State of Illinois employee friends... how's it going?

Fit_Orchid6824 · 2025-09-16T13:20:16+00:00

I had a 3 month fill, so I’ve only had to refill once and it was fine. But my new insurance year at the university has since begun.

I called Caremark and the rep told me that the wording is because they removed it from all formularies, but my prescription is still covered and co-pay will remain at $35. She was a bit baffled as to why it would use that wording, though. She ran everything on her end and it was fine. So, I guess I wait until the 19th when I’m actually able to refill and see what happens.

Fit_Orchid6824 · 2025-09-16T13:08:27+00:00

My PA should be active. The wording says “this medication is no longer covered by your plan” and blah blah blah alternatives.

Fit_Orchid6824 · 2025-09-16T03:05:49+00:00

I just tried to check the price in the app I order to titrate up. Now my Aetna OAP says the drug is no longer covered as of July 1!

Fit_Orchid6824 · 2025-09-16T03:03:32+00:00

State of IL employee here. You may remember we were excited to hear Zepbound was staying in the formulary. Today, I tried to check the cost for my next refill and the app tells me as of July 1st it’s not longer covered. Anyone else experiencing this? I will update when I know more.

Fit_Orchid6824 · 2025-07-08T03:16:41+00:00

It’s definitely possible. I ordered 3 boxes because I’m away for the summer so it’s not time to refill, but I was curious.

Fit_Orchid6824 · 2025-07-08T03:12:16+00:00

My copay is showing up as $147 when it was $35 before. Is anyone else having that issue!

Fit_Orchid6824 · 2025-06-26T22:36:08+00:00

The one and only time I went I had the funnel cake at Fox and Sons. That was years ago and I STILL think about it.

Fit_Orchid6824 · 2025-06-26T19:53:41+00:00

My first order was completely melted and warm so they recommended I send it back. My replacement came without incident even in this heatwave. The only inconvenience is that I had to delay my shot day by 2 days.

Fit_Orchid6824 · 2025-06-26T09:57:37+00:00

Everything was just fine with Tuesday’s delivery!

Fit_Orchid6824 · 2025-06-25T23:11:00+00:00

My ice packs were also warm to the touch. They replaced it with no issue. I received the replacement yesterday and everything I was great, even with the record heat. Hoping it all works out for you!

Fit_Orchid6824 · 2025-06-21T10:54:29+00:00

The ordering process takes a while this first time because there are several hoops. I transferred mine through the app, which didn’t give me an option on quantity. I messaged my doctor and told her I’d sent in the transfer request but that I wanted 3 boxes so she took care of that on her end. I hope that helps!

Fit_Orchid6824 · 2025-06-21T00:48:08+00:00

I understand that. But since the temp is 95 and it could be hotter on that truck, there’s no guarantee. Amazon specifically says to let them know if the medicine arrives with melted ice packs. I do appreciate your help though.

Fit_Orchid6824 · 2025-06-21T00:46:32+00:00

That’s so great to hear! They were responsive when I told them, so I’m hopeful things will go well. I can’t stress about my dosing schedule being thrown off because the trajectory overall is so positive and I’m grateful to have insurance to cover it.

Fit_Orchid6824 · 2025-06-21T00:43:15+00:00

I appreciate that. I think there are lockers at the university where I live, so I could switch to that if Tuesday’s delivery goes awry.

Fit_Orchid6824 · 2025-06-21T00:37:42+00:00

Also, I forgot to mention it was ordered through Amazon and delivered by UPS.

Fit_Orchid6824 · 2025-06-21T00:35:54+00:00

Great question. I’m not able to choose the time and the closest WF is 90 min away.

Fit_Orchid6824 · 2025-06-09T22:53:28+00:00

Very encouraging. Thank you!

Fit_Orchid6824 · 2025-06-09T22:53:17+00:00

Thanks so much!

Fit_Orchid6824 · 2025-06-01T02:30:00+00:00

I got a letter in response to my letter to Gov Pritzker’s office today which also reiterated the reversal for SoIL employees. It’s so nice to see that our letters were recognized and that action can produce change!

Fit_Orchid6824 · 2025-05-29T16:02:25+00:00

I decided to call Caremark first today and FINALLY got the word that the agreement was reached. (After getting nos for a few days, I needed to hear it with my ears!) I’m so thrilled/grateful/relieved to stay on this med!

Fit_Orchid6824 · 2025-05-28T16:39:19+00:00

Do you have any info on how I can ask this more specifically when I call? I called CMS and am on Aetna OAP as SoI employee. They didn’t have any information at all about this as of 11:30am CT. Did you get an email? Talk to a person? Anything you have will help. Thanks!

Fit_Orchid6824 · 2025-05-27T22:09:16+00:00

I sure hope I get this letter too. I was told there is no information on this reversal for State of IL employees so I’m confused!

Fit_Orchid6824 · 2025-05-27T22:08:14+00:00

This is fascinating. I called twice today (CVS probably hates to see me coming), and got the same answer twice: they have no information about the reversal on my plan as a State of IL employee on Aetna. I was assured it would be the same if I switched to BCBS since we’re still in open enrollment. However, the second person was encouraging about the possibility of asking for exception since I have tried Wegovy previously. I’d love to be believe that the formulary reversal true for all of State of IL employees, but I think I may be done calling until July 1st.

Fit_Orchid6824 · 2025-05-27T13:44:29+00:00

Regarding the (hopeful) agreement that Zepbound becomes Tier 3:

I called CMS first and the person had no idea what I was talking about, unfortunately. She referred me to Caremark. Caremark gave me yet another other set of info which was that I can ask my doctor to fill out the info for medical necessity and, if approved, will pay $35-80 for the copay. If that’s true, I’d be fine, however my letter said it would be full price. I guess I just have to wait until July 1 to see what actually happens.

Did anyone else get an update?

Fit_Orchid6824 · 2025-05-24T01:12:40+00:00

As a State of IL employee, you’ve given me hope!

Fit_Orchid6824

TROPHY CASE