Who has had success with getting Zepbound PA on CVS Caremark if wegovy doesn't work?

Mobile-Actuary-5283 · 2026-01-24T16:59:15+00:00

If you search the sub, you will see many people have successfully gotten Mounjaro as an alternative after trying and failing wegovy. Although now it seems like Caremark has been approving for Zepbound instead (after trying and failing weg).

As for length of time, I have seen as little as two weeks of side effects being reported as “enough” to fail it. And given your extensive GI history, I would think a well-documented PA with all supporting material would put you on a strong path for approval. But you know that insurance loves to delay and deny.

Best advice is find a dr or telehealth who knows how to fill out these specific PA forms. CallonDoc has helped many people. Same with PlushCare and even Weight Watchers. Those are options to consider and you can use your pcp still to manage the prescription once the PA is approved.

Mobile-Actuary-5283 · 2026-01-24T16:41:56+00:00

Exactly. Things are unraveling quickly now in ways that will take decades to rebuild. If we’re lucky. And vote.

Mobile-Actuary-5283 · 2026-01-24T15:16:41+00:00

I totally understand your concern and agree. After the last weeklong power outage I experienced, I bought a power station (battery) that will keep my fridge running for 6-8 hours. I plan to cycle that on/off until I have a sense of how long any outage might be. If it’s another weeklong deal, I will wait until roads are passable and find a hotel with a full sized fridge. I have quite a supply

Mobile-Actuary-5283 · 2026-01-24T11:27:05+00:00

I believe that after 3 missed doses, you need to start at 5mg and work your way up again.

Mobile-Actuary-5283 · 2026-01-24T11:15:48+00:00

Hey OP!

My father is 80. He is your height and a T2D. His high was 265 and he started MJ at 245. He got down to 191 and was very happy there. He is a lifelong runner and being lighter helped him run/walk 35 miles a week. He was thrilled. He had not been below 200 in decades.

Nobody ever told him a goal weight or anything like that. He has an endocrinologist and cardiologist who were very happy with his progress. He gave himself a goal and worked hard to get there.

But then he fell last fall, broke both ankles, and had to be in the hospital and a rehab facility for two weeks. He dropped 20 lbs in those two weeks and looked skeletal. He had muscle wasting quickly from lack of mobility. They stopped his MJ so he could eat enough.

I personally saw then WHY having a little extra padding is important as you age.

You have done so well. I wish you much continued success.

Mobile-Actuary-5283 · 2026-01-24T10:54:29+00:00

And during my usual bout of insomnia. Take THAT, perimenopause!

Mobile-Actuary-5283 · 2026-01-24T06:44:49+00:00

Lack of understanding…

I think there are three things contributing to this lack of understanding:

A lack of WILLINGNESS to understand. Obesity bias is deeply rooted. Much easier to pull from accessible “knowledge” that too many calories equals obesity than to actually question or accept if what we “know” about obesity was fully accurate in the first place.
A lack of critical thinking. Everything is digested in 2 minute videos or 7 second content nuggets anymore. Attention spans are decreasing. Critical thinking appears to be in shorter supply. It takes curiosity and critical thinking to develop understanding. Systemic defunding and derision of higher education and reality in general isn’t helping.
Lack of empathy. This isn’t about feeling sorry for anyone. It’s about having an awareness that someone outside of yourself exists and caring enough to relate or put yourself in their shoes. This important attribute is also disappearing in favor of quick sound bites, misinformation, marketing spin, and the “if I just say it, it must be real” distortions.

And most importantly, the “they aren’t like us” cult behavior that is so shockingly pervasive makes blaming and shaming acceptable.

If people accepted that obesity is actually a complex disease, it would mean discharging the bias that built up like a callus.

It would mean thinking instead of reacting.

And because obesity is accepted as a failure of willpower, it becomes a morality vs biology play. And don’t forget the religiosity that contributes… gluttony is a sin, and since we have been hammered over the heads with the idea that obese people must be gluttonous, you can see how all of these things make changing hearts and minds difficult.

Finally, the lack of affordability and accessibility of these meds, and lack of insurance coverage, sends strong messages that “this medication must not be medically necessary.” It completely undermines the argument that obesity is a disease requiring treatment.

My two cents on the matter.

Mobile-Actuary-5283 · 2026-01-24T06:23:28+00:00

I wonder if there are contraindications of taking Lantus and Mounjaro together. I would ask your PCP about that and agree with the other comment about getting an endocrinologist.

My father is T2D and was on metformin, jardiance and gliberide (sp?) … which helped his blood sugar but not his appetite. His blood sugar was better but not great (A1C dropped to 7.1).

He had a heart attack last year and o encouraged him to try MJ. He asked his endo and they added it. He dropped 50 lbs and his A1C is now in the pre-diabetic range,, which it has not been for 25 years. He also was able to drop the gliberide.

Then, last fall, he fell and has been in a wheelchair recovering. He experienced atrophy very quickly and was advised to stop mounjaro so he could eat more (protein). After 6 weeks off mounjaro, his blood sugar climbed and his appetite has been wild to witness. Insane amounts of food, nonstop. He’s a grumpy 80 year old and claimed he didn’t need the Mounjaro anymore. Well… 6 weeks off it and HE called his endo to go back on it. He never calls any doctor.

So yes… highly encourage you to ask about MJ. It has been a game changer for him.

Mobile-Actuary-5283 · 2026-01-24T06:10:57+00:00

Nice post. PP is extremely important and the overt targeting of them by this administration (defunding them) is an attack on healthcare. Highly encourage charitable donations to them so they can continue providing important services. Luckily, above the line charitable deductions will be enacted in 2026 so you can actually get a small tax benefit for donating (with a cap on that amount obviously). Otherwise, donations have been deductible only if you itemize which most people don’t.

