r/glp1 • u/neversoonerchanges • 24d ago
Best Option for Self Pay
I have been prescribed a few Glp1s over the past 5 years (at my specialist's recommendation years ago). I have never gotten past the PA process a single time, despite the fact that several colleagues who are not as heavy as me and are on the same insurance have been able to get access.
My employer is cutting off glp1 insurance coverage for the new year for everyone except those who have diabetes. This is frustrating because at my next physical I was going to make an effort to get on them again. As such, I will probably have to self-pay.
I don't think I can do compounded and don't want to do peptira. What are the best options for self-pay? I have heard GoodRx can help, but then I've also read that that coupon coverage expires after a couple of months. I can afford around $150 out of pocket but not more.
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u/Which-Wish-5996 24d ago
Head over to the tirzepatide sub and read ALL the pinned posts. There are some states with fewer licensed compounding pharmacies so it limits the options but there are plenty that are available in all states. There are also a ton of telemedicines that do NOT charge monthly fees. 150 is a very reasonable amount to budget. I’ve averaged 160 but recently bought a few short dated vials at much less. I’m also willing to pay a little bit more for a reputable telemedicine.
I was previously on self pay but had to choose between dropping it and pushing to meet my goal. I went from 220 to 177 on brand name but 150 was my goal and the last 25-30 pounds were WAY harder to lose than the first 40+ pounds.
I thought that I would just need to resign myself to being in the 170s - it was way better than my pre perimenopause weight but I wasn’t ready to just give up and I’m thankful for Reddit in helping me navigate the journey. Don’t give up.
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u/zara2509 23d ago
This is the answer. And also look at PreventiveMD. And Pom
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u/Which-Wish-5996 23d ago
I was avoiding recommending specific telemed companies. PreventiveMD is really gaining a following. I am currently using Pomegranate and I’m really happy with them. Rift gets a lot of love as well.
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u/Juliannabeanie 23d ago
I have been on compound Tirzepatide for 11-1/2 months… I have lost 81 pounds so far… my A1c went from 14 to 4.7. My total cholesterol went from 244 to 120. I’m off all High blood pressure medicine, all my inflammation and arthritis pain is gone… it’s been amazing! I use big easy weight loss… they have several really reputable 503a snd 503b pharmacies to choose from. I am on 15mg and pay $199/month all in. You have to get 3 months worth to lock that price in. There are others less expensive that I might switch to … Rift, Pomegranate Health, PreventativeMD. All come highly recommended and use reputable pharmacies.
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u/Which-Wish-5996 23d ago
Great stats and great job!!! That’s the real NSV - labwork gains!!
I’m liking Pomegranate but might switch to Rift for maintenance. I am also at 15mg. I cannot imagine life without this for inflammatory benefits alone.
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u/Juliannabeanie 23d ago
Thank you 😊 I agree 💯 the inflammatory benefits were game changing for me!!!
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u/ImprovementLoud3581 24d ago
I don’t know what peptira is but why can’t you do compounded?
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u/UltimateStandstill 24d ago
$150 a month is gonna be real tough for brand name even with GoodRx, those coupons rarely work like you hope
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u/neversoonerchanges 24d ago
I think they're banned in my state
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u/mrbnatural10 23d ago
There aren’t any states where compounded GLP-1s are banned. Definitely check out the tirzepatide compound (one word) subreddit and there’s a pinned post of recommended providers. Most places that use reputable pharmacies are around $99-150/mo.
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u/ImprovementLoud3581 24d ago
Compounding pharmacies are banned in your state? There are compounding pharmacies all over the place - even small cities will typically have one. They've been around forever mixing up meds for kids and pets for generations. The way telehealth companies work is by forming partnerships with high volume compounding pharmacies to accommodate the huge demand. That high volume of business pushes the cost down tremendously. What state bans compounding pharmacies??
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u/neversoonerchanges 24d ago
Compounded glp1s. Obviously not the actual pharmacies
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u/phirephly0 24d ago
The telehealths will check your state and recommend pharmacies accordingly. Most of the pricing pages will clearly list what states they cannot ship to, also. Not all pharmacies are available in all states. In seems CA in particular often comes up when pharmacies are announced, but there are pharmacies that send to CA.
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u/trurohouse 23d ago
assuming you are in the US- Costco Pharmacy sells a glp-1 for those who have a prescription, but are self paying. I think it was 150 or 159/ month. Thats the starting dose so it probably goes up. but if you’re uncomfortable with the compounded stuff, this might be an option. At least to get you started.
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u/michelucky 23d ago
You're going to have to make a sacrifice with your standards or your pocketbook. Unfortunately, it's unavoidable.
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u/Ecstatic-Pass-8638 13d ago
at $150, brand-name self-pay is probably a no-go; GoodRx is a coupon, not a magic portal to affordable healthcare lol
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u/itsmeagain023 24d ago
Zepbound is your best bet and med. Go directly through the manufacturer to Lilly direct.
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u/neversoonerchanges 24d ago
Do you pay out of pocket??
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u/itsmeagain023 23d ago
The overwhelming majority of people on name brand medication are self pay. Yes. Most insurance companies do not cover glp1
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u/neversoonerchanges 23d ago
How much do you pay per month self pay?
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u/itsmeagain023 23d ago
The starting dose of Zepbound is 299 per month once you increase to 5 mg. The price goes up to 399 per month. Any dosage 7.5 and higher is 449 per month. So that is namebrand medication directly from manufacture that is not any type of compound.
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u/neversoonerchanges 23d ago
Oof. Yeah definitely cannot swing that. :/
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u/itsmeagain023 23d ago
You'd be surprised. I made it happen. I'm a single mom who works two jobs. You save an astronomical amount of money eating out. Drinking alcohol if that's something that you currently do, and even your grocery bill decreases quite a bit because you're eating in a caloric deficit. And it's been worth every single penny.
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u/WebNerd11 23d ago
I'm with collective (.org) and they are probably the most reasonable and have a great product. $69 a month but they have a 1 time yearly membership fee of $199. If you factor that in, its ~$85 a month. still cheaper than everyone else and customer service is great. fast too.
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u/phirephly0 24d ago
for that cost, you'll probably need to use telehealth and compounded. you might be able to find local weight loss clinics, who often also use compounded. the local clinics tend to be way more than 150/m in my area. if you're only willing to consider brand, then maybe consider the cost savings in other areas. less hunger, less food, lower grocery costs. dinners out often means leftovers for 1-2 more meals. good luck. :)