Cigna mounjaro reddit

Cigna mounjaro reddit. Depending upon plan design, market conditions, the extent to which manufacturer I'm on a csnp gold plan. I’m already only eating about 900 calories and burning approx 400 calories with Welcome to the Mounjaro UK Support Group, a community dedicated to individuals across the United Kingdom who are using or interested in Mounjaro (tirzepatide) for diabetes management and weight loss. Or check it out in the app stores &nbsp; &nbsp; TOPICS experiences and accomplishments related to Mounjaro and Zepbound prescription medications. Has anyone had success with insurance covering Mounjaro or Ozempic for PCOS/ insulin resistance or know what the cost is without insurance with an online discount card? I’ve been on Victoza 1. Reply reply Brows_and_Butts • I have cigna too and dont have any pre-existing conditions (that would effect weight) and still got it for $25. 5 mg the entire time. However, my fasting levels have gone from 130s to the 90s. I’ve recently noticed the effects last longer than 7 days. Has anyone had success processing with Cigna? Walgreens is telling me the Dr has to send in a prior authorization. My Cigna plan (in Minnesota) has been covering it but I am T2 diabetic. I think the Basic copay is higher but BCBS has a tier exception process. 5 I just took me 4th shot) and I honestly don’t think I’ve been able to lose weight effectively because of said munchies. This is the worst insurance company I have ever dealt with, by far. One of the things you might want to mention if you are preparing an appeal is that THERE ARE NO FDA-APPROVED DRUGS FOR INSULIN RESISTANCE, prediabetes, and technically, for PCOS, although BC and metformin are industry-standard treatments for PCOS. Eli Lilly dropped a new coupon today 6/1/23. It was covered w/ authorization, $25 copay. With insurance my Mounjaro is $60 a month or $170/3 months. Since the Mounjaro coupon has run out I’ve switched to Zepbound. I'm on Ozempic, which thankfully my insurance covers. In Utah, products and services provided by Cigna Health and Life Insurance Company (CHLIC), (Bloomfield, CT). Has anyone gotten coverage for Zepbound by Cigna. While using Reddit, all users must follow the platform-wide rules as well as the rules of this community. 5 order filled and the 12. 5mg of Mounjaro. Or check it out in the app stores experiences and accomplishments related to Mounjaro and Zepbound prescription medications. That is a weekly injections. I was going to attempt to use the Mounjaro coupon for $500 but was denied that too because it's restricted to T2D diagnosis only now because of the shortage. My company is self-insured so I am exploring a review process to get it added to the formulary. Having to abort the procedure and reschedule it due to poor prep sucks for everyone. true. The most is $50 per script , and even then it’s after paying double of my monthly Medibank fees. Yes, people have gotten it approved for PCOS. Insurance Currently on 10. 25, but not Mounjaro, Where you put that decimal makes a biggggg difference when talking about medication. I have CIGNA OAP, and Express Scripts is the PBM. 5 also, live in Pa, suburb outside of Philadelphia. The 2024 plan DOES have a Prior Authorization needed to get it. I did just print the savings card and plan on going in to CVS this evening since it’s showing “on hold”. Mounjaro is brand new, less than 6 months on the market. Questions, experiences and accomplishments related to Mounjaro and Zepbound For me I still get hungry but I’ll just eat till I’m full (a lot less than before Mounjaro) and then I’m full for wayyy longer. Does anyone know what the PA requirements are for Cigna to approve Zepbound? My insurance through work does cover weight loss medications and Cigna let me know that with a PA they’ll cover it (we know how that goes) but the person I talked to with support said they don’t have the PA requirements available in their system to give me. Details Make sure you know about each of the medicines you take. This is purely anecdotal coming from my own experience, but I eat a fairly low carb high fat diet and found my stools to be very oily and loose initially on Mounjaro. I’ll start by saying I know everyone’s plan is different. Started Mounjaro last year. Ive been on Mounjaro for a year and have been using the coupon successfully at my local CVS. I just got covered with Mounjaro after being on metformin and failing. If you haven't, check with Cigna to see if any of the others may be covered. r/Mounjaro A chip A close button. I’ve gone 10 days because I simply forgot (ADHD problems) and felt the same. So here is the article they posted about GLP1s for obesity. I suspect that most insurers will begin requiring PA for GLP-1 drugs, simply because of the cost and the ballooning of off-label prescriptions. 77/month), Cigna OAP HDHP($29. I have the coupon card so I could get it for $550 but I have a feeling I’m going to need to submit it for review which Cigna told me could take 90 days. She said until then I have According to Cigna, Mounjaro is in their formulary and is considered a Tier 3 drug on their Cigna Saver RX Plan ($12 mo). A few days later I got my blood draw and then a week later Plush had the results. But the explosive, non stop tummy issues kept me in the I have been taking Mounjaro since July and have lost almost 40 lbs. Log In / Sign Up; Advertise on I signed up for Alpha Med on Sunday and got Mounjaro from my regular pharmacy (with a coupon) yesterday. If you have commercial insurance, and you are not approved through the insurance (has to be commercial) (if you don't have Type II diabetes essentially) then the co-pay card can be used and you can have with a $25 co-pay. My stomach was very upset the next day . I don't starve myself but do limit carbs to low glycemic carbs. Skip to main content. I have Cigna and they cover Mounjaro under my plan as a preferred prescription so I pay $25 a month copay - but I am diabetic and had to try another medication first and go through the prior authorization and peer review process. Reddit . reReddit: Top posts of November 23, 2022. I was denied coverage in February for Wegovy, Ozempic and Mounjaro because I didn’t have diabetes. 