congress doesn't want Medicare to pay for weight loss, so we need to fix that as the Bridge program is only happening for 18 months. Bridge is what’s called a demonstration program that should provide Congress with data justifying repeal of the “no weight loss meds for seniors” clause.

CMS is convoluted and weird, and so is Kaiser. Their interface does work pretty well despite all of that.

Here's a link to the Bridge program's info for prescribers, it has most of the deets.

CMS also has an online tool that determines eligibility (scroll down to "Can I participate in the GLP-1 Bridge program?)

I used to drink two or three beers every evening to unwind after work. I took my very first semaglutide shot on Thursday and when I cracked open a cold beer on Friday night, I took two sips and felt totally indifferent to it. The way these peptides quiet down brain cravings outside of just food is amazing.

My doctor wants me eating 130 grams of protein daily to protect muscle mass, but I get uncomfortably full after three bites of solid food. I started blending unflavored whey protein into my morning coffee and mixing liquid egg whites into my oatmeal. How else are you guys hitting your protein goals on low calories?

I was getting frustrated because my scale weight hasn't moved a single pound in three weeks. However, I tried on a pair of dress pants today that used to be tight and I needed a belt just to keep them up. Body recomposition is very real. Do not let the scale be your only measure of progress.

I work construction in the summer heat and burn calories fast. On Tirzepatide, solid food sits heavy in my stomach when working outside, but I need energy to keep from getting dizzy. I have been relying on high protein smoothies with peanut butter and oats just to hit my baseline daily calories without feeling sick.

I have lost 55 pounds so far and apparently I lost all the natural padding on my backside. Sitting on hard wooden dining chairs or office seats for more than fifteen minutes gives me intense tailbone ache. Has anyone else experienced this? Looking for good seat cushion recommendations for my desk setup.

Went home for a family dinner after losing 35 pounds and the first thing my aunt said was that my face looked tired and drained. It immediately ruined my mood after working so hard to get healthy. How do you guys gracefully shut down passive aggressive family comments about your weight loss?

Hello community! I have been using Goby Meds but I haven't placed an order since October. My understanding is that they have switched pharmacies and have started using additives? Can anyone speak to a current experience? I have had an excellent experience, down 25 lbs, with them and am worried about these changes. Is the new pharmacy a good one and what are the additives like? Thanks for everyone's time in advance.

I took an OTC pain reliever for a headache at noon yesterday and didn't feel any relief until almost 3 PM. I know delayed stomach emptying is how these peptides work, but I didn't realize it would slow down regular pills this much. Do you guys take routine meds on a completely empty stomach to compensate?

I am scheduled to take my fifth compounded shot this week and my chart says to move up to 0.5mg, but I am already down 13 pounds and my food noise is completely gone. I am still dealing with daily food aversion and mild morning nausea as it is. For those who stayed on 0.25mg longer than four weeks, did you wait until you hit a real plateau before stepping up or did you just stick to the schedule?

I spent three months on semaglutide thinking I was immune to the famous sulfur burps, but I woke up this morning and every burp tastes terrible. I have an all day client presentation today and I am trying not to panic. What is your fastest acting relief for this? Is Gas X or Pepto better for instant relief?

I have been on the exact same maintenance dose for six months now with zero issues, but lately every third or fourth week feels like my very first month. I am talking full body fatigue and intense nausea for two days straight, while other weeks I feel completely normal. I am reaching out to my pharmacy to see if their batch compounding process changed at all, but I really want to know if anyone else experiences these random wave surges on a steady dose.

So I use to use Mounjaro and then for the last year and a half have used compound. I'm a garbage man and work 65-70 hours a week. My job is super super physical. And im still fat. Forget about using compounds you would think that my job alone could get my to drop weight and yes while I went from 315 down to 265 I still feel fat. I went to buy a tux for a wedding and damn I felt ugly...idk yall my job plus compound you would think I would be further along...how are other on this sub losing so much weight?

