Mounjaro coupon without insurance reddit. They have the right to fill or deny.

Mounjaro coupon without insurance reddit Worth a shot, I thought. I believe the negotiated price under the HDHP before you hit your deductible is around $900. I am VERY lucky to have a Medicare part D insurance that covers Mounjaro and doesn’t require a diagnosis code or step therapy. I'm currently paying $750 for four 15mg pens via Amazon, without the coupon, but with Additionally, the pharmacy said they couldn’t get the coupon to run at all (updated from Eli Lilly site with expiration date 12/2024). I do but it only gives a discount so it's still over $500. Today it was $550 with the new coupon. My insurance has 5 categories and one called Specialty, it states 50% Coinsurance. I ran into this problem at Walgreens today- they said because my insurance denied coverage of Mounjaro their system will no longer let them run the coupon on its’ own without billing to insurance first (which they can’t do because my insurance denied coverage). To download it you must attest to having type 2 diabetes. However, if you had the OG coupon and have been using it, then since you have insurance coverage, it should cover you until 12/31/23 and you should only pay $25. The Walmart tech told me my og coupon was coming up expired and he told me to get a new one - didn’t say anything about T2. Hopefully this helps Mounjaro coupons terms are changing effective today. It specifically gives instructions about commercial insurance not covering it on the coupon infoit’s on the the second or The coupon is for post-insurance cost. Anyway, I hope someone finds this helpful. So it may have just approved it for you since you’ve already met the requirements of step therapy I’m currently struggling to get the coupon to work. A safe place for questions, experiences, tips and tricks, for Zepbound and a helpful community to assist you along your weightloss journey! ZEPBOUND is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight Assuming you qualify to use the coupon, you can show the pharmacy tech the terms and conditions: “For patients with commercial drug insurance who do not have coverage for Mounjaro: You must have commercial drug insurance that does not cover Mounjaro and a prescription consistent with FDA-approved product labeling to obtain savings of up to $575 off your 1 Now, post new year requiring diagnosis code and pre auth. But my first box costed $25 using the coupon. 00 off, Get the Reddit app I just got mine filled at Walmart and it’s 457. Push is telemedicine. That coupon, as most of you know, expires at the end of June. Now that the coupon for those without insurance coverage has expired, My insurance does not require a PA for Mounjaro or any of the other diabetes injectables so my prescription just went Some are lucky where their insurance approved without T2D others the insurances are getting strict and won't approve for anything other Are you adding an e-voucher of $150. 5mg dose. My copay for brand drugs is $60 with my insurance and that's all I paid. New comments cannot be posted and votes cannot be cast. Questions, experiences and accomplishments related to Mounjaro and Humana, requires a diagnosis then they can’t use the coupon without the approval of insurance. In the case of Capsule Pharmacy, originally they were refusing to honor the coupon without a T2D diagnosis. The 2 codes my dr gave (obesity related) wouldn’t work and now pre auth denied. Reddit . Try mymounjaro. insurance companies (a. All of a sudden the coupon no longer is being accepted anywhere pretty much (I’ve tried Walgreens, Publix, My old insurance (BCBS) did not cover Mounjaro, but they provided a coupon for it I guess (honestly idk) because instead of paying the retail price of $1,200+ I was able to get it for $500. their is no 150. The current $25 is IF your insurance COVERS it they take up to $150 off your copay to make it $25 (if your copypay is $175 or less) and you need to have a T2D diagnosis for the new coupon. You most likely will only have to pay $25 a month and haven’t needed to pay full price at all. during the time of taking Mounjaro, If you can't afford to stay on MJ without insurance, go lurk on r/Tirzepatide to see how others are dealing with this. If your insurance covers Mounjaro / Zepbound but you don’t have a relationship with a PCP / Endo then a telehealth provider like Mochi will charge a monthly The cost is $615 seems like my health insurance is paying for half which is good news but I wasnt expecting on paying for it until after June. My benefits just started with Cigna yesterday. 98% of questions about Get the Reddit app Valid through 12/31 for those without insurance coverage, up to $575 off. Coupon mounjaro. $25 still works with the new coupon - it just has to go through your insurance and you have to certify that you have T2D when getting the coupon. But how View community ranking In the Top 5% of largest communities on Reddit. Insurance told me they don’t approve it. I have Blue Cross Blue Shield health insurance and Express Scripts as the prescription part. If you don't have My insurance would have a co-pay of $100, but with the Mounjaro coupon the cost is $25. Has anybody had luck with a pharmacy in NYC taking the coupon without insurance approval? I do have a T2D diagnosis. 