I have been using Ozempic off and on for two years now. I sometimes need to go off when in the donut hole but it has been reasonably covered by my Part D Cigna plan. In searching for a part d plan this year I noticed that every single one I look into is requiring prior authorization for Ozempic for 2024 and it will cover it for “all FDA approved uses” which means a diagnosis code of Type 1 will generate a refusal. I checked with my endo and he said indeed many insurers, not just Medicare have been cracking down on not covering GLP 1s for Type 1. Has anyone else encountered this. It’s not just Ozempic it’s the whole class. Also use Lyumjev which is not covered yet by part b. So they have to cover that also. I found one plan that may not require PA but they do not cover Lyumjev. I’m tearing my hair out trying to get what I need!