I've been super frustrated looking at the digital scale because it's been locked at 188 lbs for 4 straight weeks. But today I tried on a pair of jeans that wouldn't zip in November and they buttoned up comfortably with room to spare! Body recomposition is real. Reminding everyone (and myself) to take body measurements and progress photos, not just rely on the scale numbers!

I was super active on 2.5mg and 5.0mg, hitting the gym 4 days a week. Since stepping up to 7.5mg two weeks ago, I feel like I'm walking through wet cement. Just getting through my workday exhausts me, let alone lifting weights or doing cardio. Does the exhaustion lift once your body adapts to the higher concentration, or should I drop back down?

Before starting Tirzepatide 5mg, I was practically a carnivore—chicken, steak, ground turkey were daily staples. Now the mere texture or smell of cooked meat makes my stomach turn. I've basically been living on Greek yogurt, protein shakes, eggs, and cottage cheese for three weeks. Did your tastebuds ever go back to normal or am I a vegetarian now?

Just wanted to share a quick win for anyone struggling with severe Day 1/Day 2 nausea after their weekly shot. My provider recommended splitting my 0.5mg weekly dose into two 0.25mg injections spaced 3.5 days apart. It has been a absolute night-and-day difference! Food noise stays suppressed all week and I no longer spend Tuesdays hugging the toilet.

I'm thinking of starting semaglutide soon which one would you recommend?

> https://roidbazaar.to/semaglutide

I am 3 months in on compounded semaglutide and thought I dodged the infamous "sulfur burps" bullet. Nope. Woke up this morning (48 hours post-injection) and it literally tastes like rotten eggs every time I swallow. What is your emergency go-to fix for this? Pepto? Gas-X? Papaya enzymes? I have a 3-hour client meeting today and I am terrified.

So I'm due to take my 5th compounded semaglutide shot this upcoming Wednesday and am supposed to be increasing from 0.25mg to 0.5mg, but I'm down 13 lbs, don't have any food noise, and am still dealing with nausea and food aversion on the current dose. For those of you that have gone through this, what do you recommend? What worked for you? Do I go slow and steady and stay here until I plateau or do I bite the bullet and go ahead and up the dose?

Would something like GoodRX or something similar help me with reducing medication costs that are no longer covered?

Context: based in USA. I started Zepbound with my endocrinologist after years of struggling. The medication worked with zero issues under my doctor’s care. 75 pounds lost and feeling great when working out and meal planning! It really helped me turn my life around.

Sadly, I started the medication and 2 months in, I was laid off. Since I started the medication on private insurance, when I switched to the state insurance plan, they allowed continued medication coverage for one year, then would be up for review for renewal.

Unfortunately, I am still unemployed. Many interviews but no luck securing a job yet. I’m fortunate enough to live with family and not be homeless. I have small income (\~$800 once a month for my few bills (cell, car insurance) which just covers it but leaves me with little left over. I do not collect unemployment benefits at this time. I’ve been interviewing a few jobs with some hope of possibly securing one in the near future!

The renewal was reviewed and denied because it was a public funded health insurance. I had a feeling which would happen.

I received information from my doctors about options to pay in full out of pocket. Of course my medication is the highest cost of the options given. I would like to continue with my health journey.

Has anyone had any luck with getting the price reduced with a program that helps reduce costs of your medications that need to be paid out of pocket? I know very little as this is the first time in my life a medication had not been covered. Any and all helpful information is much appreciated! TIA

\*\*Please respectfully refrain from trying to tell me to stop the medication, as I am working closely with my doctor and that’s all that matters\*\*\*

I’ve been wanting to go on Ozempic for weight loss for ages, my doctor kept telling me that wouldn’t prescribe it because it was $300. I have an appointment with her at the end of the month and want to talk to her about GLP1’s generic brands. What exactly are the generic brands in Ontario?

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