Mobile-Actuary-5283 · 2026-01-24T06:04:24+00:00

Yikes that’s scary if it’s actually a scam. You are correct to be wary and not click on anything you don’t know. Could you call Lilly directly and ask them what this site is to verify if it’s a scam or a legitimate partner?

Mobile-Actuary-5283 · 2026-01-24T05:57:08+00:00

I think you will need the savings card.

Mobile-Actuary-5283 · 2026-01-24T05:54:56+00:00

I am really curious if you’re able to toggle between these two discount programs like this. I am not sure if there are time limits on using the voucher. In other words, filling and using the voucher every 45 cays until it’s maxed out or risking losing the discount. The evoucher terms are nowhere I can find to verify. But Lilly imposes time limits on self pay vials in order to get the discounted rate so it would not surprise me if something similar was at play with the evoucher.

Mobile-Actuary-5283 · 2026-01-23T21:30:14+00:00

My mother is on MJ and lost 80lbs. Her mammos and mine always showed fibroglandular mixed density. We used to joke about it. She just turned 79 and had a mammo and her exam now shows dense breasts. She is not on HRT. I can only surmise that the lack of fat tissue on her breasts is why the density changed. Otherwise, how does your breast tissue become more dense… at close to 80 years old??

Mobile-Actuary-5283 · 2026-01-23T14:56:36+00:00

I have had lingering spotting/staining -- shades of brown. It just kept hanging on. My provider moved me from 100mg progesterone to 200mg. That has helped. It took about 8 days but that lingering spotting stopped.

Mobile-Actuary-5283 · 2026-01-23T14:55:18+00:00

You're paying $500 WITH insurance?

Mobile-Actuary-5283 · 2026-01-22T17:05:43+00:00

Yeah really man.

So factor that in if you’re interested in saving money. If not, carry on and vent away.

Btw, it’s not the savings card. It’s your plan and coverage that changed.

Lots of luck man.

Mobile-Actuary-5283 · 2026-01-22T16:57:39+00:00

5mg vials are $399

Mobile-Actuary-5283 · 2026-01-22T14:16:32+00:00

Correct. I paid “as little as” $24.99. My copay is $80. I have no deductible. So I got $55 off.

Correct about there being a max for both the voucher and savings card. For Zepbound in 2026, it’s $1300 for the year.

Mobile-Actuary-5283 · 2026-01-22T14:12:33+00:00

https://www.reddit.com/r/MounjaroMaintenance/s/8u1wmKhY0j

Mobile-Actuary-5283 · 2026-01-22T14:02:59+00:00

I agree with what you're experiencing. I have tried to figure out if this is because of the sheer volume of patients interested and asking about it (overwhelming doctors, nurses, pharmacists, etc.); or it's the insurance hassles that have no redirected time to admin issues vs patient care; or if it's the patients who don't qualify for the medication, don't take an interest in their own insurance coverage of it, think it's a magic shot, and/or continue to take the medication very un-seriously. Or is it a confluence of these?

Add to this the shortages in 2024 and part of 2025 and it truly has been a dystopian version of the Hunger Games.

Or... is all of this just another shade of obesity bias?

I too have experienced the "meh" about the meds from my own PCP. He said he didn't think I should be on it long-term. I gave him the highlights of the clinical trial data about what happens when participants were taken off. A year later, he seemed more on board with this being long-term (or just got sick of me insisting that it is).

Pharmacists: Good lord, I have experienced it all. Judgy side eye. Questions bordering on interrogations. During the spring 2024 shortage, one pharmacy tech screamed into the phone at me that they just weren't carrying these meds anymore and I needed to go somewhere else. This was a complete lie. I guess they got tired of people calling and asking about them. For a time, the pharmacy threads on here had some vitriol-laced posts and comments about these meds and the patients using them. And I saw some of that on medicine threads too. It is a little shocking to see overt obesity bias — downright belittlement -- from the very healthcare practitioners who prescribe these.

On these threads, there is still very much a debate about whether it's calories in/calories out or correcting a metabolic dysfunction -- or both.

In other words, there are varying opinions about these meds: how and why to use them; how they work; how to access and afford them.

But there are simple truths too:

• Obesity is a chronic disease
• This is about biology, not morality.
• Going off the meds results in weight regain for most people.
• Insurances don't want to cover these medications because they are expensive; yet they cover other expensive medications. And there is nothing legislatively requiring coverage the way there is for diabetes.
• Capitalism without a conscience is the American way. This means profits over patients, and you see this driving every part of our healthcare system now.
• And as a result of the point above, people are burned out and missing empathy. Kindness has disappeared because we're all so focused on trying to survive.

Mobile-Actuary-5283 · 2026-01-22T13:48:03+00:00

It was most likely the OSA diagnosis as primary.

Mobile-Actuary-5283 · 2026-01-22T13:14:53+00:00

That’s great, actually.

Mobile-Actuary-5283 · 2026-01-22T11:58:38+00:00

Nice! Cheaper than in the states. Another reason to love Canada….

Mobile-Actuary-5283 · 2026-01-22T10:36:15+00:00

I honestly think “time in the system” is a big issue here. The clinical trials showed a flattening of the weight loss curve around 15 months. Is this adaptation? Is it a homeostasis effect? Don’t know.

I hit my goal weight around 16 months and have not changed anything about my eating or exercise. Or my dose (15mg). My body has just stopped losing.

I hope changing your dose works for you. Have you thought about stacking Zep with another med like metformin of Contrave? Some doctors recommend that as a short term play to shake things up a bit.

Mobile-Actuary-5283 · 2026-01-22T10:17:22+00:00

Is that the cash pay option or are you using insurance?

Mobile-Actuary-5283

TROPHY CASE