00 off without going through my insurance. insurances will sometimes cover the first month of meds even if you need a PA. Just get a script and use the coupon it’s only 25/month with private insurance that covers or doesn’t cover it. When mounjaro is either approved for weight loss or a new version for weight loss is approved, it “may” be covered if you go through the list of meds they want you to try first. They told me I can’t use the discount card without insurance even if it doesn’t cover it. The coupon has a I have an extra old savings card (pre 11/10) I’ve never used and won’t be needing. A lot of people using the new coupon without T2D. They are allowing OP to fill it if there is no T2DM diagnosis without insurance, so they are not saying no completely. Does anyone have a clue what going on? I checked our insurance with UHC and it's listed as a Tier 3. 5 and apply the coupon but eventually they made it work. They replied $25. Not sure how much longer these will be honored at $25 but gave another to a friend last week and they were able to use it I honestly believe there is no rhyme or reason why the coupon card works. Rules: be nice, no bullying, no discussion of unproven “natural” diabetic drug alternatives, and **no discussion of coupons, please**. I missed the cutoff for the old coupon, so I didn't use any coupon. I contacted my insurance and they said i could file for a preservice appeal and mention some comorbids i have (hypertension, sleep apnea, and others). Some even have a small stash waiting. ) If you don’t have insurance, you aren’t eligible to use the savings card at all. The coupon won't work if you have no insurance The coupon won't work if you have Kaiser and try to use it at a non-affiliated pharmacy The coupon only works if you have insurance that covers the med OR if you have insurance that refuses to cover the med. 43, which is the same as what I've had to pay since I began Mounjaro. If it does not then it can take off as much as 575 off the regular price. Reply reply More replies unimaginableUnicorns For those of you who with no insurance (so coupon not valid) which commercial insurance plans did you sign up for in order to be able to USE Lilly’s Mounjaro COUPON SAVINGS CARD? Question A lot of much pricier group plans do not cover it without a Type 2 Diabetes diagnosis. If you have no insurance, you will pay the pharmacy price. A safe place for questions, experiences, tips and tricks, for Zepbound and a helpful community to assist you along your weightloss journey! ZEPBOUND is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight Blue cross Blue shield. I’ve seen some people able to pick up a box of Mounjaro from Walmart pharmacy for $350, without insurance coverage. Makes it about $400-$500 a month depending on the pharmacy Get the Reddit app Scan this Has anyone had any luck getting Mounjaro covered by insurance without a T2 diagnosis or a weight loss diagnosis? Mine is actually excluded according to the formulary, but comes out to $225 before the coupon and after insurance coverage. They exclude all weight loss meds, and I definitely do not qualify for Mounjaro for DMII or high A1C. if it’s doesn’t go thru insurance don’t bill. It did! View community ranking In the Top 5% of largest communities on Reddit. I ran my overweight ass down to Walmart to get it. The current Mounjaro coupon is a little unique, but it's only because the drug has only recently been approved. com that can take $500 off retail without insurance coverage for the medication. Why not charge 550 for it for anyone who has a prescription and whose insurance will not cover. I had my coupon submitted before the change and haven't had any issues picking up refills using a small town local pharmacy. Only negative is that you will be paying a lot out of pocket since you are on the HDHP, even with the “best” original coupon. Also in the card eligibility requirements: Get the Reddit app Scan this That being said the price of the medication will be determined by insurance coverage. I had great success so far and am trying to figure out how to make this work. I pay $110 without coupon but only $25 with coupon. But the last two refills, I had to remind the pharmacy tech that they had the coupon on file because I went to Walgreens told them NOT to run the prescription thru my insurance and used the coupon from the mounjaro website for $25. ” You can’t get a 3 month supply without insurance coverage, 21 votes, 35 comments. Hi there! It looks like your post is related to the manufacturer’s savings card for Mounjaro. It says in my plan multiple places that they absolutely DO NOT cover any medications for weight loss. 00 e-coupon gong through for cash pay. 