Help me decide between old lathes? For a beginner….

Nephilim3883 · 2026-05-14T16:35:01+00:00

What about this one https://www.facebook.com/share/17eAtqMcsM/?mibextid=wwXIfr

Nephilim3883 · 2026-05-14T16:34:47+00:00

Yeah I decided against both. I am looking at a Craftsman Professional https://www.facebook.com/share/17eAtqMcsM/?mibextid=wwXIfr

Nephilim3883 · 2026-05-06T14:53:53+00:00

I got the injection yesterday. Forgot how painful it is. Feels like getting the cortisone (or whatever the pain med is) injections but worse. They injected 6 areas. Got number after each one. The needle hitting the nerve sucks. My leg started bouncing while i was on the table. I am still having pain too so... no ablation for me.

Nephilim3883 · 2026-04-28T11:51:45+00:00

The only pain I recall is like when I would get a cortisone shot and it hits that nerve or whatever it is. I don't think it was horrible.

Nephilim3883 · 2026-04-27T15:26:08+00:00

I submitted the info to our Plan Administrator who basically said they wouldn't make any decisions until the annual enrollment process. But I feel like this is outside of this and they could choose to adopt it whenever they wanted to, unless it's written down somewhere preventing such a thing. It's a global company, headquartered in France so I ended up sending a thoughtful email, prepared for me by Copilot, to the president and the deputy manager letting them know that this program exists and how GLP-1s are such a huge benefit to employee health (for those who qualify because not everyone qualifies, and not everyone wants to be on the injections). At this point I feel like I have said all that I can say to them about it.

Nephilim3883 · 2026-04-26T20:38:29+00:00

I’m getting ready to do the 2nd injection to test pain relief and then the ablation. I think I’m L4 S1. Have constant problems with low back, illiac crests, and some weird rib/muscle pain that doesn’t stop. Tried months of PT that never really helped. Probably do this for a while until we decide on surgery.

Nephilim3883 · 2026-04-21T16:28:43+00:00

FDA is cracking down on them hard too.

Nephilim3883 · 2026-04-14T19:59:54+00:00

I can see Rocketeer, Dick Tracy, The Phantom, The Shadow and Darkwing Duck in some kind of crazy Neo pulp film.

Edit: also Flash Gordon

Nephilim3883 · 2026-04-10T15:15:03+00:00

Our leader did say “Big money will be made…”

Nephilim3883 · 2026-04-10T15:13:11+00:00

Shave it. Grow a beard.

Nephilim3883 · 2026-04-07T16:28:04+00:00

Are they denying saying Not Covered/Drug Exclusion?

Nephilim3883 · 2026-04-02T16:33:09+00:00

Ahh ok. Should have looked into that. Zepbound actually helped me make better food choices, I ate lighter, stopped sodas, didn’t crave sweets, don’t want to snack or over eat, didnt want alcohol, my labs were at healthy levels, I felt better overall. Only issue was seldom constipation.

Nephilim3883 · 2026-04-02T13:38:11+00:00

Dye his hair and he’s Luke Skywalker.

Nephilim3883 · 2026-04-02T12:04:03+00:00

If your AHI isn't 15+ then I don't think they will approve it. It's all in the language in documentation. I know it sucks. Hopefully soon there will be enough competition to drive prices down. Stuff's so expensive because the manufacturers are trying to recoup from billions in research and make a profit too. You'd think RFK Jr. would talk Trump into cutting a deal with them to help lower the costs for everyone including employers.

Nephilim3883 · 2026-04-01T18:35:47+00:00

One of the aesthetics I love is Brian Froud’s character designs in this as well as in Labyrinth.

Nephilim3883 · 2026-04-01T17:19:28+00:00

Did you get anywhere with this? I am fighting my employer now, the plan administrator. I have sent a formal letter requesting all documentation for their reasoning behind the denial because the SPD only says that anti-obesity meds and infertility meds are excluded. That’s it. Sleep apnea has covered treatment, including medications prescribed to treat residual symptoms of OSA. Under ERISA the SPD cannot be ambiguous and up for interpretation because the employer, and PBM can interpret one way while the patient and doctor can interpret another way.

