7 ms·

My ACA insurance (because I was unemployed) covered Rybelsus (pill form, which is a much higher dose due to lack of absorption through the stomach), then in lik

My ACA insurance (because I was unemployed) covered Rybelsus (pill form, which is a much higher dose due to lack of absorption through the stomach), then in like October or November they said "nah" and said "go to Ozempic" I had just completed my first two sets of increases before the final uppage to be on the stable dose, when insurance said "Nah." So my doc RX'd Trulicity to see if they would cover that, which, for some reason they also didn't. I haven't had the time or energy during the holidays to deal with it, so now I'm dealing with increased hunger from going cold turkey off these things all because of bullshit micromanagement from shitty insurance companies on the market place. If this makes it better and easier for companies to actually pay out for this I am 100% for it, there should not be a constant jerking about for what is or isn't paid. Also - this wasn't for weightloss (which I assume would have been Wegovy approved), this was for diabetes, and it was under control with Rybelsus, and I assume Ozempic, though we were still in the process of building up to it (I was on max dose of Rybelsus and I'm pretty sure I needed the max Ozempic as well). If they had given a reason for the denial it'd be one thing but it was just a blanket denial. I just hope this makes it easier for folks who need it to be able to obtain it.

ddorian43 2y ago
Just do keto diet. Assuming T2D. Its the easiest disease it fixes. Some people cant have it all in life. You gotta sacrifice. The carbs in our case. Source: I do it for other reasons.
- solresol 2y ago
  When I last looked up the literature, Keto diet was one of the least effective interventions. That is, if you follow it, I'm sure it works. But the vast majority of people drop out of keto diets very quickly. So it's lousy advice and an unsuccessful intervention. It's a bit like saying to a patient "you gotta sacrifice -- you should doing 3 hours a day of cardio". If they do follow through with it, it will work. But the vast majority of people won't be able to maintain doing that.
  - ddorian43 2y ago
    There are different keto diets. The epilepsy version is indeed hard to maintain, but can be life changing (increase life quality in epilepsy, bipolar, schizophrenia etc) The T2D version is way easier. If you studdy it or get a coach, you will know all the pitfalls. But its like therapy, you need to want it yourself. Cant be forced into it.
    - nolok 2y ago
      Do you have any study or literature to support your claim? Because you answer a factual comment with a random thing on my mind comment
      - ddorian43 2y ago
        Do any of these work https://www.virtahealth.com/research https://www.virtahealth.com/research ?
  - mgiampapa 2y ago
    I started keto in June of 24, lost 50lbs and added a compounded version of Ozempic in November to get through the holiday season with a little extra help. I'm on a fairly low dose, 50mg/week, and it's working tremendously. I've lost another 25lbs up to now and it's about 10x times easier to stick with keto, macro logging, and calorie tracking. I feel like even with keeping my calories to about 1500/day I'm just fine, and the cravings for sweets and over indulging just aren't in my head.
    - shlant 2y ago
      > "When I last looked up the literature" Responded to with > anecdote I'm happy you have found something that works for you but the diet tribalism on this site is getting old. At least it's good to see the initial Keto comment getting downvoted to oblivion.
      - mgiampapa 2y ago
Khelavaster 2y ago
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dbg31415 2y ago
100% agree. Insurance companies shouldn't get to pick and choose what drugs are in or out. I was at a company, and Wegovy was covered. Then randomly I got an email from HR, "Your medication is no longer covered." The fuck is my insurance company doing telling my HR what medication I'm on? Even if they didn't say it outright, it wouldn't be hard to figure out giving the drugs that came off the list that were paid for that quarter. =P Going cold turkey on these drugs is hard... like the doctors tell you that once you start taking them, you really aren't supposed to stop taking them. Or if you do, you have to do so gradually. The drugs mimic the feeling of being satisfied from being full, by overloading your system with a synthetic version of that hormone that makes you feel that way. Now... imagine going from "my parents used food to control my behavior growing up, and 40 years of bad behavior cemented that conditioning in place, so now it takes a lot of food to make me feel full / content," to "Oh this is nice, thank you drugs! Now I don't have to eat so much!" to "You're on your own, kid! And by the way, now that your body was used to the drugs, virtually no amount of food will make you feel full / content now. Let's see what happens!" Fucking insurance companies. People are nothing but pre-existing conditions and behavioral patterns. It shouldn't be up to the insurance companies which ones they elect to cover. "Oh, did you think smoking was cool as a kid? Too bad, hope you die from lung cancer!" It just shouldn't be on them to choose.
- nextaccountic 2y ago
  > Then randomly I got an email from HR, "Your medication is no longer covered." > The fuck is my insurance company doing telling my HR what medication I'm on? Isn't this a straightforward HIPAA violation?
  - MajimasEyepatch 2y ago
    No. HIPAA is rarely straightforward, and in any event it’s not uncommon for employers to have some degree of access to claims data. In a case like this I assume the company self-funds the plan.
    - nextaccountic 2y ago
Beijinger 2y ago
I partly agree with Kennedy. Ozempic will not make America healthy again. You will have to look into lifestyle choices. This being said, if you want to go the medication route, there are not patents for medications in India. You could try to obtain it from India: https://dir.indiamart.com/impcat/semaglutide-tablet.html https://dir.indiamart.com/impcat/semaglutide-tablet.html I am not an MD and this is not medical advise. QUESTION: If I live in the US in state XZ, what is the best, easiest way (zoom?) to get a valid prescription to order drugs from Mark Cuban? https://www.costplusdrugs.com https://www.costplusdrugs.com
- criddell 2y ago
  > Ozempic will not make America healthy again Will it help a significant net number of Americans be healthier? If so, then it should be made available to those people. > You will have to look into lifestyle choices That's not being questioned, is it? Who doesn't understand that exercise and eating well is better than not exercising and eating garbage all day?
  - Beijinger 2y ago
    You were obviously not able to understand my argument. Ozempic treats a problems (overweight) and might prevent problems further down the road (diabetes, high blood pressure, heart problems etc.) with trade offs like higher risk for specific cancers. It does not treat the underlying cause ob obesity. One that might be highly processed food and Kennedy, whatever you think of him, stated this correctly. Where in my post do you see that I said that Ozempic should not be made available? Please work on your reading abilities.
    - mullingitover 2y ago
      > It does not treat the underlying cause obesity. Obesity is caused by compulsive excess calorie intake. That’s precisely what Ozempic treats. Kennedy is a grifter who profits from quack medicine. Ozempic, because of its effectiveness, threatens the supplements industry which is rife with quack cures for obesity. This is the reason he’s against it.
tracker1 2y ago
I had some really bad side effects on those meds... was on for over three years when I realized that was causing my gastroparesis and other issues. I felt like I was starving 24/7 for 8 months coming off. I wouldn't ever go back. Throwing up fermented crap nearly daily isn't fun, let alone the pain and nausea.

