Insurance/pharmacy wants me to see THEIR doctor before approving a PA
I have my own endo, she wants me to try Zepbound because Ozempic and Wegovy have not helped me lose weight. I am on my wife’s insurance and she works at a medical center that basically does everything internally, so the insurance is through them too. If you live in a certain area, you HAVE to use their doctors etc. If you live far enough away, they give you a BCBS card and you can see whatever doctors take it but you still have to get your meds at their pharmacy.
I am overweight and have insulin resistance. They’ve taken so long with this PA that I’m completely out of meds so I’m currently not even treating it with any sort of GLP for the first time in a few years.
Are they allowed to do this? I get denying it if they truly think it won’t help, but denying it to force me to see their doctors?
EDIT: Forgot to mention, I was on these meds already (most recently Wegovy) and I just switched to their insurance, so I have not yet successfully gotten any GLP meds from this insurance yet
submitted by /u/Logical-Egg-5484
[comments]