*updated* HOW TO GET ZEPBOUND COVERED BY INSURANCE? / How To Get WEGOVY Covered By Insurance?

Special Report how to get glp1 medication covered by insurance and how to get Zep bound covered by your insurance hi friends I'm Elizabeth ctis of shopping and on today's episode we're going to talk extensively about insurance coverage after having a special report lengthy interview with with a huge huge mover and Shaker in the industry but first i'm Elizabeth ciss of shopping I've been on glp1 medication now for the last 16 months it's changed my life I've lost over 88 pounds on that 100 PB weight loss journey and I love sharing on ciss of shopping my channel here of how we can be encouraging uplifting with the latest information on glp1 medication I was on mararo then because of the mararo shortage then on ZET bound and now with the zound shortage I'm actually on the zip bound compound I'll link all of that information down in the description link below but on today's episode we're going to go through fully how can you get your glp1 medication covered by insurance or at least some tips uh that dramatically helped me uh and hopefully will help you I had the privilege in honor I got an email from someone very very very high ranking um who is a decision maker within the industry who asked to have a confidential interview with me which is why they're not here on camera with me their name will not be disclosed as my promise to them so I'm keeping that Anonymous however y'all know with my Integrity uh that um I'm going to keep that promise that I made to keep their name Anonymous but it is a very very high mover and Shaker and I had the privilege of talking to them for a long time I have six pages of notes we're going to go through of how to weave through and Nea navigate for your particular insurance company everything may not be applicable that I'm talking to but I have a sixo seveno action plan how many tips do I have in here uh six six tips for you as an action plan that you can go through for your insurance company and see if perhaps you can get these coverage if you're self-paying or if you're on WE GOI for example and you know that zet bound has slightly higher data for chronic obesity management but your insurance company doesn't cover Z bound that's my insurance company right now and so figuring out and also with the shortages of being able to swing over to different uh maybe from wovi to Zep bound or zound to wovi but you can't because of your insurance coverage so today's episode I felt very much like Woodward and Bernstein with deep throat back in the an era of having this amazing interview and having the privilege to interview this particular person because they are a decision maker so let's go through the first part of I'm going to go through and read some of my notes on here too if you also have questions please put them in the comments below too because I very much we're going to continue this dialogue on this so basically you're for insurance company your insurance is coming from your employer and where we need to start looking at is um from from this movement I'm going to say so to speak through your talking with your HR is how you can like how can you immediately have action you may not be able to change the entire insurance industry I know for me I'm like I'm not going to be able to change the entire insurance industry but I can look at where my benefits for my insurance company are coming from my HR and through my partner's HR now I am I I own my own companies I am HR um but through my insurance company through your house through their HR this is also applicable too if you have benefits through your partner so hr's goal is to have a healthy Workforce first and foremost they want to have a healthy Workforce too but um we know that there is a bias for chronic obesity management I mean people still don't think of obesity as a disease and therefore decision makers who are uh within HR and Within These circles who are making these decisions may not necessarily be thinking of obesity as a disease so therefore chronic obesity management treatment like wovi and like Zeb bound um there's still a bias there right and so looking at across an entire budget for HR who's making these insurance coverage decisions um the most I found this fascinating do you do you know what the most expensive insurance coverage is for an HR it's actually infertility I did not know that that's the most expensive one so they're looking across cancer fertility uh or infertility um heart disease arthritis and some of these other things within their Workforce um they're going through and figuring out okay where is the money going to go now you can go through and look for the glp1 benefits right um from somebody who is obese having joint issues and perhaps having like knee replacement surgery the cost of that or someone who eventually ends up having diabetes and then has to have dialysis the cost for dialysis and so the price if you start pricing those out is significantly smaller for a gp1 medication and so um running into these health related comorbidities um and and other health relate not comorbidities but also health related issues like a knee replacement surgery um you don't want to walk into your HR talking about the vanity metrics of losing weight um that it needs to be health related so out of this whole thing I want you to take this big nugget that when you're talking to your HR because we're going to have an action plan for you to talk to your HR who's making the decision on these healthc care benefits for your insurance company you need to frame everything around it being health related not vanity metrics you do not want to walk into your HR and start talking about I've got to lose weight for a wedding coming up I've got to lose weight to fit into this particular dress I've got to lose weight for this um whatever h a vanity thing no it needs to stay health related and so going through that's tip number one is when you're starting to frame these conversations for Health Care is you must keep it health related it's hurting your joints how much the cost of a knee replacement surgery is being potentially diabetic having to have dialysis I mean when you break out those costs piddly old G1 glp1 medication for somebody for years still doesn't touch the cost of that tip number two call your HR and say how are they deciding right like having that conversation of how are they allocating this budget how are they deciding so they can see HR can see a list of what claims are are um they don't know who it is but they can see for example does a child have leukemia a baby in the NICU so for example my my um my son