🤷‍♀️ One of the trials that will launch in/around November has no placebo. Lilly will not want to price out most of the patients who are being prescribed mounjaro if insurance isn't picking up the slack this time next year, so they very well could offer another savings program to fill in the gaps. Without insurance coverage it will cost you over $1000 OOP for your second (and third and fourth) fill. Get the Reddit app Scan this i just went through this with my pharmacy to get the 10 mg. The $25 no questions asked coupon days are long gone. The coupon was always designed for T2D patients to be able to get access to the medication at an insurance covered price while they were going through the actual insurance approval process. Thanks for any leads! This is key. Call your insurance first and see if they cover MJ and if they require a PA. Without the coupon brings the price to 550ish per month. Here are the current options: If this applies to you, please provide supporting documentation that you have Type 2 Diabetes. It seems you have insurance even though your question refers to someone without insurance. It is worth the money. And for me, the user category is "insured with commercial but not covered". Now this month it's almost full price at 1029. I'm just starting Mounjaro (via Sequence) and picked up my first pens yesterday. Depending on where you live you can find a “wellness / weight loss” clinic that will have a doctor proscribe this for around the $500 price with no coupon. They also offer assistance for people without insurance currently. 62K subscribers in the Mounjaro community. It also covers Wegovy 100% but that does require prior authorization since it’s considered a weight loss drug Vs the others are for diabetes. I paid around $26 for the 4 pens. I’m not eligible for the coupon because I’m on Medicare but only pay $47 per I am paying completely out of pocket, no insurance whatsoever. Could it be that Mounjaro is falling under the "Specialty" category? Any suggestions on getting the coupon to work again? Mounjaro has a coupon that works even if your insurance doesn’t cover it, so long as you do have commercial insurance. My doctor then prescribed the 5mg Mounjaro dose, and it came back as needing a prior authorization. Lilly’s Mounjaro. Some Is there a Coupon or discount to use if PA is denied and just going to “pay cash” without commercial insurance? How much does Mounjaro cost without insurance? Mounjaro costs without insurance will vary depending on how much you buy and the retailer you buy it from. 98% of questions about expiration dates, how often you can use the discount, and how much of a discount you will receive are explained in detail in the small print. The coupon took the price from $977 to $477. I believe BCBS does I also saw that in a Facebook post that someone mentioned here on Reddit that some people were buying supplemental insurance to cover Mounjaro but I’m not sure this is true. Before that, I was paying $500+/month. she said every coupon she's generated since the change has been denied by the same pharmacy when there's no t2 diagnosis I ended up just paying for it using the coupon. If you have government sponsored insurance, such as Medicare, Medicaid, The tech asked me if I had Insurance n I said yes n uhc and she went back n before I knew it she said I could fill 2 of the mounjaro prescriptions and I hv to come bk in November to fill the 3rd! She then checked me out and I seen the $1165 price for 2xs and I asked, did the coupon work? She laughed and said yes Ma'am it will come off. 45K subscribers in the Mounjaro community. If your prior authorization is denied, you can still fill your prescription without insurance. Hi all — is anyone who was paying out of pocket for Mounjaro running into issues with the coupon card that brings the price down from $1000 to $500? I’ve been using Mounjaro for the last 16 months or so. And worth paying retail, for me (I can afford it). We’ve seen a few people get lucky with “courtesy fills” from their insurance for 1-2 months, but it’s not sustainable to pay that little if you’re just getting started now. But most insurance plans cover the medication when it’s prescribed to treat Type 2 diabetes. Coupon for sure works. It has nothing to do with your insurance or drug coverage. Cheapest place to get mounjaro without insurancr coverage? From our understanding, the coupon cards can be used only if the insurance covers some cost of the medication. My insurance is bcbs of Minnesota From the perspective of a pharmacist, here is where the issue lies. Took it to CVS and it brings the price from 1200 to 525. I said "Oh I have the new coupon for this year" and they say "With insurance and the coupon it's still 738. I believe Mochi charges $79 per month for their services. Here’s what to kno Mounjaro (tirzepatide) is a type of dual glucagon-like peptide (GLP-1) agonist and glucose-dependent insulinotropic polypeptide (GIP) agonist approved by the Food and Drug Administration (FDA) to help manage blood sugar levels in people with type 2 diabetes, alongside diet and exe Without insurance, you can’t get Mounjaro for $25. Assuming on the backend they did their own insurance denial thing through It’s coming from Eli Lilly. Also, you did not state that you have commercial Insurance. ETA: Yesterday when I called, it was $1050 with the old coupon. It took some time I was so relieved when insurance sent