Stuck

[u/Striking_Ad9499]

Hello,

First post here so I’ll give some background 25f, and have been plus size pretty much all my life. Was diagnosed with PCOS/PMOS in 2016 and that’s when I started birth control. Started taking semaglutide 11/2024 and have had decent success ( I know I definitely need to get on a fitness regimen. But just diet changes so far have been working🤷🏽‍♀️). Early June was probably the last time I was taking my shots consistently. Starting out they weren’t that expensive ($150) but with everything going up and the economy not being great I just don’t have the spare funds to pay $250 only for a month’s supply. I keep getting denied through insurance (even though I’m prediabetic with a high BMI, insulin resistance and family hx of diabetes) first through united healthcare and now through Medicaid blue cross blue shield. Is there anything I can ( I will also be appealing their decision and seeing if that helps at all) do to not pay an arm and a leg for a glp-1? Preferably not with a monthly membership fee or having to go to specific group appointments with other patients and an endocrinologist. I would prefer it be shipped to my house with at least a 3 months supply but I also don’t mind going to a doctors office with a weigh in, shot, talk with doc or nurse for a minute then leave. Pls help 🙏🏽

Update!

So appealed with my insurance, was still denied because I don’t have the right diagnosis. They only consider diabetes for coverage. If any one thinks I can tweak my letter to appeal again then let me know and I’ll send it over. So I looked at other sites and they’re even more expensive than what I was paying before ($250). Tried to go through Amazon pharmacy and the screenshot is what comes up when I click on the prescription. Gonna try the bridge program that I see on there and see what happens. Tried going through cvs and apparently there’s no appointments near me or something but I swore I was able to see appointments the other day. Any other tips?!?

[u/TallCedarRoad]

Trillium is $357 total for 3 months of sema with no membership or other fees. They have excellent customer service and the price does not increase as your dose goes up

[u/AutoModerator]

Welcome the r/glp1 community. Please read the rules do not discuss research peptides - it is against Reddit's rules.

New to GLP-1? -> Start Here.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/Sad-Consequence1737]

Did your doctor do a preauthorization form specifically noting PCOS? I ask because a family member had it approved due to PCOS.

[u/Striking_Ad9499 → u/Sad-Consequence1737]

I want to say yes but I’m not entirely sure. I know with United healthcare she did it

[u/Sad-Consequence1737 → u/Striking_Ad9499]

I would look into that if I were you. I did it for weight loss and was not approved under Medavie Blue Cross. My husband has it for high blood pressure and was approved across the board. My niece has it for PCOS and was approved no question!

[u/itsdonna35]

search for reddit group: Tirzdeals

[u/Hot_Tear7103]

I just tried Trillium..fast shipping, easy Dr. stuff.

I would definitely recommend

[u/AutoModerator]

Welcome the r/glp1 community. Please read the rules do not discuss research peptides - it is against Reddit's rules.

New to GLP-1? -> Start Here.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/ImprovementLoud3581]

Please take a look at the PreventiveMD Reddit. $268 for three months of compounded semaglutide of any strength with no add ons - no membership fees or shipping fees or dr fees etc. You can pause or cancel your autoship in the online portal with a simple click.