was in the niku when he was born and um expenses related to my daughter's death uh and Care coverage for me and care for me throughout that and so for example the insurance the healthc care um the HR didn't get specifically that it was me through my partner's benefits but it obviously did show these massive amounts I mean a baby in a niku it's incredibly expensive a child with leukemia or these other things so they can see specifically they meaning HR can specifically see a list of the claims that are going so then that's your question to HR is where is how are they deciding and where is the money going what's that budget allocation for right like you can't go into this without knowing where that money is going so it's very helpful to frame that of okay tip number two calling your HR and finding out okay what's the budget where's the money going if you're not getting access to drugs uh for example if you have Etna for example you could call Etna the person needs an exception and an advocate on their behalf it's all about the budget um avoiding a knee replacement or dialysis the cost of everyone for glp1 medication for example Etna Blue Cross Blue Shield I'm going to Rattle off a bunch of them I'm sure Kaiser Permanente I haven't confirmed that one but I'm pretty sure it does um and rattling off these major health those are like the ones off the top of my head they perhaps have advocates for you which we're going to talk about in a minute but tip number three is within your hr's budget there's probably sponsored Wellness budget I didn't know this until I started digging into my particular health insurance company and that's tip number three I want you to do some homework you're going to do some leg work today you're going to dig into your particular insurance company because your hr's figuring this out with them too a sponsored Wellness budget so sometimes it's up to $300 per year that they have for like programs called like be healthy um mine they have a particular list I get money if I do because of this conversation I want to go look look my husband can get money and I can get money if we do particular line items and we get this gift card of money put on there it's hundreds of dollars and so I want to encourage you take advantage of these um these sponsored Wellness benefits that are within your HR already um have they also have for example um probably reduced gym rates as some of them like there's other things that you can get with these sponsored Wellness budgets too uh for them when you talk um about a PA you need to be honest for example I think for me now I've said it all on the internet but before there was very much guilt shame comination of where I put a block up and I didn't necessarily go into the amount of pain that was associated with literally fighting for my life with chronic obesity management and all of the things I have done um so don't be afraid to be honest about that when you're talking to HR about this in terms of the budget about talking about why are glp1 benefits not a part of that budgetary conversation here's been my experience I've been fighting for my life I've been on every single diet known to man for my health and again reframing that conversation this is not for vanity this is not look cute in a dress it's not for a vacation it's literally for my health for my joints my joints crack like popcorn when I'm walking up the stairs um having my blood panels like going through the specific things for you that are true that are health related again reframing that whole conversation health related not vanity metrics um for example um I can go through my CVS app and I can go through for free blood work you can then take I mean y'all free blood work like I didn't know that so I went in and I'm like oh my gosh I can get free on the CVS app I can get free blood work that prevents the cost of me paying for it so for example over with I use join Fridays I use them for they're my tella Health company for zound before it was with mararo but now zound um and then now I'm on the compound they prescribe both join Fridays does use the discount code Queen I'll link the information in the discount below but they have in there where I pay for blood panels I have insurance but uh part of this there is a cost for blood panels I could have oops I could have done this um for free through the blood work so check that out to see if you have some sort of offering for free blood work because then I could have transfer that over to join Fridays right I could have had that on my video chat with my telea health provider they said oh we need blood work I could be like bam I've already done it and then I could just have it transferred over already have that PDF set to go to put in the portal back to my telea health provider so being a little bit proactive with these things super super helpful use every single free tool that your HR is offer offering you to show that you are doing uh like that's showing that you're you're working within the system essentially you know what I mean like you're working within within the system um use so that CVS app is free check that out specifically for yourself to see if that's applicable I mean to have fully free blood work done that's amazing tip number four in Fall time is open enrollment um should you be shifting your Pharmacy benefits I thought this was very helpful my husband and I are literally having that conversation now should we be shifting um our Pharmacy benefits to a different healthc care company because we can pick our health care coverage and I'm like well who's covering zound with under my husband's health insurance right now we have amazing health insurance but it covers wovi which is awesome but I haven't gotten wovi because of the shortage the wovi shortage and now with the Z bound shortage I can't get that even but eventually this is going to absolve itself we know Eli Lily told us um that in 2025 the mararo Z bound shortage will it should be resolved by then I don't know when but they said on on my source site my source my source is the quarter one 2024 eliy investors call if you go through that transcript on El Eli lilly.com that's my source I listened to that whole interview it's a very brief snippet but it is addressed in there so when you're looking at should tip number four fall time is open enrollment can you change your your Healthcare benefits is there a better one within your HR coverage that they have cuz we get to pick for ours that's exactly what my husband and I are talking about now we're researching now so come fall which is still way away but we'll have the information if we're going to stay with our existing um benefits