Glp-1s are excluded from all of my employer’s plans, are there any appeal options?
I was doing some research to see if I can have my insurance cover a glp-1 medication again, as I was covered in 2024 before policies got very restrictive and lost 60lbs, taking my BMI from obese to normal/healthy. I had to stop the rx when I switched insurance companies, and now I can’t get covered again. I’ve been able to use samples from my provider’s office for a couple of months and do take vyvanse, so those things help, but it is still a tough battle, made extra frustrating by knowing there is something that works but I can’t access it.
What I found was even if my employer does not cover any glp-1’s, I can basically do a request for formulae exception to my employer to have it covered. Has anyone tried this? It’s not exactly financially feasible or desirable to spend $200/mo on compounded options or pay out of pocket for the name brand. If I can’t get it covered, I’m willing to simply go without and try to stay on top of my weight without it.