5 mg of mounjaro because I heard it is Skip to main content. Cigna is a horrible insurance company but then again seems like their all getting sued. I'm hoping to take the plunge but wanted to know if anyone has experience using Mounjaro as a senior. You can easily find posts about this by searching at the top of the page, or by clicking on this link: Posts about Cigna. 5 so I went to Walgreens. Have strugged with weight my whole adult life. My doctor said that she figured out that adding Metformin and Mounjaro at the time of submitting the Rx they’re more likely to approve the PA because it looks like you’re trying multiple ways to fix Pre-Diabetes (at least in my case and also having a high BMI) I was approved in Ah, I am so disappointed and stressed!! I just found out my company is moving from Cigna to Blue across Blue Shield. Reply reply Top 2% Rank by size I used to work at a doctor's office that prescribed Mounjaro quite a bit. Tirzepatide Auto-Injector (TIRZEPATIDE - INJECTION) For Type 2 diabetes. In January 2023, I got a PA approved with Aetena for a year for Mounjaro since I was pre-T2D. I’m on 10mg - because my pharmacy hasn’t been able to get the 12. Has anyone ordered from ExpressScripts (cigna)? Looking to switch my prescription there and was wondering what peoples My insurance said they will most likely cover mounjaro for weight loss once approved by the fda as my plan covers weight loss thankfully. Mounjaro is Injection newbie! Has anyone had a change with their Cigna insurance today? I was hoping to see a change as Zepbound is being added to Cigna's formulary as of today, but it is still a Tier 3 medicine, and Mounjaro is listed as Tier 2 (I meet the PA requirements for this). Just this week, CIGNA called and told me both Ozempic and Mounjaro are covered - I’m receiving my first 90-day supply of Ozempic for only $70!!! Cigna Local+ Approved me w/o T2D So excited to have been approved for an entire year,. I was previously denied since I do not have T2D and have no coverage for Zepbound (weight loss drugs excluded). . However, a few days before that I discovered “Push” was the one i wanted, so i signed up, quick online consult, Rx for Mounjaro the next day. com. Open menu Open navigation Go to Reddit Home. So, I Cigna is the worst health insurance for approving anything! I hate them with a burning passion and I have only had them since January. Log In / Sign Up; My first dose 2. I don’t know the answer to this, but I can answer an adjacent question that might be useful. I've been taking mounjaro for 7 months now and I have less energy and to the point of where I can't eat much of anything but half a cracker a day. Does anyone know what happens to Mounjaro if it gets too warm? Does it become dangerous or just less effective or inert? I had 6 pens in the refrigerator. All insurance policies and group benefit plans contain exclusions and limitations. 00 per month, $399. I have fought with my As a 41 year old healthcare provider, I was struggling with being overweight, blood pressure, A1C of 6. Or check it out in the app stores we dont have their ins info and FINDINS returns nothing. And since Mounjaro also affects gastric emptying I probably would not double up. Valheim; Genshin Impact the title of this post says "thread to help find which pharmacies have out-of-stock mounjaro dosages in your city". For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. Searching by keyword in the search box will not only will return a wealth of good information, it will help you understand the range of experiences My insurance plan does cover some weight loss medications and has step therapy guidelines for Wegovy but the formulary does state Mounjaro is only for T2D with step therapy. I am on Cigna from the market place and they said they only cover it once I meet my $2300 deductible. I feel fantastic and bloodwork is great. Check your formularies! A lot of the same as above - no T2D, no PA, no step therapy, Cigna insurance/CVS Caremark PBM. Includes 33 patient ratings with average score of 4. 0, constant hunger and fatigue. I was on Mounjaro but recently switched to Wegovy. Coverage depends on your employer and what plan they purchased from Cigna. 5 ML of Mounjaro and have been exploring some other more affordable options. Mounjaro will most likely never get the indication for weight loss. No Mounjaro in Mexico (not approved yet); Canada it’s approved but not yet available. Georgia Cigna Silver plan Mounjaro . The current Mounjaro coupon is a little unique, but it's only because the drug has only recently been approved. Speaking from someone who works for insurance they are seriously cracking down on us about letting you guys get multiple fills early in a month especially zepbound if is the same strength most plans won’t pay again until after the 23rd day some are now pushing the fill date back to after 25 days a lot of plans have start to put out the DUR edits and will flag ur script and not pay for it Get the Reddit app Scan this QR code to download the app now. Welcome to the Mounjaro UK Support Group, a community dedicated to individuals across the United Kingdom who are using or interested in Mounjaro (tirzepatide) for diabetes management and weight loss. 5 mg, being very diligent with my food intake and tracking and exercising every day. 00 until 2/14/2024. 1 Refer to plan documents for a description of equipment, supplies, select tests and services that are covered through these plans. Unfortunately my UHC insurance does not cover them unless you are a diabetic, which I am not. 5mg. This forum is designed as a space for sharing experiences, advice, and support related to the use of Mounjaro. 