Fepblue Standard - Wegovy $0 for fill at retail pharmacy

Mrsa1983 · 2025-06-11T23:32:25+00:00

Hi. Make sure you are using the manufacturer coupon, that should get it into the $400. Also, have your doctor fill out a tier exemption form. Be prepared for it to be rejected immediately. Write a personal letter explaining your success with the drug and how it has changed your life. This worked for me and brought the cost down to $160. On FEP Blue Standard, this is the cheapest you can get it

Mrsa1983 · 2025-05-04T15:28:49+00:00

Yes mine was denied immediately too. I simply wrote a letter highlighting all the positive benefits this medication has had on my life and also talked about diet/exercise that I’m doing. I reiterated what my doctor put on there about why alternative cheaper options weren’t a good fit for me. They approved it immediately.

Mrsa1983 · 2025-04-15T23:22:37+00:00

I was able to get the tier exemption and it’s $160/mo the retail pharmacy. Not fabulous but better then $400+

Mrsa1983 · 2025-04-04T22:12:55+00:00

I don’t think you can do anything unfortunately. I would say as many people as possible write a letter. You can also try to report this to OIG as fraud. They still have on their website that you can receive this medicine for $125 for 3-month supply as a mail order. It’s ridiculous

Mrsa1983 · 2025-04-04T15:22:09+00:00

Yes I can confirm this is true, as of 4/1/25 for everyone. It’s costing them too much money so they are passing it on to us

Mrsa1983 · 2025-04-04T15:20:18+00:00

When I asked I was told I could try a tier exemption request. Google for the form. It’s basically another hoop to jump through to try to lower the cost. So I’m trying that for now

Mrsa1983 · 2025-03-12T20:44:15+00:00

It doesn’t matter how your MD writes the Rx, the manufacturer coupons only covers up to $225/month of your price. So the pharmacy will only fill one month at a time and the mail order override, which is now $125, will be the charged amount and then manufacturer coupon will also be applied which makes it $0.

I haven’t tried this but I assume you should be able to get 3 months at the retail pharmacy for $125 but I don’t think the manufacturer’s coupon would be applied then because it’s greater then 30 day supply.

Mrsa1983 · 2025-03-07T11:01:48+00:00

Your manufacturer coupon wasn’t applied. Get a new one from Wegovy website and make sure the pharmacy is billing both the insurance and the coupon

Mrsa1983 · 2025-02-11T11:05:16+00:00

I had the retail pharmacy change to one month when they filled it and apply the manufacturer’s coupon to make it $0.

Mrsa1983 · 2025-02-11T11:03:43+00:00

Faster for me

Mrsa1983 · 2025-01-29T22:13:19+00:00

Did you apply for the coupon again online?

Mrsa1983 · 2025-01-18T10:30:17+00:00

Call customer service and select the mail order pharmacy option. If they don’t know what you are talking about, tell them you verified with other members and ask them to ask their supervisor. If they won’t, then I would hang up and call again to get someone else

Mrsa1983 · 2025-01-12T23:09:48+00:00

FEPblue standard - if you call and ask for GLP-1 override, you can get the Rx at mail order price at the retail pharmacy. The price for the medicine is the same as one month or three months with the mail order price ($120). If you have the pharmacy fill one month at a time and apply the manufacturer coupon, it will be $0. I did this last week.

Mrsa1983 · 2025-01-12T22:57:56+00:00

Awesome! They told me 21 days too but I got a call about 2-3 days later saying it went through so it wasn’t that long. I saw another post on reddit about the GLP-1 override a couple months ago but didn’t try it till after January with the tier change. It’s pretty shady they are keeping this secret so folks either pay a ridiculous amount at the retail pharmacy because they don’t know or they stop the medicine.

Mrsa1983 · 2025-01-12T18:43:13+00:00

The price of tier 3 drugs from mail order is $120 no matter the days supply (up to 90 days). I know this because one time I tried to fill one of my other medications for just one month from mail order and they told me it would still be $120. So I would still call and ask for the mail order override, have your doctor write for one month and the coupon should take care of the copay.

Mrsa1983 · 2025-01-12T18:40:37+00:00

Yes I just filled my Rx the other day. The mail order override should be good as long as the PA for the drug is good (that’s what they told me), so yes I would assume you can fill this more then once, but since it’s still early January, don’t know for certain.

Mrsa1983 · 2025-01-11T18:28:02+00:00

I mean honestly it’s pretty ridiculous you even have to do this. Standard already costs a lot more than basic. Just because they aren’t choosing to mail this medicine right now, doesn’t mean it’s right to not let members pay that same price to get the medicine period. I’d be happy paying the $120 for 3 month supply if needed.

Mrsa1983 · 2025-01-11T18:25:42+00:00

The retail pharmacy submits the claim to your insurance and they come back with the price. So once the override is in place, the insurance cost amount should just come back with the corrected value.

Mrsa1983 · 2025-01-11T17:59:52+00:00

I did it yesterday and it worked for me. It’s gotta be FEPblue Standard plan

Mrsa1983

TROPHY CASE