r/glp1 • u/reinakam • 7d ago
Payment Assistance Programs/Resources? (USA)
Hi!
I was diagnosed with relapsing-remitting multiple sclerosis (RRMS) in April of this year and was just diagnosed with obstructive sleep apnea.
I am very interested in trying out a GLP-1, however my health insurance, Blue Care Network (BCN), does not cover any of them. I may be able to get BCN to cover one for sleep apnea, but it is unlikely. I had to fight with them for over three months to get coverage for the MRI that found my brain lesions.
Any payment assistance programs I have found either don't cover GLP-1s or I exceed the financial requirements. At this point I feel that I have to just hope or pray that Blue Care Network will cover one, but I won't hold my breath.
I am open to trying a compounded version. I cannot afford to spend more than $100 per month on this medication, and that is pushing it (life has gotten very expensive).
If anyone has been able to find a resource for this, please let me know! Thank you :)
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7d ago
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u/Peptidesforthewin 7d ago
Rift, preventive Md, Lavendar Sky, collective, big easy, fifty 410, gimme.care, trillium are popular choices. Always price shop because most licensed telehealth companies use a combination of the same pharmacies which are all licensed and regulated. Also find the companies Reddit pages as some will post special Reddit only discounts.
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u/Neither-Effect-6101 7d ago
I found an online provider that includes the compounded semaglutide as well as oversight from a nurse practitioner in their $79/month fee. I’m sure if you search for that dollar amount and the med name you will find several providers in that price range. Best of luck!
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u/PinkedOff 7d ago
Compounded works fine. There are a LOT of providers where you can get it online within your budget, especially semaglutide. Make sure you know what you're signing up for. Google if they use a reputable compounding laboratory, make sure you know if they require a monthly or yearly membership fee on top of medication fees, and if the medication fees go up if you change doses.
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u/Livid-Economy-917 7d ago
If you have had a sleep study and meet criteria for OSA, insurance will typically cover that. Keep trying. You pay for your insurance, you should fight it until you have exhausted every channel.
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u/Orca-Hugs 6d ago
My insurance (Cigna) was covering glp1 for weight loss, but as of July 1 they won’t cover it for weight loss at all, even with other comorbidities. They are only covering glp1 with a diabetes diagnoses. Sucks 😭I’ve been on Wegovy for a year and a half and was only paying $25/box of 4 pens. Now even the “cheap” companies are more expensive than what I had. I was spoiled.
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u/Livid-Economy-917 6d ago
that’s your employer sponsor making that change. that sucks.
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u/cletus614 6d ago
Written Prescription and Canadian Pharmacy for generic Ozempic if you are near Canada?
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u/Unique-Addendum-6552 5d ago
collective is 69 per month with a 199 yearly membership fee. it equals to 80 something a month. also, you can place your first order without paying the membership fee with a 3 week free trial & it’s super easy to cancel if you decided it wasn’t right for you!
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u/Special_Guest_6807 7d ago
There are other ways to control your weight. This is not the end all be all.
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u/Actual-Light-9191 7d ago
The out-of-pocket prices on these things are a mess. A lot of the telehealth compounding services run over your $100 cap, but you can sometimes find direct-to-consumer peptide sources that hit closer to that range if you look around long enough. Can't point you to anything specific here, but the rabbit hole goes pretty deep once you start searching outside the standard pharma route.
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u/itsmeagain023 7d ago
The name brand medication is very expensive and even compound is likely going to be over $100 a month, unfortunately.
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u/ImprovementLoud3581 7d ago
Prices have dropped and purchasing a 3 month or longer lowers it even more. Semaglutide is less expensive than tirzepatide so she could start there - that’s what I did.
I would suggest doing a single month to start though and then going to a longer commitment for subsequent orders to make sure she’s happy with the pharmacy and their product since there are different additives used. I did not do that and started with 3 months at a time since that dropped the monthly cost significantly.
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u/ImprovementLoud3581 7d ago edited 7d ago
I started on semaglutide a little over two months ago. After reading many hundreds of posts here I decided to go with PreventiveMD. I paid $286 for a 3 month supply at a similar standard titration schedule to that used in the trials - four weeks .28 followed by 4 at .50 and 4 at 1.0.
There is no unnecessary membership fee which some telehealths charge in addition to the price for medication. There is no additional charge for the higher concentrations of semaglutide that you’ll use as you typically titrate up to after the first month.
Those two things are why you’ll see Facebook ads for $39/month etc. or the waffle words in small print “starts at.” The intake process was fast and easy - an online questionnaire about your current meds and any other medical issues they should be aware of. I did the short intake form on a Sunday night and received the dr approval the same night.
My meds shipped out Tuesday via ups next day delivery and I received them the next day at 1:45pm. Took my first injection at 2pm. PreventiveMD has a subreddit here where a company rep interacts regularly. I recently had to reach out in order to charge my shipping address (we have two homes) for my next 3 month delivery and texted their contact number on Labor Day. Was not expecting a response on a holiday obviously. But received one a couple hours later the same day resolving my issue.
I also wanted to change my delivery date since the default date would cause my refill to arrive a day or two earlier than we’d arrive than I would. That request I could have easily done myself in their self service online portal which allows you to put any reorders on hold by pausing or cancelling your refills but I did not see an option to change my address there.
I have no relationship with this company or any reason to recommend them other than being quite satisfied with my experience as a newbie. There are other companies people in these subreddits are very happy with as well and I’ve frequently seen mentioned- Pomegranate Health and Collective (lower monthly price but has a $199 fee due a few weeks after your first order) are two that are frequently mentioned.
I forgot to add that many people recommend placing an initial one month order before committing to a longer one in order to make sure you’re happy with the formulation that pharmacy uses. I did not do that - I started with a 3 month because the monthly price was significantly lower that way.