How to get Insurance Coverage for ZEPBOUND as low as $25!

after three denials this week my insurance company finally approved Zep bound and in this episode I'm going to share the steps that I took from paying out of pocket to get to getting the Zep bound actually for $25 yay um hello bold Brave and Brilliant ladies and gentlemen thank you so much for tuning in to zth bound with an I'm Angela Durant um and if you're new to my channel welcome um it is a pleasure to have you here thanks for tuning in if you're curious about the new Cutting Edge weight loss medications like Zep bound if you are on another medication like wovi or Monaro or um OIC um or if you're if you're just starting out on your journey and you're looking for Community or you have questions you want to find out what other people are experiencing maybe some side effects you have come to the right place um maybe you feel alone in your journey right and you just want to be connected to like-minded people this is the place for you and you're welcome here so um please take a moment hit the Subscribe button um and the notification Bell so that you get um notification you get notified whenever we post a a video and thank you for being here for those who are returning thank you so much for coming back it's so nice to have you here thank you for all the questions the comments the encouragement I appreciate it keep it coming um again for those people who are just um coming here for the first time I'm Angela Durant I've been on Zep bound since February of uh of this year 2024 and I'm almost down 25 pounds so it's almost about 8 weeks almost down 25 lbs I'm teetering right around there um not quite there just yet yet but um unfortunately like some of you my insurance did not initially cover uh Zep bound it did not approve it um in August of 2023 I was prescribed W goie and my insurance would pay for that they would cover W goie however the problem was I couldn't get it um some of you may still be on the wait list but I was on um a weight list for it with my Pharmacy and that was August from August until February I could not get it right so even though that my insurance would cover it I couldn't get it right so then I was prescribed saxenda which is also a drug by noo Nordisk um wovi is by noo nordis to um and I started taking that and that um did not it wasn't very effective for me um and the studies show that it doesn't it doesn't deliver the same amount of weight loss as a goie or a Zep bound right so then um so I was taking that and then I talked to my doctor I wasn't losing the weight um and then we decided that I would go for the Zep bound even if I had to pay for it out of pocket and that's what happened right um there was no formulary on my insurance for it because the drug was um had just come out in November it was approved um through the FDA for uh obesity management and weight management drug uh and I guess it hit pharmacies early December right so because it was so new um my insurance company didn't have it on um the formulary so that required a pre-authorization right no problem my doctors are fantastic they submitted the pre-authorization for me my insurance denied it right and I was like why are they denying it right so um the the letter came in the mail the reason why they denied it was they said they would prefer that I would try three other drugs first before going to Zep down so they wanted me to take something that's like Alli I forget the exact name of the drug but it's like Alli which is a tablet for weight loss then they wanted me I believe um then they wanted me to take sex Senda which I already took and it wasn't as effective and then the third drug they wanted me to take was wovi but there's no way for me to take wovi because we couldn't get it right I was on the weight list since August for it and I wasn't able to get it they had wovi for people who had been taking it already but for the 2.5 milligram the starting dose you couldn't find it anywhere right so um so they denied it right and um I I you know we reached out to them and then my insurance company said well um send over make go to go back to your doctor and tell them you know make sure you you give a list of all the things that you've tried to lose weight I've had two bariatric surgeries I've done the Weight Watchers I've done the sex Zenda you know explained to them about the wovi you can't get it and have them send over another authorization right so um like to appeal it right so we sub submitted that again right we never send over an official appeal let me just correct that so they did it again again denied we did that three times and I was so frustrated I called them after the after the third time I called and I said help me understand why you're denying this like if I can't get wovi why are you telling me to take a a a drug that you know the research is saying you know to try they're tell me to try those other ones first the research shows that they're not as effective as a w goie or a a Zep B bound Zep bound of all the drugs based on the research studies which is showing the best results like up to 20 21% body weight loss right so why are you denying it I asked and they said well you know it's new we don't really know how how effective the drug is I was like well the studies are there the FDA approved it and it's the same drug as mararo and manjaro's been out for a little bit and so you can use that