How can I advocate for myself to get Wegovy approved by my insurance provider?
Hello!
Here are the facts.
I have two hormone diseases. Poly Cystic Ovarian Syndrome and Hypothyroidism.
I have had the latter for 8 years. I have been diagnosed with PCOS since early this year.
I used to weigh 140 lbs at 5'5 until i was around 22 when my thyroid went kaput.
I have consistently been gaining weight since that time and have been unable to lose at ALL.
I gained 100 lbs within the first year of my thyroid diagnosis.
I have tried… everything…. to lose weight. It is not because I am lazy or for lack of trying. In 2017, I was so determined to lose weight that I bought a gym membership with a personal trainer. I worked for a year and a half to lose weight. I am talking 4-5 days a week, 40 minute to an hour sessions. I WORKED.
By the end of my time at the gym, the trainer told me to seek medical help because he did not know why I was not losing weight.
It isn't just exercise too, I have also done every diet you can think of. Raw, keto, fasting, intermittent fasting, etc etc.
I have cut out all sodas and harmful sugars from my life.
I have had a dietician for the past year working with me.
Yet, I've gained weight and continued to keep the weight. I am now steady at 295 to 300.
I have been tested for diabetes. I do have an insulin resistence, but not enough to be considered pre-diabetic.
My general doctor is convinced that these weight issues are because of my hormonal illnesses and she has prescribed me Wegovy. It is an FDA approved drug to treat weightloss. She says once I start taking it that I will start seeing progress within a few months.
Yall, I do NOT want diabetes. I do not want heart problems. I have worked SO HARD to prevent this. I do NOT want bypass surgery. I just want to be healthy and feel good about my body. I am literally crying, writing this, because I am desperate and do not know what to do. I am terrified of gaining anymore. I want children. I want a normal healthy life. I want to feel beautiful at my wedding. I want to feel healthy. I just feel so helpless right now. I have tried for 8 years. I have punished and tortured myself for so long.
My insurance company says my work did not purchase coverage that covers prescription medication prescribed for weightloss… They denied my first prior authorization. I AND my doctor have both appealed it.
My insurance is Aetna.
Please, how can I get this medication approved? I genuinely believe it will be life altering for me. I have struggled the better part of my 20s with these weight issues. I do not want to be fat. I have tried and tried and tried. I don't know what else I can do. I am an insurance agent myself, but my license is property and casualty. I don't' know how to advocate for myself when it comes to my medical care. I need advice and help. Any that you can give, would be so helpful. I am desperate at this point.
submitted by /u/LadyofDungeons
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