me the letter of approval. At its sole discretion and with or without notice, Lilly may reduce, eliminate, or otherwise modify the Card savings for any reason, including but not limited to if your commercial drug insurance plan imposes additional requirements which limits or prevents you from receiving coverage for Mounjaro, only allows partial coverage for Mounjaro, removes coverage for Mounjaro and She did. I've tried Sam's Club and Amazon. Reply Senior_Debt2499 Best case scenario without insurance coverage is $500 a month. It took about a week for Walgreens to stock 7. ) * The patient does not have a denied PA on file (the pharmacy needs to run your insurance to meet the first criteria, and if your insurance comes back saying a PA is required, you need to actually have your doctor submit one, even if Just wondering what companies cover Mounjaro (I’m in Colorado but I still want to know regardless). Use coupon until it won’t work, Then pay cash if they let me without T2dx, stretch out the injections to 3 per month so one injection every ten days. A community exclusively for type 2 diabetics using Mounjaro, Ozempic, or some of the other drugs that were created for type two diabetes, but increasingly being used for weight loss. Hope this helps! Let us know how you make out. And if you have T2D you can get a savings card that takes $500 off per month. Save an average of $235 on FDA-approved GLP-1s like Ozempic and Zepbound. My first script was covered by insurance (Humana). Not unless your insurance covers it, Mounjaro is around $1100-1200 or so per month. It The pharmacist said my insurance started covering the medication. insurance does not cover it I was told you can't use GoodRx and the Mounjaro coupon at the same time. Its crazy. The pharmacist said this was a recent change in the coupon. ETA: Those without insurance coverage for Mounjaro, who’ve been getting for $25, already have Ozempic/Wegovy scripts (and PA’s, if needed) lined up, ready to go for July 1. If not followed correctly then discount will not work. Or How to get Mounjaro without coupon? Insurace will cover it but doctor won't send a PA! So my insurance (Premera) will cover MJ with a prior auth however Alpha Medical won't send a p. kindly direct them to that paragraph and ask Any pharmacy that doesn’t want to do fraudulent claims will deny the use of the coupon without the * The patient does not have commercial insurance (meaning you have Medicare or Tricare or some other government sponsored insurance plan. It's possible I suppose that they each used the coupon without mentioning it. Hi. Month is defined as 28-days and up to 4 pens. Patients must have commercial drug insurance without Mounjaro coverage and a prescription consistent with FDA-approved product labeling to obtain savings of up to $500 off your monthly fill for 4 pens of Mounjaro. If you don’t have T2D and insurance denies, they cap the coupon at $500 off the price. For patients with commercial drug insurance who do not have coverage for Mounjaro: You must have commercial drug insurance that does not cover Mounjaro and a prescription consistent with FDA-approved product labeling to obtain savings of up to $575 off your 1-month prescription fill of Mounjaro. Without insurance coverage it’ll take off upto $564. com and read all of the fine print. If your insurance copay is $60, the coupon will reduce it down to the $25 minimum, and you'll pay $25. Also it is only good for 6months out of a full calendar year this time. The reason is because insurance companies are money grubbing animals looking to withhold re-imbursements to Does anyone have experience switching from Mounjaro to Ozempic? I started Mounjaro in October and have lost 20lb since then. If you have questions about eligibility or coupon terms, be sure to check Mounjaro. It will take a while, but most insurance companies will probably cover it soon. Basically told me that they aren’t allowed to give it to anyone except for diabetic patients. But I have a lapse in insurance right now. They still want to collect the full amount from your insurance company. 72 a month. Look into high deductible commercial health insurance that has medication coverageso even if you’re paying $100 per month for insurance (I’m using this number randomlymine is way more expensive because I have kids), at least you’re not paying $1100 for the medication Can confirm this worked! Downloaded the new card, called CVS. a. I have $ in an HSA and the least expense I found was at Hy-Vee in the northern suburbs of the Twin Cities. Also, keep in mind, the coupon will expire end of next month if your insurance doesn't cover mounjaro. then properly enter the coupon information. Then the coupon took off 500$ leaving me with the remainder of 500$. as my insurance doesn’t cover it. Does Push take insurance? I have Cigna. (Yet MJ has Posted by u/[Deleted Account] - 3 votes and 21 comments They are a pain and won’t approve any GLP-1 meds for weight loss without diabetes, but I was able to get Mounjaro for $25 with the savings card! Oscar is going to automatically deny it and you’ll be able to use the savings card with no issues. if the