as an example and I said and if it's cost the cost are about the same um as a matter of fact wovi might have been even a little more expensive um and I said to them that if there wasn't a shortage with wovi I would have been on it but I couldn't get that so um you know so that's that was what I said to them and then I also said to them that you know I'm G to have to pay out of pocket if I'm not going to get coverage for it which was the the the in my area it cost uh $1,250 for Zep bound $1,250 a month for the Zep bound right so what I did next was I applied for I went to Zep bound Eli Lily site for Zep bound I applied for the savings card and then I started to use the savings card I applied the savings card to my um you know when I went to the pharmacy the I went I went I ordered the medicine they they put a pause on it after the prescription came through they put a pause on it because they said it's out of it's not covered and I said I know it's not covered I'm paying out of pocket um they said okay it's $1250 and I said all right I have this card I want to use the savings card and they accepted the card and that brought down my out-of-pocket charge to $550 okay um I hope I'm not confusing you so I brought it down to 550 and that's what I paid out of pocket right every time it was prescribed it was denied and I had to call them and say push it through I'm paying out of pocket so I did that um and and I continued to do that and I kept calling them and asking them can you please explain why is it added yet um and I in my heart I felt like eventually it's going to be added like why would the insurance company not cover it but I didn't know how long I would have to go to get it right so then what happened was um many of you know right now this is we're we're in April 2024 and there's a shortage again right people are are scrambling to get their medication and some people are getting you know compound some people are ordering it from I'm not sure what they're doing some people are stretching their doses I'm I'm not sure but there's a shortage right so I called to find out if I could get the medication to renew my subscription my prescription because I have one more pen left which I'll be taking tomorrow and that's the 10 milligrams and all the places that I called said we don't have it we we don't have it in stock we can't get it right now there's a shortage and so I called Wegman's pharmacy uh it's a Wegman's for those of you depending on where you're tuning in from it's a a high-end grocery store and they in their Pharmacy they said they had the 12.5 milligrams so since they had 12 I was going to stay on the 10 because I've been doing fine on 10 um except for the last few days of of um like five and six I start getting hungry again um but I'm tolerating it fine so I called my my doctor and she asked me a few more questions she just wants to make wanted to make sure that it was okay for me to tie trate up and I told explained her what was going on with the shortage that that the Wegman's had the 12.5 after going through all the questions and making sure that I was okay um she she prescribed the 12.5 so um I went over there to see about getting the 12.5 and they have it but I you know I have to pay out of pocket so I said let me just um just wait a few days since I I don't need to pay for it just yet because I still had one more pen so in that couple of days on April the 8th I received a um an email from my insurance company saying that my um the pre-authorization went through that um the the drug is now approved for me and that um I can go ahead and and order it so I called the Pharmacy just to make sure because we had that I had a scare like that before where I thought oh yes yay it's covered and it wasn't so I called them they said yes it's covered I said great and then I asked them if I could use the um savings card towards that they told me it would be it would take my um out of pocket from $550 to a co-pay of $100 which is so much better right and so then I asked them well can I also use the savings card and they said you know they accepted the savings card so because I used it before and this time when I when they ran the savings card through they said that my insurance was coming up as government insurance and that um it's not that coup that savings card is not valid with government um insurance and I was like but I don't have government insurance I have commercial insurance so I should be able to apply it they're like no I'm sorry I'm sorry I'm sorry so I actually went in and talk to them because I wanted to make sure and they're like nope nope sorry sorry the lowest is going to be is a $100 and I was like that doesn't seem right that it's coming up um government um can you just double check to see how it's entered and they said the issue was on the side of my insurance so that I needed to go back and talk to my insurance so yesterday I made calls to my insurance provider and they said no no no you have Commercial Insurance it should not be coming up that way that issue is on the pharmacy they must not be keying it in correctly so and they said and if they can't help you tell them to call the pharmacy Department I guess there's a general pharmacy number that all the pharmacies know and and she said to have them call that so I um I called them and I told them what my insurance company said and they ran it through again and she goes nope it's