Insurance and Victoza

By darlene1956 Latest Reply 2018-05-12 19:58:05 -0500
Started 2010-06-16 12:38:49 -0500

I started Victoza couple months ago and I love it. I have lost 12 lbs and my sugar went from 400 down to114. I feel like a new person. The only problem I got is getting the insurance to pay for it. Anyone got any advice for fighting BC/BS?

22 replies

Jorina 2018-04-03 19:52:24 -0500 Report

For my Canadian friends, sign up for Innvocare(s) it will save you 30% on your Victoza prescriptions. Still amounts to $229 per month.

newaukumgolfer 2014-11-08 09:22:13 -0600 Report

well now 3 years after my last post on victoza thanks to obama care victoza is gone up to $600 a month and we are no longer able to afford it can't buy in canada anymore won't ship it to the states/ Thank you obama care!
John & Debby Date

jayabee52 2014-11-08 12:38:39 -0600 Report

Howdy John and Debby
Isn't PPACA (O-care) the best! (not!) I have similar difficulties with my meds as well. I pray this new congress can find a way to do away with it.


Jolene108 2013-11-19 11:24:21 -0600 Report

I have been on Victoza for 18 mos. My insurance carrier (EXPRESS SCRIPTS) just notified me that they will no longer cover it. (thru the pharmacy nor mail order). I googled " Express Scripts Victorza" and found many business postings about ES not renewing their contract with Norvo…I have contacted Norvo to see what they can due for me until I qualify for Medicare in 2016. Medicare covers Victoza.

dmiddleton35 2016-07-08 13:08:07 -0500 Report

Since this was posted, 3 yrs have passed. Curious if you are on Medicare yet?
I've been on Victoza for 4 yrs. Prior to retirement my health insurance from work covered the 3 pen a month plus I had a discount card from the manufacturer. Life was problem free.
THEN I turned 65 a yr later retired and I thought I was choosing a good plan for part D (AARP)
Now I can purchase a one month supply of Victoza at pharmacy for a $35 charge. Reasonable for a Teir 3 drug?…sure
It's my understanding a retired person on Medicare has an "allowance" of $3310 per year. That means the RETAIL cost of your drugs come out of your $3310 allowance. I.E. Victoza costs you $35 a month but Medicare is charged retail $700-$900 a month. Look at how quick your allowance is dwindling. After approximately 4-5 months you will have no allowance left. The remainder of the year you will have to pay 50% of the retail amount. I can't afford to pay $300-$500 a month for the remainder of the year. I have spent hours on the phone or emailing pharmacies and drug manufacturers looking for an answer. You would think a senior citizen on a fixed income would not have to worry about medicine required to live normal lives. You would think Medicare would want to keep you healthy in order to lower the cost from hospitalization.

Jolene108 2013-11-19 11:21:44 -0600 Report

There is another discussion on this subject under:
Victoza - Anybody figure out a way to get their ins. to help with purchasing it?

j.bc 2012-03-20 11:23:53 -0500 Report

If your insurance does not cover it and you live in Canada - you can claim your perscription costs on your taxes providing they are over a certain percentage over a 12 month period. Talk to your accountant - totally worth it! With this drug - you will reach that magical number quickly and you don't have to fret over the insurance. You will need to keep all of your reciepts for the perscriptions in order for a 100% reimbursement. There are some good things with the system - you just need to know the details. I spoke to my accountant this week and she confirmed all of this for me. This is at least one way to get it taken care of…hope this helps someone.

Evelynkay 2011-01-11 13:01:22 -0600 Report

I had trouble with my insurance pay I ask them to do an override and then i could get it.other wise it would have cost over 400.00 and there no way i could pay that.

newaukumgolfer 2012-02-02 22:55:24 -0600 Report

I buy my wifes Victoza from northwest pharmacy in Canada or $95 a pen or $285 a Month only way we can afford it. Her doctor faxed the precription to them and if you buy 3 pens or more at atime the shipping is free they pack it with a ice pack to keep it cool.

Asesina 2010-06-23 09:59:14 -0500 Report

Well, assuming BC/BS is Blue Cross Blue Shield, I myself didn't have a problem. I got my Victoza pen and needles for 25 bucks. I was on byetta before this med and it was covered too.
Hopefully you can get your medication covered, I don't know what the price is without insurance but 25 dollars didn't sound too bad to me.
Good Luck! :)

darlene1956 2010-08-17 07:41:08 -0500 Report

well with the fight with bc/bs (blue cross/blue shield) I got 60.00 out of them…I am not done fighting this. The insurance companies need to wake up and stop this controlling attitude they have. money,money,money…GREED!

kdroberts 2010-08-17 08:29:51 -0500 Report

Usually it's got very little to do with the insurance company and a whole lot to do with your employer or the policy you chose. 99% of the time if an insurance company rejects a claim for their internal reasons you can fight it with the help of your doctor and they will cover it. If it's not covered under your policy, which is selected by your employer or you, then you can fight until you are blue in the face but the only way it will be covered is to have your employer change the policy or to switch to a different one.

goldyloxnherfamily 2010-06-17 19:46:35 -0500 Report

I haven't lost any weight yet, but my insurance doesn't want to pay for it either, although it's listed in the medications that the insurance company covers, it rates it a tier 3 drug, which needs pre-approval. My doctor is appealing the decision, because Byetta didn't work as effectively for me. It is a relative new drug, and expensive, but it's working so well for me. My sugar is down. I tracked it and with Metformin alone, it still was going up to 500, but now is quite controllable. We'll see what happens next. I have Humana

kdroberts 2010-06-16 16:34:52 -0500 Report

What has been posted is true, up to a point. Denials are either because the drug is not covered by the insurance company or because it is not covered under the plan. If it is not covered by the insurance company what has been said is true, you can fight it and often get it covered. If the plan itself doesn't cover it, usually this is because it's an employer sponsored plan and your HR department decides what is covered based on the plan cost, the you cannot fight that. The only way round that is to try and get them to offer a different plan during open enrollment but since the cost would be more for every employee it is rare that you win those.

Swbtab03 2010-06-16 15:39:11 -0500 Report

I just learned something new from my doctor today, I myself was taking alltace a blood pressure med, and it made me cough like crazy, the doctor can send in a pre cert saying the med that is covered does not work or has side effects, and must go on this other med. Now I just found out today, and was going to start looking into it.
If I hear any more I will get back to you, I have BCBS also, very strict formulas they have

GabbyPA 2010-06-16 15:29:28 -0500 Report

Hello Darlene and welcome to the community. I know you will like what you find here.
Has your doctor addressed it with your insurance company? My husband requires a medicine that is not on the approved list, but because it is required, they are willing to add it for him. It just takes a form from the insurance company to be filled out by his doctor. So you might want to see if that works.

kdroberts 2010-06-16 13:03:34 -0500 Report

Is it covered under your insurance plan? If not, you will be out of luck. Is Byetta a preferred alternative? If so you may want to talk to your doctor about it.

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