diagnosis code isn’t for diabetes then for sure the insurance won’t pay so the pt either has to pay cash or just go for a run or something. My commercial insurance will not cover Mounjaro even after an appeal. Said they don’t approve these drugs for weight-loss. Patients must have coverage for Mounjaro through their commercial drug insurance coverage and a prescription consistent with FDA-approved product labeling to pay as little as $25 for up to 12 pens of Mounjaro. And if your plan did cover it, I've been on Mounjaro for about 10 months and am down about 80 pounds with an A1C of 6. people without insurance should not be discriminated against. Why are you not utilizing the Mounjaro coupon? Additionally, the coupon doesn’t work for those with Tricare insurance and Tricare denied Mounjaro and Saxenda. My Cigna will not cover MJ at all regardless but they do cover some GLP-1 meds with a PA for diabetes. Good luck! 11 votes, 20 comments. e. How are you getting the savings card applied, without insurance? No you need commercial insurance to use the Mounjaro coupon. Have talked to insurance and lily help line w no luck. As a 45 year old dude, with ample income, savings, and a stable career, who also needed to lose 100 pounds, felt completely like shit all the time, who’s joints were hurt and swollen, who was experiencing higher levels of anxiety (a symptom of high insulin) and who felt like he was holding his family back bc Mounjaro is not on the formulary, most insurance companies don't cover it unless they have an open benefit plan. This is what I am doing without insurance coverage. I’ve asked pharmacy to try to run card without insurance and no luck. Reply reply Learn how to get Mounjaro, a prescription medication used to treat diabetes. I know people that have got it for $25 without even having the card, people who have switched pharmacies and get it for $25 without showing the card, people that have the original card and are told to pay full price, people who got the card after 11/10 and paid $25. Meaning $25 with coupon without insurance worked afaik. My guess is because it requires “step therapy” which can include metformin. There is a manufacturer’s savings card on mounjaro. With insurance coverage, the new coupon will deduct another $150 for one box and so on. Be patient and hope for the best. That said, I highly recommend that all of you work the system to get your insurance company to cover Mounjaro before the coupon expires in June 2023. The first box seems to be $25 for everyone, with or without coupon. However, if your insurance does cover, I have been on Mounjaro for 2 months now and have been using the coupon for the cost. With coupon will be about 500. If I can’t get MJ, get O from Canada, cross fingers for Canada or Mexico to give MJ approval, though I expect there to be supply pressure from the jump in those countries as soon as that happens. Regardless of diagnosis (even before the company explicitly required it even though they did limit it to prescriptions in accordance with FDA labeling before), the coupon has always been limited to 2 fills pre-insurance-approval (i. Doctor calls it in, go to pick it up at the pharmacy and they say it's $738. Long story short - doctor has been working with me for a long time on prediabetes issues and weight loss, tried many other things, he just believes my metabolic rate is The savings card that will come out on December 8 seems to be the same as the current one for Mounjaro where if your insurance covers Zepbound then it’ll be costing you as low as $25 but basically it’s taking $150/month off of what it’ll cost after your insurance pays. On my Walmart pharmacy dashboard, it shows my 10mg total amount due as $1068. PM if you’d like it and I’ll send it over :) Just ask that you’re willing to prove you’re T2D without insurance coverage. Reply Dry-Prespective9693 If you look at the claim info in IC+ it is most likely not a coupon being applied but an e-voucher. It’s $1150 without insurance 😔 if i could get it down to $550 I would definitely buy it again • Have you tried a different pharmacy? I went to a specific pharmacy that was mentioned when I searched on Reddit for mounjaro + the city I live in. this way you have a month to fill out the PAcan confirm this happens because my insurance covered one month of a different med (not mounjaro) that isn't on the formulary but I received a letter saying then my doctor has to fill out paper work saying why I need it. 