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ForumsInsurance & AccessVA healthcare GLP-1 access — veteran members share experiences

VA healthcare GLP-1 access — veteran members share experiences

SteveThurs Mon, May 25, 2026 at 3:30 PM 29 replies 743 viewsPage 1 of 6
SteveThurs
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Sep 2024
Wisconsin
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May 25, 2026 at 3:30 PM#1

Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the talking.

The question I want answered is what actually works on a prior-authorisation denial, as opposed to the list of things that sound like they should work.

I have searched first, so if this is covered somewhere point me at it and I will read it.

37 7MaxMetOK, MounjBrad, nick_newbie and 34 others
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VendorMark
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14,567
Jan 2024
Texas
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May 25, 2026 at 3:36 PM#2
SteveThurs said:
Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…

Financial impact of cost and coverage weight loss beyond medication cost:

  • Groceries: SAVED $233/month (eating less)
  • Restaurants: SAVED $163/month (fewer meals out)
  • Alcohol: SAVED $113/month (stopped drinking)
  • Life insurance: Premium REDUCED by $43/month (lower BMI)
  • Copays: SAVED $53/month (fewer BP/cholesterol meds)

Net impact after medication cost: approximately BREAKING EVEN. The medication pays for itself through reduced food spending and healthcare costs. This surprised me.

36 6KristenIndy, MarkLI_maint, Dr.PeteFamMed and 33 others
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TrialNerd_Beth
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Jan 2024
Bethesda, MD
May 25, 2026 at 3:42 PM#3
VendorMark said:
Financial impact of cost and coverage weight loss beyond medication cost: Groceries: SAVED $233/month (eating less) Restaurants: SAVED $163/month…
VendorMark said:
...regarding the discontinuation data for cost and coverage...

I want to reframe the discontinuation narrative. We don't say "insulin fails because blood sugar rises when you stop it." We don't say "antihypertensives fail because BP goes up without them."

Why do we apply different logic to anti-obesity medications? The answer is stigma. We still, unconsciously, believe obesity is about willpower rather than biology. The discontinuation data actually PROVES it's a chronic biological condition requiring ongoing treatment.

This reframing isn't semantic — it has implications for insurance coverage, treatment duration, and patient expectations.

35 5TomTeleRx, DoseLogDan, SleepFixSam and 32 others
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pam_stl
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Oct 2024
St. Louis, MO
May 25, 2026 at 3:48 PM#4
SteveThurs said:
Denied on prior authorisation twice, approved on the third attempt after a peer-to-peer, and the only thing that changed was who was doing the…

Can confirm. Same sequence, different timescale. I had assumed I was the exception until I read this.

34 4SleepDoc_PDX, RegAffairsDC, BiostatsBrad and 31 others
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BariatricNurseD
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Feb 2024
Dallas, TX
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May 25, 2026 at 4:23 PM#5

Adding the clinical framing, because it changes how the question reads.

Telehealth prescriber review for cost and coverage: I've used 3 different telehealth platforms to get my GLP-1 prescription. Comparison:

FeaturePlatform APlatform BPlatform C
Initial Consult$70$90$0
Monthly Follow-up$40Included$55
Prescription SpeedSame day24-48 hoursSame day
Lab MonitoringRequiredOptionalRequired

I settled on the one that required labs — it shows they care about safety, not just prescribing volume.

33 3Dr.EndoIndy, tom_AK, josh_phd_bmore and 30 others
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