The list price and the price I actually pay differ by a factor of six depending on which of four routes I use, and none of that is transparent from the outside.
The question I want answered is what actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work.
Numbers rather than impressions, if you have them.
tyler_CSCS said:The list price and the price I actually pay differ by a factor of six depending on which of four routes I use, and none of that is transparent from…
My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.
anders_CPH said:My insurance denied my PA related to cost and coverage.
Insurance coverage hack for cost and coverage: if your insurance denies brand Wegovy/Ozempic, consider these alternatives:
Don't let cost prevent access to effective treatment. There are options at every price point.
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View Resultstyler_CSCS said:The list price and the price I actually pay differ by a factor of six depending on which of four routes I use, and none of that is transparent from…
This is my experience too, for whatever a second data point is worth. Nothing to add that would improve it.
From the other side of the consultation, briefly.
Telehealth prescriber review for cost and coverage: I've used 4 different telehealth platforms to get my GLP-1 prescription. Comparison:
| Feature | Platform A | Platform B | Platform C |
|---|---|---|---|
| Initial Consult | $77 | $97 | $0 |
| Monthly Follow-up | $47 | Included | $62 |
| Prescription Speed | Same day | 24-48 hours | Same day |
| Lab Monitoring | Required | Optional | Required |
I settled on the one that required labs — it shows they care about safety, not just prescribing volume.