Hello all-
Just joined this group. My endo prescribed Victoza today, but the pharmacy told me my health insurance won't cover it (Anthem Blue Cross of CA). 

Anyone had any luck getting coverage for it yet?

Views: 7762

Replies to This Discussion

I have Anthem Blue Cross Blue Shield of VA, and they have covered my Victoza, but my co-pay was much higher than Byetta. It was $200 for a 3 month supply (9 pens). The interesting thing is that they required prior authorization for Byetta with a letter from my doctor, whereas with Victoza, there was no pre-authorization.
I have United Health Care through AO Smith. I covered a three months supply for the co pay of $30.00. I didn't have any trouble at all. I was a former Byetta user, but I could not stand the constant nausea, but so far so good with victoza. I have recently lost over 50 pounds and am hoping to lose more. I have tried insulin but it made me gain weight and that was the last thing I want to do. I have the biggest problem with my fasting blood sugars in the mornings, does anyone have any pointers.?
Try needymeds.com to see if you qualify for free or drastically reduced medications (insulin too) I'm getting all my meds that aren't on the $4 list at Wal-mart for FREE!
Good luck!
I don't really understand why, but for some reason I was getting the Byetta, and now Victoza, at the generic price of $10/month through my pharmacy. Even the pharmacy staff have commented on the low price. According to my insurance formulary, Byetta should have been at the mid-price of $25/month, and Victoza isn't even on the list yet. I work for a county government and we are "self-insured" and required to use BC/BS providers. Our prescriptions are covered through Walgreens Healthcare or something like that. But then, our prices were supposed to go up on January 1 from $7 to $10 for first tier, $20 to $25 for 2nd tier, and $40 to $50 for 3rd tier. I went for a good 3-4 months paying the 2009 co-pays at the pharmacy. I did ask a couple of times and was told they paid for it so no problem. I finally decided it wasn't my problem. Anyway, from what I'm hearing, I'm definitely not complaining about my co-pays.
I have UnitedHealth, they pay everything except 30 dollars every three months. I had no problem with them at all.
Hey fgiraffe
My doctor was giving me sample pens for awhile, and when it became evident that Victoza was cutting my high blood sugar numbers more than in half, he gave me a prescription. I sent it to my mail in pharmacy but they couldn't cover it. Then I took it to my regular pharmacy and the insurance (County plan since I work for a county agency) wouldn't pay for it and wanted me on Byetta. I read so many bad things about Byetta side effects I didn't want to try it. So my doctor did a preauthorization letter for me, and now my insurance pays, even though I have a higher copay of $95 for three pens. Upshot is that you can go to Victoza's website and call them and get 12 $25 discounts, so you save $300 the first year.
Hope this helps!
John
My bad, I should have followed up on this thread months ago.

Anthem BC of CA is covering my Victoza. There was a recurring foul up every time I tried to refill my scrip, but I never did sort out whether it was the fault of my local Walgreens or Anthem BC. But they were only giving me 2 pens for 30 days, which at my dosage level of 1.8u/day was only a 20 day supply. We went round and round on this every refill for 4 months before it got sorted out. My endo mentioned that there might have been an error in the dosing info with Anthem BC.

So if your scrip is for Victoza at 1.8u/day, make sure you are getting one pen for every 10 days!

Victoza is still working out well for me.
I have had this same problem with Aetna specialty pharmacy. My prescription was very specific, 1.8 mg of Victoza per day and each pen holds 18 mg. Yet, they somehow dispensed and quoted in units of pens, yet they had a lot of difficulty understanding the difference between a box of two pens and three pens. They shipped it wonderfully, in a huge styrofoam box. Yet I would have to call them up and give them grief when my 20 day supply somehow didn't last 30 days. After a few times, they apparently have it figured out.
I have Blue Cross Blue Shield of Florida - My prescribing Doctor had to write a letter to the insurance company stating I had been on other drugs for diabetes control which were not able to bring it down to an acceptable level. That's why Victoza was being prescribed. The insurance company re-considered and approval the medicine for 6 months. I understand from the pharmacist Victoza is extremely expensive ($295 - per month) which is why some insurance companies do not cover it. Good luck!
I have an AETNA PPO and they cover my 2 pens a month at $45.00 copay. That's a lot better than I was expecting given some of the comments about AETNA.

BTW, I'm also concerned about V. not continuing to be as effective. It doesn't seem to suppress appetite as it did before. Also sugars have stabilized at lower but not at target levels despite increased exercise.

Thinking of taking a break and then coming back to it.
I have BCBS of Florida and they do indeed cover Victoza, although it did take a letter from my prescribing doctor.
I just started with Victoza about 6 weeks ago. I'm going on Medicare 8/1, and the only insurance available to me for Rx in CA that covers Victdoza is Humana. My co pay is about $74/month but that's not bad.

RSS

Advertisement



REsources

From the Diabetes Hands Foundation blog...

Where are you Medicare? The elephant was not in the room

  This was the question burning in people’s mind and passionately talked about yesterday and today at the General Sessions of the AACE/ACE Consensus Conference on Glucose Monitoring, an event to bring together in Washington, DC all relevant stakeholders to Read on! →

#MedicareCoverCGM Panel Discussion

If you follow the diabetes online community, you know that #MedicareCoverCGM is a big deal. We have continued to raise awareness on #MedicareCoverCGM because we believe that ALL people living with diabetes should have access to continuous glucose monitors (CGM). With Read on! →

Diabetes Hands Foundation Team

DHF TEAM

Manny Hernandez
(Co-Founder, Editor, has LADA)

Emily Coles
(Head of Communities, has type 1)

Mila Ferrer
(EsTuDiabetes Community Manager, mother of a child with type 1)

Mike Lawson
(Head of Experience, has type 1)

Corinna Cornejo
(Development Manager, has type 2)

Desiree Johnson  (Administrative and Programs Assistant, has type 1)


DHF VOLUNTEERS


Lead Administrator

Bradford (has type 1)


Administrators

Lorraine (mother of type 1)
Marie B (has type 1)

Brian (bsc) (has type 2)

Gary (has type 2)

David (dns) (type 2)

 

LIKE us on Facebook

Spread the word

Loading…

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information: verify here.

© 2014   A community of people touched by diabetes, run by the Diabetes Hands Foundation.

Badges  |  Contact Us  |  Terms of Service