still coming up government right and so I said there has to be something has to be wrong and so she said well hang on a second let me just check check with my supervisor whatever so she did and she came back on the line and she said I have great news for you it went through we just needed to use a special code I don't know what that code is we had to use a special code it went through and your um coday is only going to be $25 I was so happy I was so happy I was like are you sure I was like are you sure I don't want to come down there and it's not are you sure she go goes nope we already processed everything through your balance is 25 you can come pick it up today right so um I have it I picked it up today I won't be taking it until next Thursday because I have one more pen left of the 10 milligrams uh so I'll let you know how I do how I'm feeling when I tie trade up um but I could have stayed on 10 if it was available because of the shortage I decided to tie trade up okay so I just wanted to share that with you and I wanted to tell you about this journey with the insurance approvals and I know so many of you are struggling with getting it approved and it's frustrating right because you need it right and it's something that you you feel like your doctor prescribed it and you you know you you need it for it's not like just vanity you you need the medication so um what I would say to you is don't give up be persistent um right now the card still works the savings card still works with um Insurance uh so but if you get you know that error message that I had you make sure that you're persistent and you make sure that they key it in correctly because that was what was the difference between saving you know you know having my co-pay be $100 versus having it be $25 and who couldn't use an extra $75 right of course um so I just want you to be persistent and not give up I know some of you are frustrated because you can't find the the medication um and and I recommend if you know try different places try like pop shops UMES sometimes they have it where the bigger um pharmaceutical uaes don't have it like a Walgreens or a um a CVS they they're out of stock so try the smaller ones in your area maybe you have to go out a little bit further than your area and then also try places like um grocery stores loc local grocery stores that might also be able to get it for you um and then once you're able to get it I would say if you're on a certain dose see if you're doctor can prescribe it for a 90day um dose a 90day um prescription versus only a 30-day because then you're not stressed um I know that I'm I'm sure Eli Lily is working really hard to um deal with the shortage and so is nooris because they want their patients to get their medication right why wouldn't they wouldn't they want that um so just be patient um my hope is that this will be cleared up soon and everybody nobody has to stress about getting the medication um but if if you're paying out of pocket or if you're paying the co-pay of a 100 you go to the the Eli Lily site I think it's zb.com and just scroll down and apply for the savings card and that'll save you you know you can get it as low as $25 so I wanted to share that with you if this has added value to you and you'd like to join us on this journey um all you have to do is um ju just hit the Subscribe button um share it if there's somebody um that you know who's also going through this journey please share our videos with them this is an a community of amazing people Everyone is really kind and sweet they um they're bold right they made this bold decision to go out and try this Cutting Edge Med medication um after maybe trying and failing many times with other um methods and um and they're really a brilliant community so you be being good company if you join us so just hit the Subscribe button and hit the the notification button to the Bell because every now and then if something happens I will come on and give an update um outside of my my weekly updates uh regarding how I'm doing with my weight loss Journey okay um and then before I go I might as well just give you guys a view of what I look like um I know when I'm watching videos sometimes I'm curious like what does that person look like um this is a where I am my little dress here so this is a view of what I look like and I also want to do document it for myself too because um I like to look back and see the progress because I can't really tell right now I can't really tell if I'm losing weight but people are saying they can see it in my face so I appreciate that so um if you have any questions or comments or um uh any concerns you want to share with the community please send them my way I love uh getting uh your your um your comments I love love love it it's one of my favorite things each to check and I respond to every single one of them right now I'm respond to every single one of them so if you haven't seen a response check your inbox because it's there and um and thank you so much for joining me I appreciate you being on this journey with us and um if you have any great tips to share we're open to that we want to learn as much as we can in this community so we can share good content I'm just one woman and it's one woman's Journey I'm not a doctor so check with your doctor um before you make any you know decisions on this medication and thanks again for tuning in take care bye for now