Cheat codes for Ozempic?

Scale_Jail_Inmate

Scale_Jail_Inmate

Well-known member
Alright, folks, listen up. I'm a doc and I'm constantly battling insurance companies to get Ozempic authorized for my patients. Seems like the standard answer is NO unless you have the big D (diabetes). I kinda stumbled onto a workaround... You know how an A1C over 6.5 is diagnostic for diabetes? Well, I had a patient stuck at 6.4... So I suggested a glucose tolerance test (GTT), which is more sensitive. Boom, diabetes. Now here's where it gets interesting. GTT involves slamming 100g of sugar and testing your blood sugar like 2 hours later. Technically, you're supposed to fast beforehand. But, like, *wink wink*, no one's watching what you do in those two hours. So, I'm just saying... maybe you want that Ozempic? Maybe you "accidentally" become diabetic. /s Keep this between us, okay?
 
I'm not going to get into the ethics of bending the rules since the meds are so overpriced anyways. But you need to consider the potential repercussions of a diabetes diagnosis on your health record. Down the road, it could affect your ability to get affordable life insurance or even health insurance, especially if protections for pre-existing conditions disappear. Getting a diagnosis you don't actually have could cost you big time later on.
 
I know people who've deliberately raised their fasting glucose to get a T2D diagnosis and access to the meds. They understand it'll be on their record forever. Honestly, I don't see a huge issue as long as people are aware of the risks. If I needed the med, I'd probably do it too, considering how much it's helped me.
 
It's not fraud; it's using the system. I work with insurance daily. Why are people worried about insurance companies? They don't care about you! They will pay as little as possible. So, go ahead, drink those sugary drinks and don't feel sorry.
 
Fraud? Probably. Ethical? Questionable. And parts of my original post? Who knows, maybe it was all a big joke... Have I *really* told my patients to commit fraud? Never! I just want people who need these drugs to get them and live better lives. My heart goes out to them. And if my little story helps someone, it's worth it.
 
Better make sure you've got all the life and disability insurance you'll ever need BEFORE you pull this stunt!
 
I'm diabetic, but my A1C wasn't high until after I had already been eating healthier/exercising regularly for a long time. My insurance wants a high A1C to authorize the meds, but my doctor and I don't want me to intentionally sabotage my health. I'm going to ask if they will accept GTT results, thanks Scale_Jail_Inmate!
 
Once you're labeled with T2D, it's on your medical records permanently and can impact travel insurance, life insurance, and even medicals for certain jobs. It's unethical to manipulate results when it could cause future issues. People are so desperate for this drug, they're losing sight of potential consequences. My mom had T2D mistakenly added to her chart once, and she constantly got sugar-free meals and blood sugar tests, even while dying of terminal cancer. No one listened that it was an error. It's not a consequence-free hack.
 
I thought you could get Ozempic if you just pay enough, even without diabetes? Like how the celebrities do it. Can't we all just pay for it?
 
I actually have diabetes, and my dietician suggested a trick to get a continuous glucose monitor covered. Since I don't need insulin and my A1C is good (5.5), she said my doctor could prescribe insulin with instructions to use it only if my blood sugar gets too high. That way, I can get the monitor covered even if I don't actually take the insulin. Has anyone heard of that before?
 
I see how desperate folks are if they think this is their only way to get the meds. But be SUPER careful about insurance fraud and a false diabetes diagnosis. It could bite you later with life insurance, travel insurance, etc.
 
I pay like $100 for it in Hungary, no insurance needed. I heard the US subsidizes medicine for the rest of the world. Seems true for Ozempic.
 
Hey everyone! Just wanted to mention that I know there are new formulations coming out, like pills. I'm hoping these are cheaper and easier to get approved! Fingers crossed.
 
I've heard insurance companies are becoming stricter with approvals, even yanking them after years. A friend was telling me how his coverage, which was supposed to last until 2039, was suddenly canceled! Anyone else dealing with this?
 
I'm not surprised insurance is getting stingier. They'll probably force people onto the pill versions to save money. It's all about the bottom line...
 
My friend's insurance changed and now needs lab results to prove her diagnosis *after* being on Ozempic for 3 years. She's gained almost 20 pounds!
 
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