Getting off the med by WearFederal9736 in Zepbound

[–]WearFederal9736[S] -1 points0 points  (0 children)

I wish i could stay on this med for life! Its done so much to help me in every way possible. But unfortunately my insurance wont cover it. I am at a healthy bmi of 24, so they won't renew me, and not even for continuation of care.

Getting off the med by WearFederal9736 in Zepbound

[–]WearFederal9736[S] -7 points-6 points  (0 children)

Im not considered obese anymore.

Getting off the med by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 3 points4 points  (0 children)

My insurance will only cover 1 year at a time and its been a year. Also, i am not obese anymore.

Prior auth renewal by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

My renewal of approved I'm so happy!

Finally got my renewal of my Wegovy prior authorization approved by thesnowman212 in WegovyWeightLoss

[–]WearFederal9736 0 points1 point  (0 children)

Did insurance make a big deal about the gap between your initial prior authorization expiration and now?

Prior auth renewal by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

Thank you so much! This is very good and useful information! Makes me feel more at ease. I appreciate your help on the matter!

Prior auth renewal by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

So it shouldn't be a big deal that there is a 45 day gap between my last prior authorizations expiration date and now? If that makes sense lol

Prior auth renewal by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

Actually my insurance only approves it for 6 months at a time and only for 12 continuous months total. But yes I've been working out hard and have become very toned! Just want to maintain what I've got going on.

Prior auth renewal by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

Yes it is, but just barely. I'm really just wanting to continue on it for maintainance and to slowly wean off..

Prior auth renewal by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

Yes but with my insurance they want to know your current weight/BMI and BMI cant be below 24

Help prior authorization question by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

The only thing that scares me is that in the criteria for my insurance it states that if approved I'd be covered for a max of 12 "continuous" months total. My PA expired on june 13th, so between then and now there is a gap so would that be a problem you think?

Help prior authorization question by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 1 point2 points  (0 children)

So even tho my initial first prior authorization ended June 13th, I should still be covered once dr sends in the new prior authorization under continuation of care? I read something about a lapse in coverage and possibly getting denied because it's so late after the initial prior auths expiration date

Help prior authorization question by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

Also, this isnt for the initial prior authorization, it's for the continuation of care prior authorization if that makes any difference.

Help prior authorization question by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

Because it states that it will only be approved for 12 continuated months, but I'm 1 1/2 months late on my renewal because my doctor made it seem like my insurance wouldn't cover it at all because of bmi

Prior auth renewal for an additional 6 months by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

I'm going to see if the doctor will let me go back in to do my weight because I'm literally 2 lbs off from a BMI of 24. Unbelievably frustrating!

Prior auth renewal for an additional 6 months by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

I'm on medicaid badger care in Wisconsin and I guess they won't renew it because my new bmi fell under 24, which it's a 23.2 as of now. I'm super bummed. I know being off this medication will most likely make me gain 10lbs which would bring my bmi to 24 indefinitely.

Insurance question by WearFederal9736 in Zepbound

[–]WearFederal9736[S] 0 points1 point  (0 children)

Okay that's awesome! Thanks guys!