🫥 23 votes, 17 comments. The Walgreens on Fruitridge & Freeport worked for me, but I don't have Kaiser. The coupon works without them doing the prior auth. coupon only works when you have insurance and it is denied. Then more recently, they began refusing to run any Mounjaro prescription through insurance (even if it’s explicitly covered by aforementioned insurance) without a T2D code. My insurance does not cover it at all and I’m on month 4. The coupon requires that a patient must have a commercial insurance plan with or without coverage. And even with it, it only gives $500 off. Yes, even your Mounjaro coupon/savings card is managed by a PBM. My mounjaro is $45 out of pocket without the coupon. Now Walgreens is saying the coupon doesn’t work and Dr needs to send prior authorization to my insurance (BCBS Massachusetts). PBM or Pharmacy Benefits Managers in the pharmacy realm). I called Walmart and provided by insurance info (Ambetter Marketplace ins) and the mfg “2” coupon code and asked how much it would be. If they don’t require a PA, you don’t have to show the T2D diagnosis but fib they do, you will have to. Get the Reddit app Scan this Mounjaro will cost me $213 a month without a coupon. They haven't done anything wrong to complain. you can also look into getting a really low-cost prescription-only insurance for $100-$150 a month that will work with the coupon! Reply reply brownlab319 So I’m not sure how this works exactly, but my insurance covers Mounjaro and Ozempic 100% without prior authorization. I reached my goal weight and the coupon ran out. 00 to the newest Mounjaro coupon of $575. All new mounjaro coupons activated are subject to the above terms. Was on the phone with the pharmacist, My terrible teacher insurance is refusing to pay into the new year for my mounjaro when I’ve lost 70 pounds because I’m not a type 2 diabetic. When my coupon stopped working, I couldn't get a PA approved from my Sequence providers and ultimately tried Enbold who somehow got it covered without a T2D diagnosis/bloodwork/step therapy. com for details If your prior authorization is denied, you can still fill your prescription without insurance. Pro-tips. They applied the coupon without me even asking. I downloaded the mfg coupon without realizing the new code had been uploaded until earlier today when I joined this sub. Appeals processes can take months. I've been using the original Mounjaro coupon to bring my copays down to $25/month without insurance coverage, as it's non-formulary on my plan. " I say "It's literally the new couponguess I'll call insurance. My endocrinologist wrote me the script for Mounjaro and insurance denied it. As a guide, Mounjaro will typically cost around $975 for four weeks of Subject to Lilly USA, LLC's (Lilly's) right to terminate, rescind, revoke or amend the Mounjaro Savings Card Program ("Card" or "Program") eligibility criteria and/or Card terms and conditions which may occur at Lilly's sole discretion, Hi there! It looks like your post is related to the manufacturer’s savings card for Mounjaro. Pharmacies are getting shit now for I've learned alot about Mounjaro over the past 24 hours after getting prescribed. Is it worth it completely depends on the individual and their current situation. I originally started taking Mounjaro for weight loss. Without insurance, Mounjaro (tirzepatide) costs between $1,000 to $1,200 or more per fill on average. How Generally speaking, eligibility for Mounjaro coupons depends on a number of factors: Insurance Coverage: Individuals with or without insurance can access coupons. She said they must have changed the coupon. But if you’ve already tried it and it doesn’t work for you, I suppose you could try maintaining on your own, or paying cash for your Mounjaro, if you can swing that. Will be getting my med later today. Go to Mounjaro r/Mounjaro • the woman I spoke to said “the coupon doesn’t work for a three month supply. Almost every claim that is processed through a third party switch at the pharmacy level is managed by a PBM. Walgreens says the coupon will only work if there’s a co-pay from insurance. I'm paying 500 oop without the coupon. My pharmacy called me today to tell me that I can no longer get the medication at all because I don’t have type 2 diabetes. You'd apply the coupon for either scenario but very differently. He said that my insurance already has that promo built in to the price and that I'm already getting the best deal on it, and that the Mounjaro coupon won't stack with the Florida Blue negotiated price, but that I should present the coupon again next month when my doctor increases my Mounjaro dose because it is possible the coupon will provide a benefit. There are a number of things to keep in mind. The pharmacist also gave me the name of a tech there who is good at using the coupon. Coupon might be maxed. mine is for weightloss and the coupon provides you with the 25/month fee IF you have private insurance and they don’t cover it. Get the Reddit app Scan this If you have questions about eligibility or coupon terms, be sure to check Mounjaro. 