5 mg of Mounjaro and have lost 15 pounds. I am looking for Mounjaro 15mg, been out since 7/11, could do 12. I called and spoke with Giovanni Colon at 877-581-5373-3433 and it does! Get the Reddit app Scan this QR code to download the app now. I have high bp, PCOS, and prediabetes. We both found limonene (made from cirtus peels) to be extremely effective preventing them and also pretty much eliminated heartburn/indigestion stuff. All I’ve come across online is just what Cigna Open Access Plus offers. To get Mounjaro covered, you have to try metformin plus two other GLP1s - Sending out some hope for my fellow PCOS / insulin resistance ladies! I was just approved for MJ after my endocrinologist sent in a thorough appeal letter. I am not ready to stop. August 2022 vs September 2023 . Does anyone know if and when insurance companies will start covering this medication for diabetics? This thread is archived Cigna approved it with a PA and moved very quickly. My PA was denied when our insurance changed, but my cash pay amount at CVS was only $225 for 84 days. Brand Name (s): Mounjaro. I read online that a lot of doctors don't take ACA insurance. first Appt via a telehealth provider (thinking PlushCare), but not sure if anyone has recommendations for in-network on Cigna? Thought I’d check here According to Cigna, Mounjaro is in their formulary and is considered a Tier 3 drug on their Cigna Saver RX Plan ($12 mo). 2 to a 5. $1200 later, I’m in the same boat as Mounjaro. Got a new prescription for 12. I have A1C of 6. I’m thinking of calling my senator since they have I just found out last week that Cigna will cover Mounjaro, my third script pickup was $25 dollars vs $450 for the previous two. I've been learning so much here about Mounjaro. My dr has done this several times when the insurance didn’t want to pay for a drug. The content I started with Ozempic and then moved to Mounjaro in July. I've been trying to be low carb since starting mounjaro. Or check it out in the app stores &nbsp; Mounjaro Questions, Experiences, Accomplishments! metabolic syndrome and Hasimoto's thyroiditis. I have also experienced pharmacist personnel who don’t first run my CIGNA before applying the savings card code, and I believe that impedes approval of the savings card. gov and typed in mounjaro into the drug plan search and quite a few were covering it with no PA or Step therapy requirement. The quality of food I am eating has improved therefor the calories are lower and Mounjaro helps me feel satiated after eating less so even 1000 cals can be a struggle! Cigna OAP($56. If you have insurance, you typically won’t pay the list price for Mounjaro. Even though I have a valid PA for Ozempic that issued last January. Will have Cigna beginning Oct 1st. View community ranking In the Top 5% of largest communities on Reddit. Limitations of Use: Mounjaro has not been studied in patients with a history of pancreatitis. they have a physical card showing a Cigna PPO plan. My (33m) wife’s (32f) company if offering Cigna health enrollment for 2024. Please Brand: Mounjaro. I am in what's called the "donut hole" currently. Every employer/plan is different. So it may have just approved it for you since you’ve already met the requirements of step therapy Mounjaro is Tier 3 on the formulary for both Standard and Basic. Brand: Mounjaro. I just don't think my body is digesting the fat with this medication and it's just finding its way through. You can reasonably expect pharmacists to be able to tell you how the drug will affect you, it’s counter indications and what not to mix it with, but knowing every drug company’s patient savings program is asking too much. 3 was used. ) My Cigna covers Mounjaro, I just pay $25 copay (no coupon) as it falls under their tier 2 medication. The original intention for Mounjaro was as a Just wondering if anyone has been successful getting your Rx if this ICD 10 code Z71. experiences and accomplishments related to Mounjaro and Zepbound prescription medications. I hate that insurance companies deny Mounjaro. How are you going about getting approval? My employer has a list of all medications covered by Cigna and Wegovy is listed as a non-preferres tier 2 med, but the website says it's not covered. The Dr is telling me she sent it My insurance said they will most likely cover mounjaro for weight loss once approved by the fda as my plan covers weight loss thankfully. The coverage will probably be similar to what they currently do for Ozempic. Cigna-Oscar has been the biggest pain in the ass to deal with. CERTAIN CIGNA COMPANIES I learned (the hard way) that not all CIGNA plans are the same. I called and spoke with Giovanni Colon at 877-581-5373-3433 and it does! 3 Pages - Cigna National Formulary Coverage - Policy:Weight Loss – Glucagon-Like Peptide-1 Agonists Prior Authorization Policy 7% of patients had a BMI of 40 kg/m2 to < 45 kg/m2, and just over 3% of patients had a BMI ≥ 45 kg/m2. November 2022/Mounjaro, December 2022/Trulicity, then 8 more Will have Cigna beginning Oct 1st. Wellness. It really just depends on your insurance. I am ok with paying $125 for three months as I have a FSA with extra funds. Look for some advice. Remember that you should NEVER rely on strangers on the internet for medical advice. For those whose insurance covers Mounjaro it will cost as little as $25 per the coupon with other details included. 5 for 2 weeks, which I hope is the issue. Cigna denied mounjaro right off the bat with the PA. Came home and the Mounjaro was missing. The only thing they Get the Reddit app Scan this QR code to download the app now. So I got high on THC and then I think ate too much. (To some flavor of Cigna) I was due for my first refill on the new insurance I am in the middle of my sixth week of 2. I'm on Wegovy after switching from Mounjaro and it works great. 🥲 I have to decide on a new SoCal insurance and after searching thread after thread haven’t seen anyone have success so I’m hoping this will make it easier. Apples and oranges. Mounjaro has a few extras in it than Ozempic - so it's being shown with even better results for Insulin Resistance and T2D issues. Bcbs getting sued by ford motors. wegovy was approved to treat weight loss. Your insurance company isn’t going to care that “a study in 2021 showed that Mounjaro lowered blood Hi everyone my PA just expired from Cigna after being on Mounjaro for a year. I asked, because I'd been looking through everything related to Mounjaro and Cigna online, if it still needed a prior authorization even with a diagnosis of t2d. The difference that 1 year has made for me is absolutely staggering and I am so grateful. Been taking Mounjaro since October. Insurance. The list price for Zepbound is about $1,060 for a 28-day supply. They just aren’t covering any. The manufacturers of Mounjaro are Gf and I are both on Mounjaro, and we're both on Rybelsus prior. The fumigators THREW OUT the Mounjaro. Hopefully, with Zepbound now approved for use, insurance companies will start covering Mounjaro more. I have PCOS with a history of Metformin. 