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Evidence-based GLP-1 & peptide discussion since 2023
ForumsInsurance & AccessInsurance said NO again and I am about to lose it Page 3

Insurance said NO again and I am about to lose it

JenPlateau Tue, May 12, 2026 at 3:42 AM 23 replies 787 viewsPage 3 of 5
DanielChem_CHI
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Mar 2024
Chicago, IL
May 13, 2026 at 3:55 AM#11
TrialTracker_MD said:
Dr.MetabolicMD said: ...compounded vs brand cost and coverage...

My insurance denied my PA related to cost and coverage. Has anyone successfully appealed? I'm considering going compounded instead.

11 9fiona_VT, denise_HTX, raj_cambridge and 8 others
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MarkLI_maint
Member
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Jun 2024
Long Island, NY
May 14, 2026 at 1:31 AM#12
Dr.EM_Chicago said:
DebRD_ATL said: ...regarding the discontinuation data for cost and coverage...

This answered a question I did not know how to ask.

12 10TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 9 others
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RickReta_CO
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Jan 2025
Colorado
May 14, 2026 at 11:06 PM#13
TrialTracker_MD said:
Dr.MetabolicMD said: ...compounded vs brand cost and coverage...

Telehealth prescriber review for cost and coverage: I've used 2 different telehealth platforms to get my GLP-1 prescription. Comparison:

FeaturePlatform APlatform BPlatform C
Initial Consult$63$83$0
Monthly Follow-up$33Included$63
Prescription SpeedSame day24-48 hoursSame day
Lab MonitoringRequiredOptionalRequired

I settled on the one that required labs — it shows they care about safety, not just prescribing volume.

13 11hyun_seoul, jim_asheville, matt_MKE and 10 others
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bri_stats
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May 2024
Seattle, WA
May 15, 2026 at 8:42 PM#14
JenPlateau 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…

Insurance coverage hack for cost and coverage: if your insurance denies brand Wegovy/Ozempic, consider these alternatives:

  1. Prior authorization appeal with peer-to-peer review
  2. Manufacturer copay card (for commercial insurance)
  3. Patient assistance programs (Novo Nordisk, Eli Lilly)
  4. Compounded medication from a 503B pharmacy ($147/month)
  5. Canadian pharmacy (requires prescription, ~40-60% savings)

Don't let cost prevent access to effective treatment. There are options at every price point.

Last edited: May 16, 2026 at 12:42 AM
14 12JessicaM_2024, TomFromTexas, mike.trainer_LA and 11 others
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Admin
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May 16, 2026 at 6:16 PM#15

Moderator note: the sourcing question belongs in the vendor section and has been split out. Report rather than reply if it drifts again.

15 13PeptideSynthNJ, Dr.KarenChen, Dr.NateNeph and 12 others
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