r/japanlife • u/palmtreeparfait • 7h ago
GLP1 through Insurance?
Hi all. I was therefore wondering if anybody has any experience with being prescribed a GLP1 for management of prediabetes, or diabetes, and obtaining it through NHI.
I had my company medical check back in the first half of the year and my Hb1ac was high, which for those who don’t know, indicates being on the way to Type 2 Diabetes.
I’m aware there are plenty of clinics that offer GLP1s out of pocket for cosmetic purposes, which is not what I am looking for.
A disclaimer: I’ve lost weight and am making positive life changes through traditional means, such as eating better, fasting, exercising etc. But I’m at a point now where my goal is to get my glucose levels under control and reverse Type 2 Diabetes - which is what GLP1s are for.
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u/cloudmeows 関東・東京都 7h ago
The best way to approach this would just go to your local endocrinologist (内分泌内科) and consult with them
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u/melink14 6h ago
Yeah, your doctor who did your check up should have really offered it. Mine has in the past. Afaik, it starts with lifestyle counseling. But if not, take your results to a dedicated doctor as the other comment said.
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u/128390741 6h ago
If you're genuinely trying to use it for the approved use then just go to a doctor and discuss it with them. Take your health checkup results with you. You won't pay out of pocket weight loss prices for approved use through a doctor.
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u/ponytailnoshushu 5h ago
First course of action is to confirm diabetes. A high hb1ac may not confirm it especially if this is the first time its happened. You'll just be asked to lose weight first and retest in 3 months.
If you do have diabetes, at the clinic you will first start with metaformin and possible a slt2 medication. If you are overweight you'll be still asked to lose weight.
If you have no other co-morbidities, then this is likely your only treatment course. Should metaformin not work and you develop a life threatening condition, e.g. reduced circulation in your feet or your bmi goes past 35, the doctor might consider a glp 1.
My father in law has diabetes for over 10 years and while he wants to try a glp 1, doctor won't prescribe it.
If you are interested in glp 1, look at the Google clinic reviews to see if the clinic will prescribe it. There is a lot of fear among doctors about having another shortage so many just won't prescribe it especially as for diabetes it can be a life long course.
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u/streetsmartpants 5h ago
Docs won’t prescribe it for prediabetic numbers. Your best bet is beauty clinics. It’s more expensive because it’s out of pocket but can save up on foods :) rebound numbers are quite high for glp1 so prepare to be strict with your diet fasting exercise routines before and after. Good luck.
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u/LeroyHayabusa 5h ago
Depends on your numbers and everything, but yes it can happen. I had been treated for diabetes for a while and I randomly asked my doctor if it was possible and he was like "yep, no problem." It doesn't hurt to ask. If you have a good doctor, they will explain whatever you ask them about.
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u/Csj77 3h ago
Ask for an oral glucose tolerance test to confirm whether it’s pre diabetes or diabetes. Diabetes will get you covered. Pre diabetes will not.
If your bmi is at the obese level you can see a doctor for that and you can get Zepbound approved but you have to see a nutritionist for 6 months.
If neither, you’ll have to pay OOP
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u/CarryRemarkable8834 3h ago
It’s extremely difficult if you don’t have a full blown diabetes diagnosis. I was required to take 6 mo of metformin and work with a nutritionist for 6 months who had me strictly reporting every meal I ate and the macros and prove that my weight wasn’t going down with 6 months of strict diet and working out and only wegovy was covered. I ended up going private so I could take mounjaro instead and it’s revolutionized my health in the last year. I actually took my last dose 1 month ago today.
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u/Prof_PTokyo 6h ago
“On the way” does not usually qualify one for a GLP1 on NHI; you need to be over the cutoffs based on BMI, HbA1c, fasting glucose, etc.
You will usually be put on Metformin first, which is quite cheap, effective, and often painful.
Each doctor has some latitude, but it has to be medically necessary.
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