the pharmacy benefits right um if we're going to be shifting to see that now right now you can't get zip bound easily because of the Zep bound shortage uh we GOI is still on the FDA shortage and to my knowledge you can't get wi GOI easily either so for chronic obesity management care and if you're on off label prescri prescription of mararo you you you can't you can't it's switching that I'm looking to see because eventually this will get absolved but it's helpful to know about the Open Enrollment in Fall okay um let's see here let's go on to our next tip talking about tip number five call your spouse's benefits your program manager yourself so for me my health insurance is within under my husband and so me calling my husband's Health um benefits to figure out the benefits and having that conversation right like my husband he is amazing and he's been awesome on this journey he's been doing the leg work to help me figure these things out I'm not the best at paperwork in terms of this I've got G thingss but some of this nitty-gritty stuff I'm not the best at so um having if if your partner is that way calling their HR too helping to support your partner or your spouse with that as well um looking at the bigger picture and talking to HR about that too having a diabetic episode you see what I mean that literally pays for the cost of the glp1 medication within five years reframing having a heart attack is and coverage for a heart attack for HR versus having glp1 medication for a lifetime there was an article that came out and it's not necessarily true and I had talked about this in the interview with my uh my source my uh anonymous Source I said well there's this article that came out about how people are saying they're switching from uh the health insurance I've even referenced it if you remember what this article that I'm speaking of and um I'm not going to reference it below because it's actually not true parts of it got poked holes into that actually if you do talk about these things a lot of people are on the same Insurance health insurance coverage and then I thought about my own health insurance I've been on the same health insurance plan for five years six years somewhere in that ballpark it's been quite some time right and so if you go through and talking with your health your hr's um decision makers on this or who is the decision maker or working your way up to the decision maker to have an appointment that's very helpful tip number six Health Care Advocates are available it's called EAP program I don't know what an EAP program was I was just talking with my spiritual adviser over dinner last week about EAP program you can call an EAP EAP advocate service to help with mediation is my notes right on this moderation mediation I was writing as fast as I could so my notes are a little bit wonky but you can get an advocate to basically work on your behalf at no cost at no cost and so that's something to look into you're battling with health insurance companies but can you get one of these EAP Advocates to help speak on your behalf to help with um knowing the code this has been a big thing for me is these Dagon insurance company codes and so knowing the buzzwords these Advocates know the buzzwords they know the codes that's their job and so can you get partnered up within your um Health Care System healthcare advocates are available with this EAP program start looking within your own resources on this and again this is where you're going to have to take some accountability and leverage for your own and here at the C shopping Community we are smart cookies we can do hard things we can we read find and print when I did the video on the mararo coupon savings and zound coupon savings it blew my mind how many people weren't necessarily willing to read the fine print which um I sometimes have a hard time reading things like that as well but we are putting on our critical thinking caps we can do hard things to figure these things out to be able to be an advocate for our own health and that's what I've been learning a lot over the gosh the last 16 months having lost 88 pounds is being respectful and being kind but being an advocate for myself and so having an advocate that you can pair up with with one of these AP program Advocates may be helpful for you and maybe not the friend that my spiritual adviser I was talking to she came back to me yesterday and was like I am not I'm not eligible she wasn't able to have that but maybe you are now I got a Bonus tip for you there's preventative care things that may be within your health company your health insurance and so getting explanations on those or digging further or within your insurance companies too to help with those about this preventative um care and talking about preventative care and using that as part of your conversation with hr2 Within These as well um let's go over here um number tip number seven so there were more tips okay so I had said there's six there's actually seven we're going to keep going flexible spending for next year I've done a whole video on this there's more information on that too is spending for the flexible spending you spend all of your money UPF front and not have to wait for a payment so the difference between FSA and HSA the flexible spending has on there of where you can can um spend it all up front so you could use it like in January at the beginning all due flexible and you can start spending it on January 1st I didn't know that I thought that we had to wait so that was help help ful for me too of spend it right away you can spend it you don't have to wait throughout the full year on that too um I found this interview fascinating and so if this person who I interview is watching I I don't know if you've made it through this interview but I'm incredibly grateful I learned a tremendous amount I mean six pages of note golly day of how to get and to work I'm going to be leveraging I want my Z bound covered by my health insurance and granted yes I cannot get it right now because of the Z bound shortage but that is going to absolve itself we it's not in the bird's eye view if you look at the bird's eye view six eight months 10 months is not that long relative to the the the framing of this and uh getting that coverage oh my goodness like that's huge huge huge huge because most people can't spend $1,000 doll per month two thou up to $2,000 on jp1 medications and that is the cost right now for the cost of wobi the cost of zound for chronic obesity management care with Jill P1 medications it's Insidious to me that it's not covered by Insurance when it can prevent so much with health and that my friends is why we're