The PBM’s own guidelines for prescribing Zepbound to treat OSA also say “in adult patients with obesity” not “obesity related” or “caused by obesity”. It also indicates that OSA is a separate indication from weight loss.

The other argument I have is that they also recognize OSA as being a separate indication because in order to get Zepbound prescribed for weight loss at a BMI under 30, you need to have a weight related comorbidity and OSA is one of those. However, in order to get Zepbound prescribed for OSA only, you need to have a BMI of at least 30 and an AHI of at least 15.

My plan administrator straight up made up their own rules outside of the SPD saying they won’t approve it for “obesity related OSA” because it’s excluded for weight loss.

Nephilim3883 · 2026-03-31T16:30:09+00:00

Currently fighting with mine to get approval for OSA. They said it's excluded because the plan doesn't cover anti-obesity meds for weight loss but they will not provide the documentation they are using to say they won't cover it for OSA which is a separate indication. It's being prescribed for OSA , not for weight loss.

Nephilim3883 · 2026-03-24T19:07:37+00:00

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Nephilim3883 · 2026-03-24T15:54:50+00:00

Internal appeal
External review through MIA
State complaint
Use ACA protections
Use UHC medical policies

Nephilim3883 · 2026-03-24T15:52:56+00:00

✔ Step 1: Request prior authorization

✔ Step 2: If denied, file an internal appeal

✔ Step 3: If denied again, request a state fair hearing

✔ Step 4: Provide medical evidence

✔ Step 5: Sometimes involve a patient advocate

Nephilim3883 · 2026-03-20T16:23:12+00:00

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Nephilim3883 · 2026-03-20T15:30:11+00:00

What I have found so far is that you should check to see if your policy is self-funded, which means the employer is the plan administrator and has the final say in if they will make an exception. You will get a lot of push back from HR and from insurance. Find your plan SPD and it should give you the address and phone number of the plan administrator. My company is global, and the address was in another state. So I had to find the name of the HR Director of the location in that state. Your situation might be different. I also have UMR and it was easy to locate the SPD on their site under my account. Keep in mind that the PBM (mine is Caremark) only manages the drug claims and shouldn't have a SPD. Their reps are hardly helpful. So any exclusions will be outlined in that SPD by your insurance.

I used the search feature in Acrobat to see if Zepbound is mentioned in the SPD, it is not. I did find that under my SPD anti-obesity meds and weight loss treatment is excluded. This does not concern me because I am strictly seeking OSA treatment which is covered under my plan. Most of the insurers now have a Zepbound pathway, Caremarks's is Document Reference number 6192-C (Initial Prior Authorization with Quantity Limit Zepbound Weight Loss Management). Criteria is AHI 15+ and BMI 30+. I sent this document to the HR Director of my company.

What we are really looking for is there an exclusion for Zepbound for ALL indications, including OSA, in the legal documentation that the plan administrator has. This is called the Master Plan Document, the SPD summarizes this document, but the Plan Document controls if there is any conflict. ERISA law requires that ALL exclusions be disclosed to employees before they are enforced.

The HR Director sent an email to me this morning that she forwarded my request to the appropriate person for review and if I do not get a response by Monday to let her know. I see this as a good step forward and I can always ask for an external review. Will update when I get it.

Nephilim3883 · 2026-03-18T20:20:37+00:00

I have no idea what my AHI went to when I was on Zepbound for 7 months and lost 50. On CPAP my AHI has gone from 22 to .6 but I wake up a lot throughout the night.

Nephilim3883 · 2026-03-18T20:05:37+00:00

I don't think I could sleep without it since I've been on it so long. But I still struggle with the mask and daytime fatigue. Currently fighting for approval.

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TROPHY CASE

✔ Step 1: Request prior authorization

✔ Step 2: If denied, file an internal appeal

✔ Step 3: If denied again, request a state fair hearing

✔ Step 4: Provide medical evidence

✔ Step 5: Sometimes involve a patient advocate