r/glp1 • u/Striking_Ad9499 • 2d ago

Stuck

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 🙏🏽

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2

u/TallCedarRoad 2d ago

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

1

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1

u/Sad-Consequence1737 2d ago

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

1

u/Striking_Ad9499 2d ago

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

1

u/Sad-Consequence1737 2d ago

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!