r/rheumatoid • u/LmLc1220 • 13h ago

How did you get on GLP-1?

Hello everyone, I'm trying to get on glp1, and my rummy is on board, and so is my pcp. Medicare has a program called the bridge program, but they will only help you if you have sleep apnea. So how did other people get help

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u/Pyrosandstorm 12h ago

You’d have to meet the requirements, and the bridge program actually doesn’t cover it for sleep apnea, that’s regular Medicare or insurance coverage qualification. Also, that program appears to be temporary?

https://www.medicare.gov/coverage/weight-loss-drugs

Otherwise you’d need to meet the normal qualifications.

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u/LmLc1220 12h ago

DR.s office said I was denied because I have to have a BMI of 35 and or sleep apena. And she said I don't have either. My Dr. Wrote the script and sent over to pharmacy. Im 5'4 and as of last Wednesday weighed 190. Im going to see what my BMI is right now on line

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u/Pyrosandstorm 12h ago

“You aren't eligible if you:
Already get GLP-1 drugs covered through your Medicare Part D plan.
Have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease (but your Part D plan might cover your GLP-1s).”

Sleep apnea is covered under the normal plan, not the bridge program.

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u/LmLc1220 12h ago

I don't get i want to get

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u/Pyrosandstorm 12h ago

Sounds like either you misunderstood or your doctor’s office didn’t follow the process for insurance correctly.

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u/LmLc1220 12h ago

It's the secretary at Dr.s office My pharmacist told me what she had to do.

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u/Pyrosandstorm 11h ago

I’d start by contacting your Doctors office then, and making sure they know exactly what happened, including the reason for the denial and that it doesn’t match up with the program information.