Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I suppose I would be, but there's the difficulty of finding one that's accepting new patients, scheduling an initial appointment, getting the prescription (I would actually need TWO months' worth to use all the funds) and, of course, all that takes time, along with follow-up appointments. I have only a month to spend this money. Since my doctor and I HAD discussed my weight - and even Wegovy - in the past and he HAD my BMI and labs on file, I thought it would be an easy matter to get started on this. I was wrong! If I end up with outstanding expenses once I transition off my insurance, it won't be covered at all since Medicare doesn't pay for weight loss drugs (although Medicaid does, which I find interesting), and that seems risky. If I end up having to pay out of pocket, I'd rather pay $325 to a weight loss clinic than thousands to a doctor.
Did you confirm with the administrator whether the cutoff is for service dates. If based on service dates, you should be able to submit for reimbursement. I don't know know your situation and what is triggering the deadline. Are you receiving COBRA coverage? Have you exhausted COBRA due to eligibility for Medicare?
Did you confirm with the administrator whether the cutoff is for service dates. If based on service dates, you should be able to submit for reimbursement. I don't know know your situation and what is triggering the deadline. Are you receiving COBRA coverage? Have you exhausted COBRA due to eligibility for Medicare?
It's an HRA (debit card). It has to be spent by March 1 - using the card - or it disappears, and it can't be used to pay in advance for services not yet rendered; I asked about all that.
I’ve been taking Metformin since the end of September 2023. The GI side effects lasted about 2-4 weeks for me and were tolerable. I’ve been pre-diabetic for >10 years so at this point I was desperate to find a solution to normalize my blood glucose. The combination of a low-carb diet + Metformin has brought my blood sugar back to a normal range. I want to note that I am someone who will only take Rx drugs as a last resort. I’ve been told that Berberine supplements work like Metformin, but Berberine didn’t help me.
Curious how many carbs you allow yourself per day and do you think there are any other supplements that help? I only take allergy meds. Who knows what all they would be pumping into me if I let them.
I gathered that he's not a fan of Wegovy, from what little we discussed. In fact, his exact words were "if they would just shut their pieholes instead," and we laughed. That was the extent of our discussion (we had other things to discuss), but that should tell you something. And, again, that's his prerogative; just because I meet the protocol doesn't mean he HAS to prescribe it; in fact, he doesn't HAVE to treat me at all.
The fact remains that I DO "qualify" for it, so for him or his office to say I don't is false, and that irks.
I've decided to go with something that's a sure bet instead: a cap for a tooth that I've been needing but putting off. I could have gone longer without it and possibly even gotten a discount with my future Medicare Advantage Plan, but oh well! That should almost to the penny use up all the funds and not be subject to controversy or complications.
Keep the feedback coming, though! I'm interested in your Wegovy stories, particularly if anyone else meeting the criteria was denied, although it doesn't sound like that happens very often...
Yeah, that's what I thought as the Human Dentist and Cat Dentist have taken me to the cleaners. If you are going to do the other meds hopefully you can figure out how to get them covered as time goes by.
Or, he doesn't feel that you would be successful. I meet all the criteria necessary to successfully have a hysterectomy. Except one, very important one: I don't need a hysterectomy.
Your doctor, for whatever reason, has determined that you don't need Wegovy. Maybe he's determined you need something different. Maybe he's determined you don't need anything at all. Maybe he's already given you advice, and you've chosen to fixate on the newest fad in weight loss instead. No one here knows, and all you're trying to do here on this forum is seek validation for your own poor decisions. You won't get that from me.
Although OP feels that she qualifies for a Rx, there could be other reasons for the Dr not prescribing a wt loss drug, but she doesn’t want to consider that.
I’ve never heard of an HRA that won’t cover ANY of the suggestions given, but would cover a wt loss drug (that’s only recently become popular). And on the subject of being popular, OP did mention that she “feels left out” because so many people around her are taking the meds (one of her first posts).
To be honest, she is extremely lucky (IMHO) that she can get around, hike and have “normal” mobility. If I could have that, I wouldn’t worry about 10 or 15 pounds.
Last edited by metamorphosis; 01-30-2024 at 05:58 PM..
Curious how many carbs you allow yourself per day and do you think there are any other supplements that help? I only take allergy meds. Who knows what all they would be pumping into me if I let them.
I do not count carbs because I just don’t have the patience for that. I started wearing a continuous glucose monitor (CGM) so I know what I can and cannot get away with, and I cannot get away with some foods like roasted sweet potatoes and winter squashes. I need to eat them steamed or boiled and in small portions. If I go overboard, I will spike and crash badly, so I try to keep my blood sugar mostly level throughout the day. The CGM has been a real eye-opener. I’m very much attached to it. I constantly check my values. I don’t know how I’ll ever live without it, but I hope I will be able to discontinue at some point (if my fasting BS ever comes out of the pre-diabetic range) since it costs me $82/mo and I’ve been using it since July 2023. I started to panic when I saw my blood sugar levels rising for unknown reasons, and that is when I decided to go on Metformin. It took some time, but it seems to be working!!!
The only supplement I’m aware of that is supposed to help regulate blood sugar is Berberine, as I mentioned previously, but it didn’t work for me. Hope you find what works for you! Good luck!
...there could be other reasons...but she doesn’t want to consider that...I’ve never heard of...OP did mention that she “feels left out”...
I believe what I said (without looking back) was that I'll probably be the heaviest person I know since everyone else is dropping weight like crazy thanks to these drugs. Carrying an extra 20 pounds around the midsection is no joke; nor is having elevated lipids. It's not about "fitting in," as I've never been a conformist; that's not why I requested Wegovy. It's about "fitting in" to my clothes. But thanks for the free psychoanalysis! And I didn't even have to use my HRA...
I do not count carbs because I just don’t have the patience for that. I started wearing a continuous glucose monitor (CGM) so I know what I can and cannot get away with, and I cannot get away with some foods like roasted sweet potatoes and winter squashes. I need to eat them steamed or boiled and in small portions. If I go overboard, I will spike and crash badly, so I try to keep my blood sugar mostly level throughout the day. The CGM has been a real eye-opener. I’m very much attached to it. I constantly check my values. I don’t know how I’ll ever live without it, but I hope I will be able to discontinue at some point (if my fasting BS ever comes out of the pre-diabetic range) since it costs me $82/mo and I’ve been using it since July 2023. I started to panic when I saw my blood sugar levels rising for unknown reasons, and that is when I decided to go on Metformin. It took some time, but it seems to be working!!!
The only supplement I’m aware of that is supposed to help regulate blood sugar is Berberine, as I mentioned previously, but it didn’t work for me. Hope you find what works for you! Good luck!
Yes, thank you! I was asking about the Metformin because it's off label use is anti-aging.
An article recently appeared that suggested BMI is not the best measurement to determine the need for these drugs, and I agree. Central obesity (around the midsection) is the health danger, so it should be a waist-to-hip or waist-to-height ratio instead, and I agree. No way I wouldn't "qualify" for that since that's almost exclusively where I carry all my extra weight...
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
