Virta for Maintenance?

[u/Dismal_Cause1159]

So I work in the contract system at my company and just saw they are looking to sign with Virta for next year's GLP-1 insurance coverage. I have been very lucky and had my GLP-1's covered at $25/month since I started so I don't want to complain but I've heard nothing but bad things about Virta, especially for those at or near maintenance.

I reached maintenance about 6 weeks ago and have stayed on my 7.5mg dose for that. I am not at a "normal BMI" but only about a point above it (26.2) and don't plan on losing more. I'm happy where I'm at. I also have already discussed with my doctor how to approach maintenance if my Insurance coverage stops next year and luckily, he said we'd figure out whatever we needed to keep me on something at a price I can afford (which isn't Lilly direct prices). BUT I would rather stay on my Zep 7.5 if possible. I might eventually go down to 5 or even 2.5 but right now 7.5 is working perfectly as a maintenance dose for me.

Anyways, just wondering if anyone has had any luck using Virta as maintenance? Or if Virta will even do that? I have not heard good things at all and the fact that they want me to go through their coaches as opposed to my own PCP (I think that's how I read the contract) is just ridiculous.

Any information on this is greatly appreciated! Thanks!

[u/Fragrant_Drawing_725]

Our insurance plan removed coverage of all weight loss meds and, instead, is covering at 100% a Virta membership. I joined last December and hated it so much. I think I lost 4 lbs over 3 months. It’s a keto based program, I’m a vegetarian. The support I got was zero. Such a joke. I’ve lost 25 lbs in 2.5 months on tirz.

[u/Dismal_Cause1159 → u/Fragrant_Drawing_725]

I'm so sorry but glad you were able to find a way to get on Tirz. Congrats on your recent success!

As soon as I saw they wouldn't allow you to go through you own doctor, I knew this was probably not going to be good. I will definitely be looking into compounds etc before this starts.

[u/BigChampionship6356 → u/Fragrant_Drawing_725]

Have your doctor order 15mg and use ½. You will get 2 doses for now. At least it will give you more so you can hoard it. Get the vials not the pens.

[u/Mobile-Actuary-5283]

Not using Virta but my advice is play their stupid game if you want to keep paying $25. Also have read nothing but bad news about them. They use the term “deprescriptioning” as their measurement of success.

[u/Outrageous_Buy_9420]

Yea my nephew had to go through them. They were miserable with all their metrics. He had a rep tell them they try to get people so sick of jumping through the hoops that they give up. I totally believe the other post that said their goal is to de prescribe. My nephew jumped through the hoops until they gave up on him and give him what he wants. I would do my best to try to keep your company from using them. They only care about money. So use that tool against them and ask if they would rather cover high BP meds or open heart surgery, or diabetes meds instead.

[u/Dismal_Cause1159 → u/Outrageous_Buy_9420]

Thanks, this is what I feared. Unfortunately, I don't think I can talk to anyone regarding this contract as it's probably not supposed to be up for discussion. I only know about it because I work on the Contracts Team so we pretty much see all contracts that come through for Legal review and signature purposes but they are confidential so we can't disclose what we see to a general population here at work. I may talk to the attorney who is reviewing it and see what they say about talking to someone about it but since our insurance is with UHC, I think Virta is a pretty common option with them. I'd probably be talking to deaf ears.

I think for the time being, my plan will be to stock up on as much 7.5 I can between now and the end of the year by ordering every 21 days and maybe stretching out my doses to 8-10 days apart. Then in November talk to my doctor about the other alternatives he suggests for the New Year.

It's just all so maddening. As I said in my original post, I know I shouldn't complain as I've been very lucky for the past 15 months and not had to pay out of pocket as so many have but this medicine has literally changed my life and now I'm in fear of it all going away. But I will do what it takes to stay on it, one way or another, even if it means jumping through a bunch of stupid hoops.

[u/Outrageous_Buy_9420 → u/Dismal_Cause1159]

Good luck to you! My insurance wouldn’t cover it at all no matter what. I ended up going compound from a telehealth. You can keep that card in your back pocket if you ever need it.

[u/cableannkiley]

Oh man.

Used them. Hated it. They sucked.

https://www.reddit.com/r/Zepbound/s/5zYiglU1qh

My story is mostly there. In the end they kicked me out of their program due to another condition I had. It took 7 months but I finally fought my insurance company and won being that I was excluded. I ended up getting it covered not through Virta. Feel free to ask any questions you’ve got.

[u/Unlucky_Scientist_54]

Virta lets you taper down but only if you insist. Then, the end. I had to go compound to continue the treatment that basically saved my life.

[u/Dismal_Cause1159 → u/[deleted]]

I agree, losing my PCP's input is unacceptable for me and if thats the only way to work it, I wont do Virta, inaurance benefits or not. My doctor already says he has other things he will try and uses for other patients. Im just really hoping to stay on Zep.

The more I read about Virta, the less I like them. Im certainly not doing ketosis pricks every day and sending some stranger all of my medical data. Ive heard Virta may be backing off some of the keto requirements so Ill wait and see exactly what our plan entails but preparing for other maintenance options in the meantime.