8 were before mounjaro,but losing as much in one week on mounjaro as it took me 6 weeks to lose without it after initial water weight drop of 6 lbs first two weeks of changing to mediterranean way of eating. He wrote me a prescription with my Type 2 diagnoses and it was immediately approved Like a lot of others, I will be changing due to not being able to get Mounjaro anymore. (Major happy dance!!) I have Cigna / Express Scripts. 77/month). m. My plan requires step therapy. 7. The GLP-1 agonists, Ozempic and Trulicity (high dose) and the GLP-1/GIP agonist, Mounjaro (tirzepatide subcutaneous injection), are among the agents considered to have “very high” Consumer ratings and reviews for Mounjaro (tirzepatide). CVS CareMark letter requesting a PA (Cigna Ins) (Cigna Ins) My insurance has been fully covering Mounjaro since the end of June. 1, I've lost 60+lbs, I look better, I feel better and my entire quality of life Between Aetna, Cigna, or United Healthcare, what insurance provider would be best for Charlotte? Discussion I have the opportunity to choose between these 3 insurance providers with my employer, and I'm curious to read others experiences with how it's been being covered by them and if any one of the three of them is more readily available in Charlotte. That said, it sounds like what you got was an approved prior authorization, so you’re covered for a year! Mounjaro Questions, Experiences, Accomplishments! View community ranking In the Top 5% of largest communities on Reddit. After that my PCP filled an appeal to the insurance company which also got denied, their claim is I need to try Ozempic first. Members Online • Portugalboo . ca for the Mounjaro patient support program for financial assistant if you have type 2 diabetes Get the Reddit app Scan this QR code to download the app now. I’ve lost a little weight on Mounjaro. Expand user menu Open settings menu. They like to deny lots of claims and noe alot of controversy with them pulling coverage away for obgyn patients in Arizona I hope Cigna ends up going bankrupt. I am so stressed out thinking I am going to loose coverage or Whew!! My husband recently changed jobs so our insurance changed. I checked the security cam. Instructions. Questions I have: -those using it for weight loss, how is your insurance handling it? I have Cigna, and worried they wont cover. It wasn't covered in February and March, then April 1st it popped up as approved. We are now on a new plan with Cigna through husbands new work and the premiums are very inexpensive like $300/month for family of 4. We’re considering going on a family plan with Cigna. I saw Cigna did not list a Prior Authorization for either Ozempic or Mounjaro. Some are lucky where their insurance approved without T2D others the insurances are getting strict and won't approve for anything other than T2. I use the mail order and my copay is $125 for three months. It seems to be very similar so far so if your insurance will cover Wegovy, I'd certainly consider it instead of paying the $1000+/month out-of-pocket for Mounjaro. Get app Get the Reddit app Log In Log in to Reddit. -compounding 77K subscribers in the Mounjaro community. there are still stock issues otherwise you wouldnt need this Get the Reddit app Scan this QR code to download the app now. I didn’t lose any weight on Ozempic or have improvements in my blood sugar. My Cigna plan refuses to cover any of the GLP1s, just denied me for Mounjaro too after denying Saxenda. r/Mounjaro_Community A chip A close button. Good luck! Because dosing can be very important in some medical conversations, you took 2. Had horrible belching and gas overnight, threw up, couldn't sleep from the stomach pain laying sideways. No change to my Cigna/Caremark plan- $7, no PA for mounjaro (and ozempic), $980 for zepbound w/PA, $1260 for Wegovy w/PA. Members Online. I would try to check their formulary each month for changes. It’s been a slow but pretty much steady loss, however every few weeks I will stall and for 2-3 weeks be stuck around the same weight yo-yoing up and down the same 2-3 pounds. hi! i saw some have had bad experience with Cigna, but i’ve had great experience! So i think it depends on what type of plan you have. Always a year later and 50 lbs less, I am not pre-T2D and believe this is a miracle drug. I lost 4lbs We would like to show you a description here but the site won’t allow us. except, I just quit my job and now I’m no longer going to have this insurance. It’s so tough to get unless you shell out $$$ or go the cpd (don’t think I can say the actual term🤷‍♀️), which is around $400/month, where there’s a Questions, experiences and accomplishments related to Mounjaro and Zepbound prescription medications. A fill contains four pre-filled pens, which is equal to about a month's supply of Mounjaro. 192 votes, 63 comments. So I went back to Walgreens. We went out of town and had our house fumigated. I now need to wait for my doctor and I to figure out what to do. That means Mounjaro costs over $12,800 annually, at the list price. If I eat a good meal I’m pretty much set for the next 24 hours 😂 I was in a similar situation with Ozempic last month, going from BCBS to Cigna. No one wants to go through the prep all over again, especially when it pretty much Has anyone switched from ozempic to mounjaro? I am currently taking 1mg of ozempic and now considering 2. We’re all healthy. 00 a month. Members Online First-ever randomized trial of Ozempic for alcohol use disorder shows significant reductions in drinking Umm not for me. I did come across GLP-1 Probiotics from Skip to main content. Your risk for getting low blood sugar may be higher if you use Mounjaro with another medicine that can cause low blood sugar, such as a sulfonylurea or insulin. I’d be weary of using ChatGPT give the inaccuracies and basic information it provided especially asking it to include evidenced-based studies. I need to lose 65 lbs to achieve ideal BMI. 5. Cautions. I have Cigna and they don’t cover any weight loss meds but Mounjaro is on their formulary and requires a prior auth for type 2. No RX deductible needs to be met. Make sure your pharmacy has the cheat sheet and yes, some insurers are sending back non-denials. 