UPDATE: PA submitted yesterday, approved this morning. Less than 24 hours. I've been fighting for coverage for 14 months and it took less than a day once it was actually on formulary.
My new cost: $25/month with the Zepbound savings card stacking on top of my $50 specialty copay. Down from $549/month.
I'm going to save $6,288 this year. I genuinely cannot stop smiling.
Love seeing this! And for anyone whose employer currently excludes GLP-1s, here's what you can do:
- Write a professional letter to your HR/benefits department requesting the exclusion be reviewed
- Include data on cost-effectiveness (JPMorgan's internal analysis showed net savings within 2 years of adding GLP-1 coverage)
- If your company does an annual benefits survey, advocate loudly for GLP-1 coverage
- Connect with other employees who want coverage — there's strength in numbers
Most employer plans renew annually. Changes requested now could take effect at the next plan year. Don't give up — the trend is clearly moving toward coverage.
Pharmacy side update: we've been seeing a FLOOD of new Zepbound PA approvals through UHC this week. Our pharmacy filled more Zepbound prescriptions yesterday than in the entire previous month.
Heads up: there may be short-term supply pressure as demand spikes. If your pharmacy is out of stock, ask them to check other locations or consider the mail-order option through OptumRx (UHC's pharmacy benefit manager). Mail order has been more reliable for supply in my experience.
Also: make sure you enroll in the Zepbound savings card BEFORE your first fill at the new copay. It's free to enroll and could save you $25-50 per fill depending on your copay tier.
Sigma-Aldrich — Research-Grade Standards
Certified reference materials, analytical reagents, and research-grade standards for peptide verification. Trusted by laboratories worldwide.
Shop Reference StandardsHappy for those of you who got coverage. Genuinely.
I took the advice and emailed our benefits team. They said they'll "bring it up at the Q3 benefits review." It's not a no. Small progress.
In the meantime, I'm staying on compounded tirzepatide at $199/month. It's working great for me (down 43 lbs) and honestly, even if my employer adds coverage tomorrow, I might stick with compounded. No PA hassles, no formulary changes, no pharmacy games. There's something to be said for simplicity.