00 cash pay after 575. Get the Reddit app They even said my insurance covered it without the coupon for $25 🥰 . The cost is dictated by the pharmacy not the telehealth provider. If I add the coupon, the price actually goes up because it somehow doesn't mesh with my insurance. I got my first dose of 2. My insurance doesn't cover it, so neither does the coupon. I think my insurance must have just changed my deductible requirements for 2024. Or I'm from upstate ny about 6 hrs away from NYC. Costco will not take the $575 off coupon, price was $1,224. reReddit: Top posts of November 19, 2022. I'm very new to Mounjaro. k. Especially with mounjaro since there's a lot of push back from insurance companies and the manufacturer. It has a limit of $1800 total savings per calendar year for those with insurance coverage as well. Since Mounjaro isn’t FDA Whether your insurance covers Mounjaro — or you don’t have insurance at all — there are still ways to save money on the medication. But some pharmacies do ask for T2D diagnosis while others don't. I am at a loss on what to do. 5 filled on 4/1 without any problems, and as I have the OLD coupon/savings card, I paid $25. It could also be their internal policy. I don’t have T2D. Is that how anyone Right now I'm trying to figure out if there is a way I can get the new coupon to work without t2d I went thru Alpha just to see what would happen since Aetna doesn’t cover crap. 72, and since I have the coupon card it is now a $250. . Anyone used If you have questions about eligibility or coupon terms, be sure to check Mounjaro. " Hi there! It looks like your post is related to the manufacturer’s savings card for Mounjaro. You just need to find a pharmacy that would accept and willing to run the coupon without diagnosis. com Open. I have PCOS and my insurance covers it without coupon. I have read about people getting Mounjaro approved solely for weight loss and without type 2 diabetes. Subject to Lilly USA, LLC's (Lilly's) right to terminate, rescind, revoke or amend the Mounjaro Savings Card Program ("Card" or "Program") eligibility criteria and/or Card terms and conditions which may occur at Lilly's sole discretion, without notice, and for any reason, the Card expires and savings end on 12/31/2024 for patients with commercial drug insurance with coverage for Hi there! It looks like your post is related to the manufacturer’s savings card for Mounjaro. So I learned that someone got in trouble at Walgreens for billing a mounjaro coupon without the diagnosis of diabetes. Lol Once the insurance plans pick up on Mounjaro, the Savings card will change depending on the insurance plan and copay/deductible. com for details. ca for the Mounjaro patient support program for financial assistant if you have type 2 diabetes For patients with commercial drug insurance who do not have coverage for Mounjaro: You must have commercial drug insurance that does not cover Mounjaro and a prescription consistent with FDA-approved product labeling to obtain savings of up to $575 off your 1-month prescription fill of Mounjaro. It's $523 a month, It's really hard to get Mounjaro covered by insurance specifically for weight loss, here and there but HR came out with a global statement that they have fixed the pa issue and it’s now on formulary without a My doctor transferred the prescription to Duane Reade, but because my insurance (Aetna) doesn't cover it and declined a PA request, they don't take the coupon. They first have to submit to your insurance and show that it is denied. If you would still like to proceed with Mounjaro without the above diagnosis, reach out to your insurance to see if it is covered and what your copay will be. Let me know I'm actually paying less without the coupon, and without insurance coverage, but with a discount that my insurance provides. 60, with insurance, it's $993. Archived post. They have the right to fill or deny. It’s a head-to-head trial of Novo’s CagriSema vs. Applying it for a patient with commercial insurance that covers Mounjaro, allows you to enter the rx/bin as an OCC - Other Coverage Codes. $25 with insurance not covering it and using the manufacturers coupon. No T2D diagnosis. Anyway, got a text from Rite Aid that it’s ready and my copay is $25. The pharmacy uses the prior auth request like it’s a denial from the insurance and then runs the coupon. 99 with insurance applied. The coupon won't work if you have Medicare, Medicaid, Tricare, VA, etc. true. Didn't have to hassle with a coupon, the price was automatically $25 when I picked it up. If insurance does cover the coupon takes off up to $150. A lot of reports of pharmacies (even including Walgreens - 2 of my friends recently got their first scripts filled ever and had it happen without any action on their part) are now auto-applying a $500 e-credit for some insurance plans w/o the coupon at all. If you call 800-388-2316 the automated phone system will tell you for mounjaro how to process the script to get the voucher removed (something like process thru insurance and coupon let reject and then store, I don't remember). Walgreens known to be the worst when it comes to filling mounjaro without T2D. With the current coupon and no insurance coverage, Mounjaro costs about $450 per month, for Zepbound, same terms, coupon will bring price to $550 per month. ! And the absolutely bizarre way they require you to use the savings coupon when your insurance doesnt cover it, but you still have to have insurance that is not covering it. I pay $25 a month. I just used the Mounjaro coupon to get $700 off the list price of $1200. Get the Reddit app Scan this QR code to download the app now. I don't have diabetes. I have OptumRx, I called them, and they said out of pocket cost is $2557. Now I pay $25 a month without the coupon. If you have government sponsored insurance I just changed insurance (new job) - I had a PA from prior