5 mg was mostly okay side effects wise but I did have some extreme nausea a few times the day after a shot and Get the Reddit app Scan this QR code to download the app now. I definitely can’t pay full price out of pocket. Wow - I have Cigna and they told me they don't cover it at all. But Cigna is pretty corrupt. I will be starting medicare next year. - plus they are prohibiting shipments to the US. Hi- I start Medicare March 1 and I found Medicare drug plans that paid for Mounjaro as tier 2. I had something similar happen to me with my continuous glucose monitors. com” after your search topic. THE FOLLOWING COVERAGE POLICY APPLIES TO HEALTH BENEFIT PLANS ADMINISTERED BY CIGNA COMPANIES. Your first fill was probably a fluke, or I’ve heard of insurance I signed up for a Cigna drug plan for Medicare ONLY because on the Medicare site it showed it covered MJ with no step or PA requirement. Wouldn’t give me details when I called to check coverage (even tho I’m sure they know damn well what they will cover for); my dr submitted a PA for pre-diabetes and PCOS and they came back with a denial saying it’s not covered except for T2 diabetes and you have to have tried Get the Reddit app Scan this QR code to download the app now. 1, comments, side effects, dosage, sex, age, time taken. I’ve spoken with multiple reps from Cigna and can confidently say they are one of the worst insurance providers out there. Or check it out in the app stores &nbsp; &nbsp; TOPICS I was quoted a cigna package. I really need this medication to control my pre diabetes. For availability, costs and Ask your dr to fill out an appeal with the insurance. 3 Pages - Cigna National Formulary Coverage - Policy:Weight Loss – Glucagon-Like Peptide-1 Agonists Prior Authorization Policy 7% of patients had a BMI of 40 kg/m2 to < 45 kg/m2, and just over 3% of patients had a BMI ≥ 45 kg/m2. r/Ozempic A chip A close button. I’m insulin resistant so I couldn’t lose weight at all before Mounjaro. local time, 7 days a week October - March, Monday to Friday April - September. 64f HW 219 SW 204. ADMIN MOD Multiple refills different dosage . I guess different plans within Cigna cover different things. Ozempic was approved to treat diabetes. Has anyone been approved through Cigna without diabetes? UPDATE: Denied everything because I'm not T2D. Internet Culture (Viral) I am on Medibank and it doesn’t seem like any of the options cover for the full cost of mounjaro . On Mounjaro, somedays I find it difficult to meet that 1000 calorie minimum. It's all about how much you want to put into it, like calorie counting, exercising, and eating well. The research doesn’t correlate. A friend of mine has T2D and his insurance stopped covering Ozempic for him but he was able to get Mounjaro instead. My employer has a "plan restriction" on ANY drug used for weight loss. So everyone’s body . The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. And maintenance of weight loss due to titration of Mounjaro to a dose where your weight stabilizes for two years is different than successfully maintaining weight loss for two or more years without Mounjaro. I was told Ozempic, Trulicity, and Victosa are all covered for me, but I did the savings card for Mounjaro instead. I’m on 10 mg Mounjaro but had increased my dosage to 12. My guess is because it requires “step therapy” which can include metformin. Have had sulphur burlps at random times w both. Today I took 5 dissolving Zofran and violently vomited 6 or 7 times anyway. My friend is also on Mounjaro and she has no issues drinking once n a while . What is the most important information I should know about tirzepatide? The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. If you have the signature plan you should be good, as I’m under my moms plan haha and have that and have been able to get pretty much everything- I’m on mounjaro now on it and just have a copay of $25 per month (in the past I was on ozempic Cigna Healthcare may receive payments from manufacturers of certain preferred brand medications, and in limited instances, certain non-preferred brand medications, that may or may not be shared with your plan depending on its arrangement with Cigna Healthcare. What will happen, with almost absolute certainty, is Lilly will release a new branded product that is the EXACT SAME INGREDIENT (Tirzepatide) as Mounjaro and it will Even if your insurance doesn't cover weight loss meds, I have gotten PAs approved by indicating it was necessary for cholesterol control through weight loss and/or reducing high blood pressure through weight loss. Thank you for sharing! CIGNA plans do use automated lookbacks, so if you have a claim history of metformin in the past 130 days (idk why the CIGNA lookback period is such an odd number of days) the claim for Mounjaro should be covered. For Georgia residents, health plans are offered by Cigna HealthCare of Georgia, Inc. I want to do something I can Mounjaro is in your body for a week and the half-life is 5 days beyond that, so if you’re not doing well with it, you’ll stay not doing well for a while. 5ml and have found it helps with suppressing the desire to eat all the time to an extent and helps me feel less hungry. I have pcos, insulin resistance and high cholesterol. Generic Name: Tirzepatide. I read somewhere else on here caused by carbs and fat - makes sense. PA is already approved with Cigna (after another provider had theirs denied months ago) and my rx is ready for pickup. They refuse to cover Mounjaro since it's so new. If you want to understand if Mounjaro is right for you, or if the side effect you're feeling is Cigna may not control the content or links of non-Cigna websites. For those with commercial insurance that does not cover Mounjaro it takes off $575 of the full price. Get the Reddit app Scan this QR code to download the app now. Monday afternoon I definitely had zero appetite. They won't cover Zepbound even though it's been approved by the FDA specifically for Does anyone know what the PA requirements are for Cigna to approve Zepbound? My insurance through work does cover weight loss medications and Cigna let me know that with a PA they’ll cover it (we know how that goes) but the person I talked to with support said they don’t have the PA