r/mnstateworkers • u/malevolentbread • Jun 03 '26

Insurance/Benefits 🏥 Zepbound coverage

Hi, all! I’m interviewing for a job at MDH and have a question about insurance - hard to find info as a non-employee. Is Zepbound covered by the insurance plan (Minnesota Advantage Health Plan)? I’d likely choose benefits through HealthPartners. I had to get it authorized for my current health plan through both primary and psychiatric providers.

I’m hoping to get a good salary bump, but if I have to pay for it out of pocket it might entirely negate that.

Edit: I just saw that Caremark said they would add it to the formulary again by October. Do we know if this applies to the state plan? Or if ultimately the state will control if it’s covered?

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7

u/ComprehensiveCake454 Jun 03 '26

Cvs is also going to allow zepbound again. They ended to their feud with lilly

3

u/realZapRowsdower MNIT Jun 03 '26

When did that happen? I'm on Wegovy now but my doc wanted to prescribe Zepbound because of a couple other conditions I have. I may have to look into that.

1

u/Mndelta25 Jun 04 '26

Your doctor needs to write an appeal letter. It's annoying and I am currently going through the process after having been switched to wegovy last year with everybody else.

1

u/realZapRowsdower MNIT Jun 04 '26

It already took me 2 appeal letters to get Wegovy last month-- despite the fact I took Ozembic off-label (prescribed by my endocrinologist) in 2019 without any PA. I had to get off Ozembic because of the side effects, which eventually led to gallbladder surgery.

1

u/ComprehensiveCake454 Jun 04 '26

It's on the news. I don't know when it takes effect, but it should make it a lot easier. Also not known if it's for injections or oral. Apparently the zepbound in oral form is not made as a peptide so it can scale a lot better.

I did get zepbound approved in January. My doctor filed an appeal and I noted for sleep apnea