Anyone else having trouble getting a prior authorization approved even though they meet all the requirements?
11 replies (most recent on top)
What did you end up paying for which dr-g? Has anyone filled a 90 day GLP-1 prescription through Express Scripts or local pharmacy and had an e-voucher or coupon applied to lower the cost? Would love some details on what this is actually costing people through EncircleRx!
Everyone has their own unique Omada code. You can find it on the Express Scripts site (accessed through MyCigna) or call Cigna for it and theyll check a list for your name. And no one I've talked to has received communication through mail or email, at home or work.
You should look in your inbox for Omada. They’ve sent several invitations. I believe the code was the same on all invitations.
I signed up for Omada before 7/1. My Doctor sent the prior authorization for Zepbound on 7/1 and they approved it right away. Took seconds.
I have the HSA plan extended network. Met my deductible. Copay is zero. Secured a 90 day supply from a local chain.
Wow seems easier to get when not a Cigna employee. I left Cigna a year ago and my new employer used Cigna. I am able to get Zepbound for $24.99 a month. I use a local pharmacy because ESI is horrible. I could never get it filled through them or they said it was filling and then canceled it. Plus when I did get one filled through ESI it was $125 for a 90 day but if I get a one month from local pharmacy it is $24.99 so cheaper to stay with them.
It’s still expensive (1k/mo with coupon) until you hit deductible then I think 50/month depending on your plan. Express scripts doesn’t wegovy so find it before your doc prescribes.
People should be careful with these GLP receptor dr-gs.
I predict substantial class action lawsuits 20 years from now.
I was told my dr would have to put in a script for it so it could be rejected and then I could get an Omada code to sign up. Talk about a waste of time, money and resources!
You would be better off going through a compounding pharmacy. Its cheaper and no red tape.
They’re stuck. The employees know too much about how the system works.
YES!!! Never received EncircleRx communication like they said we would, so I've just been struggling on my own to get answers and approval. I can't get a single straight answer on price, and it's so frustrating to deal with all this hassle just to have it end up potentially costing full price in the end. So much for transparency.