requirements available in their system to give me. An earlier post claimed this was acceptable but it’s not a diabetes code, although diabetic counseling/services fall under this code. I can’t find much information as to the differences between these three plans and where I enroll on my work page doesn’t share any details as to the differences. Here's a picture from my license before and after. I still need to lose weight and have changed my diet. I went on Medicare. They work slightly differently. Insurances are weird right now so call and try to find out what they cover. All redditors and communities operate by a shared set of rules, found in Reddit’s Content Policy. Any suggestions for who would be best to go with in retirement. I’m losing about 1 to 2 lbs a week, which is a healthy, sustainable rate. Plans are insured by Cigna Health and Life Insurance Company or its affiliates: For Arizona residents, health plans are offered by Cigna HealthCare of Arizona, Inc. I’m also considered morbidly obese. Ozempic comes in . Internet Culture (Viral) Amazing; I proceeded to sign up, had a video consultation, doc would consider Semaglutide but only after a new blood panel. A1C went from a 6. 78K subscribers in the Mounjaro community. 5 is Cigna (Tufts). In January 2024, I am switching to Cigna, and my plan does not cover weight loss. I’m following WW and eating normal types of food. It ended up being around $900 at sams club. Complete effing nightmare! Reply reply 22rockyroad • "Moving more and eating less!" If only it were that easy. Log In / Sign Up; Rule 6: Respect Reddit's Content Policy. Or check it out in the app stores experiences and accomplishments related to Mounjaro and Zebpound prescription medications. We may have additional information after the weight loss studies are completed regarding the success rate of reducing the frequency of doses or titrating off of MJ for some, when the purpose is entirely for weight loss. Part D plans are weird with their various coverage % depending on how much has been spent by the plan and by the customer. Find information about medications covered by Cigna INSTRUCTIONS FOR USE. Looking at Henry Meds, Zepbound and Mounjaro are normally $449. Mine says the same thing. Mounjaro is I have CIGNA and they don't want to update there formulary to cover any of these health issues iv even tried ozempic and Cigna will not cover for my cardiovascular disease they will only recognize for T2D. I've had much better experiences with an endocrinologist treating obesity and prescribing these medications. What is the most important information I should know about tirzepatide? What is tirzepatide? What should I discuss with my healthcare provider before using tirzepatide? Discover prescription medications covered by your Cigna Healthcare insurance plan by utilizing the Prescription Drug List Search Tool. Instead, I decided to ask my Dr for Mounjaro. But if the insomnia gets too bad you could probably just take a stool softener to make sure things keep moving or at least stay regular. Mounjaro and I've been on Mounjaro/Zepboubd for over 10 months and have remained on 2. I’m going through this right now. Both affect your body in similar ways - helps improve blood sugars and makes your feel full faster. it has all the rx info, experiences and accomplishments related to Mounjaro and Zepbound prescription medications. ago. Mounjaro is not on the formulary, most insurance companies don't cover it unless they have an open benefit plan. The dr appeals stating that the medication is medically necessary to treat your condition and denying the patient this medication will lead to further health issues that will lead to higher medical costs in the future. It varies by each as you'll see on this reddit. Cigna, denied my prior authorization for my Mounjaro. Mounjaro Prior Authorization Process Tips Indication and Select Safety Information Indication: Mounjaro is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Your health care provider. Enjoy! Skip to main content . For example, I see many people with Cigna that have this approved but since Wegovy is not on my plan's formulary, I cannot even get it with PA. These are gnarly burps. I have Cigna and my insurance through work won’t cover wegovy and other such “weight loss” meds. If you're type2, low income, you can get on the waiting list for the organizations that provide grants for copay assistance. Randomly got 7. They didn't have Mounjaro 7. I planned to start Friday, but I‘ve been feeling really nervous. 77/month), and Cigna OAP Plus($29. I called Express Scripts for the refill the next month and they didn't have it again. I am almost at goal weight and lost all of my weight on 2. Walgreens filled the request with a one month supply. They are not approving Mounjaro for weight loss or BMI. Some people told me Cigna covers it for Medicare people. Or check it out in the app stores &nbsp; &nbsp; TOPICS. I subsequently ordered from Canada. Her company is based in NJ and we live in CT, she works remote. 5 was lay Sunday afternoon. 77K subscribers in the Mounjaro community. They don’t cover Mounjaro was formulated and designed as a drug to be taken indefinitely. I'm already on Mounjaro for T2 - but was checking to see if Wegovy was covered for my work friend who is not T2. Didn't even require PA. Ten years ago I had sleeve surgery and lost 40 pounds but I've gained most of it back. 26 votes, 15 comments. I do not qualify for any extra assistance. I sleep better. I currently have myself and my 6 year old daughter on my anthem plan and she covers herself. To my confusion, I call my PCP office, and then insurance for them to tell Cigna Healthcare may receive payments from manufacturers of certain preferred brand medications, and in limited instances, certain non-preferred brand medications, that may or may not be shared with your plan depending on its arrangement with Cigna Healthcare. BUT has anyone figured out a way to get MJ I'm on Medicare and my current Part D drug plan, (Cigna Saver Rx) includes Mounjaro without having to get a PA. Sorry for the TMI. Mounjaro and Yes, people have gotten it approved for PCOS. Nope. I'm 70. I got the dreaded "you need a PA and it must say T2D" letter from CareMark. I signed up with a Cigna plan that was I believe about $50 a month with a $100 deductible. Side Effects. Everything is just so disgusting and makes me want to puke. So I called Cigna and asked if Mounjaro is covered and if it was how much it might be. 8 BMI. Mounjaro Questions, Experiences, Accomplishments! I just received a denial from Cigna for Mounjaro. If you want to understand if Mounjaro is right for you, or if the side effect you're feeling is Cigna is now asking for written proof of this “allergy,” as if the submissions I provided to them regarding having to go to the ER as I was covered in hives and sick as a dog due to this medication. 