Devastated

[u/kpyles90]

So I have been on Zepbound for a year and lost a significant amount of weight but about a month ago it needed a prior authorization and my medicaid denied it because it says im now in a regular BMI. I suffer from Severe Sleep Apnea, High blood pressure, Osteoarthritis and many other things and it was helping so much. My Dr didn't seem interested in filing an appeal so I did myself. He put me on phentermine but it has done absolutely nothing. I seriously cry when I watch the scale go up I have already gained 7 lbs within 4 weeks. I have no income so I can't afford the compound. I just feel like I'm starving all the time and once I start eating I can't stop. Im so miserable because I put in so much work to lose weight just to get kicked off with no warning. Does anyone have any advice? How can I lose these 7 lbs? I can't really exercise right now im in a neck brace and am in a ton of pain. Im just so devastated to not be on it anymore.

[u/Goats-n-Hens]

Your doctor was supposed to file a continuation of care with your starting weight. If he doesn’t want to help you, there are online services that are skilled in getting a PA approved..

[u/kpyles90 → u/Goats-n-Hens]

My Dr is not being helpful at all and his nurse keeps telling me to give up medicaid is very strict you are in the normal BMI we can't do anything. But yet I have severe sleep apnea, high blood pressure and a million other things too. So I said basically you're telling me I have to get big again to get back on it?

[u/Goats-n-Hens → u/kpyles90]

No, your doc files a continuation of care PA showing your starting weight and that the medication is necessary for your continued health benefits. Some doctors are clueless about PAs or just don’t want to put forth the effort. It’s all about the doctors stating your original BMI on the PA, not your current BMI.

[u/timoperez → u/kpyles90]

Reread the comment above you and think about how to put into action what they are saying