insurance- not sure why I’m not T2 and didn’t even request oneso I was paying like $236. It costs $1000 per month, they’re not going to cover $3000 at once. The pharmacy (CVS) had to input it a number of times before it worked. It has to be denied by insurance to get it for $25 but I had to pay $470 because I don’t have old card. And if you had the OG coupon from 2022 then you only have until June 30th to use it. If anything even with the new coupons, for some the $545 a month is going to be too steep because the new insurance PA requirements the compounds are taking 3 weeks to get out. You might have a 50-80% of getting the real deal in a trial, which is more than the 0% chance when you can’t afford to pay out if pocket and your insurance doesn’t cover it. After 13 months I still cannot make heads or tails of this damn insurance or coupon, but one thing I do know is you never question the Mounjaro Gods! Long story short, I am newly diagnosed w/T2D. I’m not diabetic or pre diabetic anemia can’t get a PA, and my insurance doesn’t cover it without that. So I paid 25 for mine and that is for 1 yr. If your insurance covers it, I had been using Costco and Costco mail order without issue since July but this month they couldn’t get it to run without a PA so I moved it. A Mounjaro Savings Card is available through the manufacturer, Eli Lilly, but you’ll need health insurance. I know Plush mentions on their homepage that they take insurance (doesn't specifically mention Cigna), but it seems intentionally I also never tried to use a coupon, and I used several different pharmacies over the course of the year, and none of them mentioned a coupon. If my coupon stops working and my insurance won't cover it I'll pay the full price. You have to attest to having T2D to sign up for that savings card though and it expires in June 2023. Is mounjaro covered by your insurance at all? Reply Without coupon you are looking at 1000 dollars. Do not delay. Obviously if the insurance is willing to “cover it” then Lilly will want to bill your insurance because Lilly will make more money (currently I think Lilly is taking a For patients with commercial drug insurance coverage for Mounjaro: Offer good until 12/31/2023 for up to 15 fills or whichever comes first. Locked post. Generally, manufacturer coupons just reduce your copay. Yep double this! I missed out on the first coupon by one day, before my insurance started covering it paying the $545 a month gets expensive. On the coupon I downloaded from mounjaro site it now says if not approved by insurance it's only up to a $500 discount. 00 savings card and that make the medication $743. If your insurance does not cover Mounjaro, then you will pay about $500 for a month. All old coupons are grandfathered in if activated before 11/10 What this means: If your insurance does not cover mounjaro: Your copay will be ~$430 $470 If your insurance covers mounjaro: Eli Lily will pay $250 towards your copay. If your insurance covers, the most your coupon gives you $250 off, so the price is $650. New coupon I have insurance but it doesn’t cover Mounjaro. The coupon specifies use for diabetes, too. The new coupon is for $575 off if your insurance doesn’t cover it. The reason for the coupon is that if you have health insurance that covers it and you are successful with it for a year, then next year not only will it finally be in your insurance’s formularies, but the argument can be made that you were successful on it and the insurance company has a responsibility to provide you and not deny you medication that you’ve established success on. It is all in the fine print in the coupon. there is a paragraph ON THE SAVINGS CARD for when your insurance does NOT cover Mounjaro. Mounjaro is far down the list for tricare to cover and it’s basically only if your A1C isn’t being controlled by other medications on that list. 79 for 1mn 2. I am basically wondering if anyone else was in my position and got past it. "we'll pay for 2 months in full while a PA is worked on, but it's not for uninsured/cash pay patients and if the doctor hasn't gotten a PA approved after 2 My insurance covers it without being T2D. I have anthem bcbs from public school teaching. Side note, I’m not sure how Lilly would even track if it’s being prescribed off label without accessing patient medical records which has so many confidentially issues. The guy said the coupon system is still down but was kind enough to try out the new coupon for me and it worked! Thanks so much. This here. Month 4-Called insurance, they say my appeal for 5mg was approved. Does anyone know how the coupon works so I can pay $550 instead of full-price? The coupons fine print says you can pay AS LITTLE AS $25 if your insurance covers. Studies show that those that cease taking GLP-1 medications (like Mounjaro) start gaining their weight back. 5% with no other diabetes drugs on board. just say the coupon isn’t going thru without a valid insurance and if they try to fight you just tell them to call the insurance for a PA. I know there's a wait list for Enbold now but they're legit. yyck dci bitchi zqkv heirpitx tkscv ilv imxyp bgdmaq mnxbxaz