seeing all these other FDA approvals for other things besides chronic obesity management we GOI for example had the FDA approval um because it showed the reduction in cardiovascular activities for heart disease and strokes and I did a whole other video on my breaking news series on that um that we're seeing about sleep apnea that that Zep the the Zep bound um is doing other for the haars tears eptide they're testing to for sleep apnea and maybe that's going to get FDA approval on there um there's other ways that perhaps these medications Medicare friends can't even get it because of the Medicare law uh blocking any sort of obesity related drugs hopefully that law it sounds like there's a lot of lobbying going on to get that act um repealed or taken away that was back in ffen days which is why it was um made into law but now that we're seeing and we have scientific data this is not woo woo this is not um saving people's lives it's it's truly in my my life I'm the prime example right here I mean literally the conversations I had 16 months ago and the conversations I'm having now I I've shared this but we've changed my we're changing my retirement plan I I I didn't plan to I didn't think I was honestly to live as long as I think I'm going to live now and now I need to revamp our financial strategy for retirement I'm like oh my that is there going to be a money left I'm going to be living a lot longer than I thought as a result of losing 88 pounds and I'm going to I will get to that 100 pound weight loss I know I will but having these conversations of how to get glp1 medications covered how to get zet bound covered if you're not having these coverages how talking to your HR but it always the biggest takeaway of this conversation is the framework for you framing it around Health around heart attacks or dialysis with uh diabetes or knee replacement surgeries I mean going into the cost of those a big cost for the coverage of it and do not get Sid swiped by that one article that I referenced to about how insurance companies and that article was misleading in some capacities after thinking hearing about it and then thinking further about it I'm like it's not necessarily true because just for my own example I've been on that health insurance the same health insurance company for five or six years if they'd cover zound I'd be on it longer too and I think I will but again I want you to start proactively thinking too for open enrollment in the fall for us folks I know we've got a lot of UK folks and our Australian friends and other countries watching as well but here in the US we have open enrollment for our health care and um our Canadian friends too I know y'all y'all are having the massive shortage as well but um and I'm not sure for the Canadian your Healthcare System is completely different than ours here in the US but I found this fascinating if you found it fascinating too let me know down below uh if you have other questions on this I am not an expert of course I'm going to go to The Experts and find out this information but ask your question it may take me a while to get to the answer to it but I will certainly try because I think having broader conversations on this of why our insurance companies are not covering this now that we do have scientific facts because before and I think earlier on like even when I started this 16 months ago I got from my own family that they thought I was taking a gp1 medication for vanity and I'm like no no no no have you seen my blood panels have you seen all of the thing I mean my health was horrible and how drastically different in 16 short months my life has changed and my health has changed so these are important conversations two things we do here at C of shopping one I want to hold you accountable what are you doing today to move you closer to your goals gosh I hope that your goal movement and your goal focus today is talk about HR uh for insurance or looking into your insurance benefits or looking into an EAP Advocate or looking into your free programs that you already have access to you may not have even known that you can go on the CVS app if that's through your health insurance and obviously each health insurance is different but maybe yours is through Walgreens yall know my thoughts on Walgreens pharmacies um but you may have all these free programs like I did after this conversation I ran over I I was doing the leg work too to have 100 hundred of dollars for myself and hundreds of dollars for my husband by doing Simple Stuff within our insurance company if I can get an extra $600 per year through my insurance company by managing my health which I want to be doing anyways absolutely and they were not hard things either so I'm going to be I'm very excited to be doing that um that was tip number one tip number two if you've made it this far on the video we do a little thing here at count of shopping of where we do Emojis and today's Emoji is going to be typ tying some sort of emoji related to typing or if you write if you are not near your phone to make an emoji you can just write in typing that would tell me that you got this far in the video and that probably means you like my content if you do I will then pray over you if you don't believe in prayer I will uplift you in positive thought I like to know there's thousands of you but there's one of me but I really do my heart's desire is to know you and to encourage you and to help you and we have this incredibly strong Community here at count of shopping I do have a free group uh for wovi ZB compound uh users um and mararo and OIC folks as well it's linked down in that description link below just click that dot dot dot more button check that out um to a ton of free resources countless of shopping.com I have a free meal plan there for you that was dietician created for a full week um my gift to you I bought that with my own money as a gift to everybody um an own the licensing rights on that for free uh to give to you as well so check that bad boy out and I look forward to having these further conversations I know this is one of many uh of fighting the fight of getting glp1 medications covered by insurance and whether your insurance is ETA or Blue Cross Blue Shield Kaiser Permanente United Health I mean there's a ton Try Care Now TR care folks you're falling under that in bracket with a savings card ofin where the savings card would not be applicable because savings card that's a different ball of wax but my sweet friends be kind to yourself be kind to others I'm count us of shopping count my blessings because life is delicious I look forward to seeing you next time have a great day friends see you