Discovering the Life-Changing Benefits of Ozempic
Steve Haines, a resident of Champaign, Illinois, had always enjoyed going for walks. However, his weight and diabetes made exercise a nightmare. At 380 pounds, Haines would develop foot ulcers after long walks. That all changed when his doctor prescribed Ozempic, a medication approved by the FDA to treat diabetes and aid in weight loss. Now, at 220 pounds and with his diabetes under control, Haines is able to walk 10 to 15 miles a day. His story is just one example of the many Americans who live with diabetes.
The Prevalence of Diabetes in America
According to the Centers for Disease Control and Prevention, approximately 1 in 10 Americans have diabetes, with the majority having Type 2 diabetes. This condition occurs when the body cannot properly control the amount of sugar in the blood.
The Lifeline of Ozempic
Ozempic, also known as semaglutide, has become a lifeline for individuals with diabetes. It stimulates insulin secretion and helps control blood sugar levels, effectively managing Type 2 diabetes. Additionally, Ozempic slows down digestion and sends signals to the brain that the stomach is full, resulting in weight loss.
The Rising Popularity of Semaglutide Medications
Despite its high price tag, prescriptions for semaglutide medications like Ozempic have increased by 300% from 2020 to 2022 in the United States. Depending on factors such as dosage and pharmacy, Ozempic can cost over ,000 annually. While some patients have insurance coverage, others must find alternative ways to afford the medication.
Understanding Insurance Coverage
Most health insurance plans, including Medicare and Medicaid, offer coverage for semaglutide medications when prescribed to treat Type 2 diabetes. However, coverage can vary based on individual plans and state requirements. To determine coverage and out-of-pocket costs, it is recommended to contact your insurance provider.
When selecting insurance, choosing a low-deductible plan can be beneficial for ongoing prescription costs. Additionally, utilizing a health savings account or flexible savings account can help mitigate out-of-pocket expenses by using pre-tax income for healthcare expenses.
For individuals without insurance coverage for Ozempic or those seeking the medication for non-diabetic reasons, alternative payment options must be explored.
Exploring Payment Options
Hillary Filstrup, a customer success manager from Tulsa, found herself in a situation where her insurance would not cover Ozempic since her condition was not diabetes-related. Determined to manage her weight after being diagnosed with polycystic ovary syndrome and developing insulin resistance, Filstrup chose to pay out of pocket for a semaglutide medication from a compounding pharmacy.
For individuals facing high out-of-pocket costs or lacking insurance coverage for Ozempic, several options can help alleviate the financial burden:
- Manufacturers’ savings programs: Pharmaceutical companies often provide savings cards to reduce out-of-pocket costs for eligible patients. Novo Nordisk, the manufacturer of Ozempic, offers a savings card that can significantly lower the cost for up to three months for qualifying patients with private or commercial insurance.
- Patient assistance programs: Designed to assist uninsured patients who cannot afford their medications, patient assistance programs have qualification criteria such as income limits and lack of insurance coverage.
- Borrowing money for medical bills: Medical credit cards like CareCredit or personal loans can be used to finance medical bills. However, it’s important to note that both options come with interest, which can increase the overall cost. Loans or credit cards are best suited for one-time urgent medical expenses rather than recurring costs like semaglutide medications. They can serve as temporary funding solutions while patients sort out insurance coverage and long-term finances.
Being Proactive
If you decide to start taking Ozempic, it is crucial to create a plan that incorporates the additional costs into your monthly budget. Hillary Filstrup acknowledges that despite the benefits, Ozempic can be an expense that not everyone can afford. However, both Haines and Filstrup agree that semaglutide medications like Ozempic, when combined with exercise and nutrition, can lead to significant improvements in health.
Steve Haines sums it up best: “The medication is just very helpful. It provides you with the opportunity to become healthier.”
This article was written by NerdWallet and was originally published by The Associated Press.