6 (Of course, there is some overlap between these populations. I was wondering if anyone was able to get a PA approved after their first one was over. Tried to get PA with Cigna and was denied. Mounjaro, a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) agonist, is indicated as an adjunct to diet and exercise to improve glycemic I’m on my second week of taking Mounjaro 2. 5 of Mounjaro first and are currently taking 5. They even acknowledged it themselves 'While type 2 diabetes currently afflicts about 10% of Americans, that is far exceeded by the percentage who meet the clinical definition of obesity. Low blood sugar (hypoglycemia). It also showed Humana covered it as well with no As of the new year, my Cigna health insurance no longer covers my Mounjaro prescription. I took my first 10mg shot today. Some pharmacies will back out the insurance and still run the card but most won’t I am not comfortable injecting something into my body from an unknown source. 1 and my insulin resistance score is 96. • 3 mo. I just found out last week that Cigna will cover Mounjaro, my third script pickup was $25 dollars vs $450 for the previous two. After looking at Bob and Nancy's medical histories and taking into consideration safety factors, I determined that both of them were good candidates for Mounjaro for the treatment of their type 2 diabetes, although they were at different stages of their type 2 I have cigna. UPDATE 2: A couple of days after the rep did something in the system allowing for the pharmacy to run the script at $25, I got an automated notice that the PA had been rejected and today for the actual letter stating that indeed CIgNA only allows 2 doses of Mounjaro A YEAR and that an appeal would have to document scientific literature of why Friend optum is the same way. Depending upon plan design, market conditions, the extent to which manufacturer This would also imply that Mounjaro will eventually be available from Canada for $250-300 per box. There is a published 2024 CIGNA formulary available online, but it is not for a plan that I am on. Since starting Mounjaro in April, I’ve never once been covered. – 8 p. Try mymounjaro. That means it is eligible for the significant price reduction mandate starting January 1, 2023. My doctor has advised from the beginning to follow a 1300 calorie a day goal, no fewer than 1000. Down 50 lbs total as of yesterday (though the first 9. #weightloss #mounjaro View community ranking In the Top 5% of largest communities on Reddit. Shits are back. This community is moderated to avoid repeat posts. Questions, experiences and accomplishments related to Mounjaro and Zepbound prescription medications. Any suggestions or thoughts would really be Cigna Local+ Approved me w/o T2D So excited to have been approved for an entire year,. Yes, but maintaining significant weight loss over time is rare. The way they charge for Mounjaro as long as I don't use it to fill any other med I haven't hot the donut hole. The list price for Mounjaro is approximately $1,069 per fill. Cigna sucks with mental health coverage but at least now i'll just be depressed instead of fat and depressed lol Reply reply Mounjaro isn’t really on our providers radar yet so I’m going to bring it up to them so that we can establish a policy to ensure our patients a successful prep, especially as Mounjaro becomes more common. I chose Cigna I am on my second week of 2. ) Cigna is now asking for written proof of this “allergy,” as if the submissions I provided to them regarding having to go to the ER as I was covered in hives and sick as a dog due to this medication. I had my PCP sent Prior Authorization in order for my insurance to cover my Mounjaro, it was denied. I’ve heard that some people are having increased insomnia with Mounjaro as well. #weightloss #mounjaro Even if your insurance doesn't cover weight loss meds, I have gotten PAs approved by indicating it was necessary for cholesterol control through weight loss and/or reducing high blood pressure through weight loss. Reddit's hub for advice, articles, and general discussion about getting and repaying student loans. Or check it out in the app stores &nbsp; &nbsp; TOPICS It's not covered by my Cigna plan. I have looked at several different sights, plus a local Med Spa has Mounjaro for $399. This is no more than 25% of price. Or check it out in the app stores Does anyone know what the PA requirements are for Cigna to approve Zepbound? I recently gained since stopping Mounjaro but my last appointment was at 29. A safe place for questions, experiences, tips and tricks, for Zepbound and a helpful community to assist you along your weightloss journey! ZEPBOUND is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight I don’t know the answer to this, but I can answer an adjacent question that might be useful. Gaming. Humana will not cover the other medications like Mounjaro. So the reason many are requiring the PA is to prevent off-label hence the letter I got from Optum in December. I pay $25 for a 3 month supply of it. Feeling defeated - Cigna. Messaging service used weekends, after hours and on federal holidays, or visit CignaMedicare. Cigna denied my generic medication for Currently, Mounjaro is only indicated for those with type II Diabetes. This is completely a one-off, but my company's Cigna didn't cover WL meds until just a few weeks ago on April 1st. Or check it out in the app stores &nbsp; experiences and accomplishments related to Mounjaro and Zepbound prescription medications. I have had drinks twice for two gatherings I was at. I on Mounjaro since December 2022, I recently switched insurance to Anthem Blue Cross Blue Shield. And bad headache. They told me to have my doctor submit it again as “urgent” and 24 hours later I got the call it was denied again. Just switched over to Zepbound, hoping because it’s just weight loss targeted, that my insurance would cover. Limonene may occasionally give you "orange burps"(one popular brand is actually called "orange burps), but Ozempic is a GLP-1 medication while Mounjaro is GLP-1 and GIP medication. If I eat a good meal I’m pretty much set for the next 24 hours 😂 r/Mounjaro_Community: A community for seasoned Mounjaro users and beginners. After OVERVIEW. 