Sep 24, 2024 at 2:03 PM#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.
Last edited: Sep 24, 2024 at 8:03 PM
24 19mike_mealprep, NicoleRaleigh, james_edin and 21 others
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Sep 24, 2024 at 3:48 PM#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. 🤷♂️
23 18MounjBrad, nick_newbie, DadBodDave and 20 others
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Sep 24, 2024 at 5:33 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.
22 17sarah_nash92, FitDadDave, RunnerRach and 19 others
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PeptideDetective — Independent Peptide Analytics
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View ResultsSep 24, 2024 at 7:18 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. 🙃
Last edited: Sep 25, 2024 at 1:18 AM
21 16FranDenver, Dr.BariatricHTX, LindaRN_retired and 18 others
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