816
you are viewing a single comment's thread
view the rest of the comments
[-] medgremlin@midwest.social 4 points 1 week ago

If they have cardiovascular disease or kidney disease, those are getting added as indications for the GLP-1's so they might be able to resubmit the authorization/claim with those diagnosis codes added to get it covered.

[-] simplejack@lemmy.world 4 points 1 week ago

Yeah, but the problem is, if tests / labs show the precursor indicators for those diseases, and you have a family history, they’ll still deny until you actually have the something like a heart attack or stroke.

GLP-1s are the hot new thing, but it’s pretty common for insurance companies to deny expensive preventative care, even after all other avenues have been thoroughly explored.

[-] medgremlin@midwest.social 3 points 1 week ago* (last edited 1 week ago)

In my family medicine rotation a couple months ago, we got it approved for someone with pre-diabetes, high blood pressure, and stage 2/3 kidney disease (which is not very advanced. A lot of people over the age of 35-40 can technically fall into stage 1/2.)

[-] simplejack@lemmy.world 4 points 1 week ago

We just changed insurance and were able to get through with one provider that valued preventative care more, but our new insurance company is a complete pain in the ass. And the person in my family dealing with the insurance company actually works for the company and knows all the ins and outs.

They even give their own employees crap policies.

[-] medgremlin@midwest.social 3 points 1 week ago

This is entirely unsurprising. Hopefully they can wrangle something functional out of the insurance at some point.

this post was submitted on 11 Dec 2024
816 points (99.3% liked)

memes

10549 readers
2667 users here now

Community rules

1. Be civilNo trolling, bigotry or other insulting / annoying behaviour

2. No politicsThis is non-politics community. For political memes please go to !politicalmemes@lemmy.world

3. No recent repostsCheck for reposts when posting a meme, you can only repost after 1 month

4. No botsNo bots without the express approval of the mods or the admins

5. No Spam/AdsNo advertisements or spam. This is an instance rule and the only way to live.

Sister communities

founded 2 years ago
MODERATORS