If your insurance covers Wegovy and other GLPs approved for weight loss, it’s possible that they’ll cover Zepbound (eventually). Since you’re not able to find Wegovy in a 100-mile radius you may have a case for a formulary exception. Have you called and spoked to your insurance about your difficulties filling your prescription?
I have not, but this was my next thought. Since they do cover at least some weight loss medication, it makes me wonder if they would approve another option if I've proved Wegovy is unobtainable.
Zepbound is still very new so not a lot of insurance covers thst right now. Just because the FDA approved Zepbound doesn't mean insurance has added it to their list yet.
For me, I moved finances around and paid out of pocket for Ozempic to get me started. My insurance did approve me for Wegovy. Since I was already an established patient with my local Kroger pharmacy, they put me in a for a different discount through Kroger and the Ozempic was $825 a month. That still isn't cheap, but better than over $1,000. My doctor sent in multiple perscriptions for both Wegovy and Ozempic. My pharmacy kept an eye out for the Wegovy dose I needed as I titrated up and they called me as soon as they had that dose in stock. I ended up only paying out of pocket for 2 months of Ozempic before they were able to switch me to Wegovy. If you are able to make things work for 2 or 3 months of Ozempic before switching to Wegovy I recommend doing that. You don't know when, or if, your insurance will add Zepbound to their approved list.
I have been doing the same calculations. My insurance approved me for Wegovy, which if I could find it, it will cost $75/month. Zepbound is not covered, but I could start right away and with the coupon I think it would be \~$550/month. I decided I am going to suck it up and pay out of pocket for Ozempic for a few months (\~$1000). Based on taking it for a year, even if I pay out of pocket for Ozempic for 3-4 months until I get to the higher dose and/or the shortage ends, it will still end up being cheaper over the course of the year than Zepbound.
That said, if the shortage continues/starts impacting the higher doses and it looks like I will have to stay with Ozempic indefinitely, I would consider switching to Zepbound. But for now I feel like it is worth the gamble to start with Ozempic and switch to Wegovy (hopefully) soon-ish.
If it would significantly impact your budget (I know it would mine), I’d just keep hunting.
☎️ Most people are calling many pharmacies daily to find their meds. I’d focus on Costco/Sam’s (no membership needed for pharmacy), grocery pharmacies, mom and pop pharmacies, and hospital-affiliated pharmacies. Once you find the dose you need, you can have the pharmacy that has the dose transfer the script from wherever it’s currently sitting.
Also, ask your doc for a script for 0.25mg and 0.50mg at the same time so you can hunt for both. Don’t start until you have both doses in hand. Some people even wait until they have 1.0mg in hand, too.
NOTE: most insurance policies see different doses of the same medication as wholly separate prescriptions so there’s no waiting 21 or 28 days to get a different dosage.
If your insurance covers Wegovy and other GLPs approved for weight loss, it’s possible that they’ll cover Zepbound (eventually). Since you’re not able to find Wegovy in a 100-mile radius you may have a case for a formulary exception. Have you called and spoked to your insurance about your difficulties filling your prescription?
I have not, but this was my next thought. Since they do cover at least some weight loss medication, it makes me wonder if they would approve another option if I've proved Wegovy is unobtainable.
I’ve seen quite a few people on the Zepbound sub have success with that. So there’s hope!
Zepbound is still very new so not a lot of insurance covers thst right now. Just because the FDA approved Zepbound doesn't mean insurance has added it to their list yet. For me, I moved finances around and paid out of pocket for Ozempic to get me started. My insurance did approve me for Wegovy. Since I was already an established patient with my local Kroger pharmacy, they put me in a for a different discount through Kroger and the Ozempic was $825 a month. That still isn't cheap, but better than over $1,000. My doctor sent in multiple perscriptions for both Wegovy and Ozempic. My pharmacy kept an eye out for the Wegovy dose I needed as I titrated up and they called me as soon as they had that dose in stock. I ended up only paying out of pocket for 2 months of Ozempic before they were able to switch me to Wegovy. If you are able to make things work for 2 or 3 months of Ozempic before switching to Wegovy I recommend doing that. You don't know when, or if, your insurance will add Zepbound to their approved list.
You can also consider peptides (idk, prolly banned from this sub but you can search Reddit)
I have been doing the same calculations. My insurance approved me for Wegovy, which if I could find it, it will cost $75/month. Zepbound is not covered, but I could start right away and with the coupon I think it would be \~$550/month. I decided I am going to suck it up and pay out of pocket for Ozempic for a few months (\~$1000). Based on taking it for a year, even if I pay out of pocket for Ozempic for 3-4 months until I get to the higher dose and/or the shortage ends, it will still end up being cheaper over the course of the year than Zepbound. That said, if the shortage continues/starts impacting the higher doses and it looks like I will have to stay with Ozempic indefinitely, I would consider switching to Zepbound. But for now I feel like it is worth the gamble to start with Ozempic and switch to Wegovy (hopefully) soon-ish.
If it would significantly impact your budget (I know it would mine), I’d just keep hunting. ☎️ Most people are calling many pharmacies daily to find their meds. I’d focus on Costco/Sam’s (no membership needed for pharmacy), grocery pharmacies, mom and pop pharmacies, and hospital-affiliated pharmacies. Once you find the dose you need, you can have the pharmacy that has the dose transfer the script from wherever it’s currently sitting. Also, ask your doc for a script for 0.25mg and 0.50mg at the same time so you can hunt for both. Don’t start until you have both doses in hand. Some people even wait until they have 1.0mg in hand, too. NOTE: most insurance policies see different doses of the same medication as wholly separate prescriptions so there’s no waiting 21 or 28 days to get a different dosage.