Oct 5, 2025 at 7:52 AM#6
To be clear — my doctor genuinely believes I'm on the path to T2DM. Family history of diabetes on both sides, metabolic syndrome (high triglycerides, low HDL, central obesity, hypertension), A1C trending up from 5.9% two years ago to 6.4% now. She told me "it's a matter of when, not if" without intervention.
So the diagnosis isn't fabricated — it's a clinical judgment call about where on the continuum I fall. The fact that it ALSO happens to get insurance coverage is a bonus.
46 24mike_mealprep, NicoleRaleigh, james_edin and 43 others
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Oct 5, 2025 at 11:41 AM#7
Honestly I gave up on insurance entirely. I use compounded tirz. $150/month vs fighting with insurance for months, dealing with prior auths, worrying about audits, and having my treatment depend on how a PBM employee interprets a diagnosis code.
My time and mental health are worth more than the insurance game. 🤷♂️
Last edited: Oct 5, 2025 at 2:41 PM
47 0MounjBrad, nick_newbie, DadBodDave and 44 others
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Oct 5, 2025 at 3:30 PM#8
that's valid for people who can afford it. But $150/month is a LOT for many families, and brand Mounjaro/Zepbound with insurance can be $25-50/month with a good plan. The system is terrible but the financial math favors fighting insurance if you can get coverage.
Also worth noting: the Inflation Reduction Act capped insulin costs at $35/month for Medicare patients. There's legislative momentum to do similar things for GLP-1s. The landscape may change.
Last edited: Oct 5, 2025 at 4:30 PM
48 1sarah_nash92, FitDadDave, RunnerRach and 45 others
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PeptideDetective — Independent Peptide Analytics
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View ResultsOct 5, 2025 at 7:19 PM#9
Update for anyone following: been on Mounjaro 5mg for 6 weeks now. Insurance continues to cover it without issues. A1C already dropped to 5.9%. Triglycerides down 35%. Lost 18 lbs.
Irony: the drug that my insurance said I didn't need for obesity is treating my obesity (and metabolic dysfunction) spectacularly. Almost like... obesity IS a medical condition that deserves treatment. 🙃
49 2FranDenver, Dr.BariatricHTX, LindaRN_retired and 46 others
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