ddorian43 2y ago

Just do keto diet. Assuming T2D. Its the easiest disease it fixes. Some people cant have it all in life. You gotta sacrifice. The carbs in our case. Source: I do it for other reasons.

solresol 2y ago
When I last looked up the literature, Keto diet was one of the least effective interventions. That is, if you follow it, I'm sure it works. But the vast majority of people drop out of keto diets very quickly. So it's lousy advice and an unsuccessful intervention. It's a bit like saying to a patient "you gotta sacrifice -- you should doing 3 hours a day of cardio". If they do follow through with it, it will work. But the vast majority of people won't be able to maintain doing that.
- ddorian43 2y ago
  There are different keto diets. The epilepsy version is indeed hard to maintain, but can be life changing (increase life quality in epilepsy, bipolar, schizophrenia etc) The T2D version is way easier. If you studdy it or get a coach, you will know all the pitfalls. But its like therapy, you need to want it yourself. Cant be forced into it.
  - nolok 2y ago
    Do you have any study or literature to support your claim? Because you answer a factual comment with a random thing on my mind comment
    - ddorian43 2y ago
      Do any of these work https://www.virtahealth.com/research https://www.virtahealth.com/research ?
- mgiampapa 2y ago
  I started keto in June of 24, lost 50lbs and added a compounded version of Ozempic in November to get through the holiday season with a little extra help. I'm on a fairly low dose, 50mg/week, and it's working tremendously. I've lost another 25lbs up to now and it's about 10x times easier to stick with keto, macro logging, and calorie tracking. I feel like even with keeping my calories to about 1500/day I'm just fine, and the cravings for sweets and over indulging just aren't in my head.
  - shlant 2y ago
    > "When I last looked up the literature" Responded to with > anecdote I'm happy you have found something that works for you but the diet tribalism on this site is getting old. At least it's good to see the initial Keto comment getting downvoted to oblivion.
    - mgiampapa 2y ago