0. Two weeks ago (7 weeks into not being able to fill my Ozempic prescription due to the shortage), I asked my insurance/mail-in pharmacy (Cigna/Express Scripts) hotline about coverage for switching to Mounjaro. There's a handy search function, and you can also use Google to search this Reddit by typing "site:reddit. It wouldn’t allow my to get the full discount at $550 because cigna wasn’t technically denying or declining the claim. NelNet The representative from CIGNA admitted that the baby won’t have health insurance and therefore, for the first 30 days after birth there was a grace period that everything that is incurred by baby would be billed to the mothers insurance, however, they’re being difficult right now and want me to have my husband Reach out to the HR eligibility person and have them reach out to CIGNA to I first heard about Mounjaro before it was even “Mounjaro,” in the early phases, through articles and through journals. This was an issue with Mounjaro with one PBM sending the coverage decision back as restricted vs denied or non-covered. I haven’t had great experiences with drinking while on Mounjaro. Standard includes the use of mail order pharmacy, managed by CVSCaremark. Find the best posts and communities about Cigna on Reddit. Sorry - I had to open it up to find my original prompt: “Write a letter to Blue Cross Blue Shield of Illinois requesting an internal appeal and formulary exception to prescription of Mounjaro for treatment of Type 2 Diabetes and mention previous use of Metformin, Actos, and Ozempic, which caused severe intestinal symptoms and cite studies A safe place for questions, experiences, tips and tricks, for Zepbound and a helpful community to assist you along your weightloss journey! ZEPBOUND is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight Hello friend! There have been several people in this subreddit who have asked similar questions about Cigna approval. I gag constantly at the thought of food. For me I still get hungry but I’ll just eat till I’m full (a lot less than before Mounjaro) and then I’m full for wayyy longer. 6 CW 193 GW 125 TD2 Thank you everyone for posting about your journey, for asking questions, and providing answers. i get mounjaro is only FDA approved for T2D but has been proven to benefit someone with PCOS and being insulin resistant. I do not have type 2 and right now my insurance Highmark Blue CrossBlue Shied has been paying for it but just this week has asked for a PA. We also ask that everyone who participates in r/Mounjaro also follow proper Reddiquette. Very few patients (< Mounjaro is Tier 3 on the formulary for both Standard and Basic. As long as the dose continues to work for you, ride that dose until it no longer works. Which is total BS and really makes the patients suffer He has had a terrible time with Metformin and has to take the ER version which isn’t covered at all. 8 and while I feel like it helps prevent me from out of control weight gain, losing is still incredibly difficult. I know others have had issues with CVS, but mine has honestly been a joy to work with. Very few patients (< I smoke mainly for mental health benefits (type 1 bipolar) but the munchies are insane, even on Mounjaro (I’m on 2. Cigna will only approve the PA if it's for T2D. Like many people, I’ve had to come up with the $1,000 a month for this life changing med. How are you going about getting your prescription r/Mounjaro. Would they cover Ozempic or another GLP1 agonist drug? My insurance (not Cigna) requires a trial of metformin before they’ll cover a GLP1 (ozempic, trulicity, rybelsus, etc), but that’s all that’s required. LINA and NYLGICNY are not affiliates of Cigna. This includes why you take it, how to take it, what you can expect while you're taking it, and any warnings about I also have Express Scripts. members. It will take a while, but most insurance companies will probably cover it soon. Basic-Repair-2696. Hey there, my employer just moved over to Cigna this year and I’m in the same exact boat. I did have the benefit of losing the majority of weight on Mounjaro, but I lost the last 35lbs on Wegovy. Or check it out in the app stores &nbsp; &nbsp; TOPICS to be approved for alternatives! 1500mg of metformin daily at MINIMUM for at least 6 motnhs to be approved for 2. Members Online I’m tired and at least for me, this journey hasn’t been easy. We’re leaning towards Cigna or United, but I’ve heard terrible things about their commercial plans and am wondering if their Part D plans are better. #weightloss #mounjaro My endocrinologist wrote me the script for Mounjaro and insurance denied it. Or check it out in the app stores &nbsp ; &nbsp; TOPICS type, South Beach, Scarsdale, etc)only to lose a little and regain it plus more. Thanks!! I also have Express Scripts. I didn’t even drink alot, but it totally didn’t agree with me . You seem to have a perfect history to support use of Mounjaro. I'm having issues this month filling my medication and my friend (who still works there) just sent me this: "Not sure if your provider orders Mounjaro but there has been a new update effective today: I spoke with our drug rep today. Or check it out in the app stores &nbsp; &nbsp; TOPICS My Cigna covers Wegovy for obesity AND a secondary condition that is a result of obesity, like acid reflux or high BP. There are no published guideline criteria for Mounjaro that I could find. The agent told me that it is not covered and I'd need to get my doc to submit a prior authorization. For more recent information or other questions, please contact Cigna Healthcare Customer Service, at 1-800-668-3813 (TTY users should call 711), 8 a. Members Online • gsp83. estr ocurwb qzrxns qgbjf smvbzf boai muatwvjr yopi wfmvd ipmqypp