Khelavaster 2y ago

[dead]

dbg31415 2y ago

100% agree. Insurance companies shouldn't get to pick and choose what drugs are in or out. I was at a company, and Wegovy was covered. Then randomly I got an email from HR, "Your medication is no longer covered." The fuck is my insurance company doing telling my HR what medication I'm on? Even if they didn't say it outright, it wouldn't be hard to figure out giving the drugs that came off the list that were paid for that quarter. =P Going cold turkey on these drugs is hard... like the doctors tell you that once you start taking them, you really aren't supposed to stop taking them. Or if you do, you have to do so gradually. The drugs mimic the feeling of being satisfied from being full, by overloading your system with a synthetic version of that hormone that makes you feel that way. Now... imagine going from "my parents used food to control my behavior growing up, and 40 years of bad behavior cemented that conditioning in place, so now it takes a lot of food to make me feel full / content," to "Oh this is nice, thank you drugs! Now I don't have to eat so much!" to "You're on your own, kid! And by the way, now that your body was used to the drugs, virtually no amount of food will make you feel full / content now. Let's see what happens!" Fucking insurance companies. People are nothing but pre-existing conditions and behavioral patterns. It shouldn't be up to the insurance companies which ones they elect to cover. "Oh, did you think smoking was cool as a kid? Too bad, hope you die from lung cancer!" It just shouldn't be on them to choose.

nextaccountic 2y ago
> Then randomly I got an email from HR, "Your medication is no longer covered." > The fuck is my insurance company doing telling my HR what medication I'm on? Isn't this a straightforward HIPAA violation?
- MajimasEyepatch 2y ago
  No. HIPAA is rarely straightforward, and in any event it’s not uncommon for employers to have some degree of access to claims data. In a case like this I assume the company self-funds the plan.
  - nextaccountic 2y ago

Beijinger 2y ago

I partly agree with Kennedy. Ozempic will not make America healthy again. You will have to look into lifestyle choices. This being said, if you want to go the medication route, there are not patents for medications in India. You could try to obtain it from India: https://dir.indiamart.com/impcat/semaglutide-tablet.html https://dir.indiamart.com/impcat/semaglutide-tablet.html I am not an MD and this is not medical advise. QUESTION: If I live in the US in state XZ, what is the best, easiest way (zoom?) to get a valid prescription to order drugs from Mark Cuban? https://www.costplusdrugs.com https://www.costplusdrugs.com

criddell 2y ago
> Ozempic will not make America healthy again Will it help a significant net number of Americans be healthier? If so, then it should be made available to those people. > You will have to look into lifestyle choices That's not being questioned, is it? Who doesn't understand that exercise and eating well is better than not exercising and eating garbage all day?
- Beijinger 2y ago
  You were obviously not able to understand my argument. Ozempic treats a problems (overweight) and might prevent problems further down the road (diabetes, high blood pressure, heart problems etc.) with trade offs like higher risk for specific cancers. It does not treat the underlying cause ob obesity. One that might be highly processed food and Kennedy, whatever you think of him, stated this correctly. Where in my post do you see that I said that Ozempic should not be made available? Please work on your reading abilities.
  - mullingitover 2y ago
    > It does not treat the underlying cause obesity. Obesity is caused by compulsive excess calorie intake. That’s precisely what Ozempic treats. Kennedy is a grifter who profits from quack medicine. Ozempic, because of its effectiveness, threatens the supplements industry which is rife with quack cures for obesity. This is the reason he’s against it.

tracker1 2y ago

I had some really bad side effects on those meds... was on for over three years when I realized that was causing my gastroparesis and other issues. I felt like I was starving 24/7 for 8 months coming off. I wouldn't ever go back. Throwing up fermented crap nearly daily isn't fun, let alone the pain and nausea.