Blue Cross Inobata Zepbound?

BCBS yekuvhara Zepbound inoenderana zvakanyanya nezvirongwa zvako zvakasarudzika, nyika yako, uye nei mushonga wakarongedzwa. Mazhinji marevha eBCBS haawanzo vhara Zepbound pakuderedza muviri. Zvirongwa zvimwe zvinozvovhara nekutenderwa pamberi, uye zvirongwa zvevashandirwi vanozvipa mari zvine simba rakanyanya. Ngatitarisei kuti zvese zvinoshanda sei.

Nei Kuvhara Kwaita Kuti Kusiye Sezvakasiyana NeBCBS?

Kusiyana nevazhinji vachibhadharira, Blue Cross Blue Shield haisi imwe kambani. Inoshanda senge network yeakazvimirira mapazi enyika munyika yese. BCBS yeMichigan ine mitemo yakasiyana neBCBS yeTennessee, iyo yakasiyana neBCBS yeIllinois.

Chimwe nechimwe chikamu chinogadzira yayo formulary (runyoro rwemishonga yainovhara) uye mitemo yayo yekutenderwa pamberi. Pamusoro pezvo, vashandirwi vanozvipa mari zvirongwa zvavo zvehutano kuburikidza neBCBS vanogona kusarudza kusanganisira kana kusasanganisa mishonga yekudzora muviri zvachose. Izvi zvinoreva kuti vanhu vaviri munyika imwechete vane makadhi eBCBS vanogona kuwana mhinduro dzakasiyana zvachose nezvekuzara kweZepbound.

Nderapi Zvirongwa zveBCBS Zvinonyanya Kubatwa Zepbound?

Pakutarisa maformulary mune akawanda BCBS mapazi, mashoma chete parizvino anosanganisira Zepbound pane runyoro rwemishonga yavo. Heino yakazara maitiro ezvirongwa zvakasiyana zvinozvibata nazvo.

Zvirongwa zvevashandirwi vanozvipa mari ndizvo zvakanyanya zvinovhara Zepbound. Mune izvi zvirongwa, mushandirwi wako anoita sarudzo dzekuvhara, uye BCBS inongogadzirisa mabhenefiti. Vashandirwi vamwe vakasarudza kusanganisira mishonga yeGLP 1 yekuderedza muviri semutsigiro wezvavanopa. Kana uchishandira kambani huru, zvakakodzera kubvunza dhipatimendi rako reHR zvakananga.

Zvirongwa zvevatengi vanovharirwa zvizere ndipo panobuda miganhu mikuru. Akawanda BCBS mapazi ari kubvisa mishonga yeGLP 1 yekuderedza muviri kubva pamaformulary avo. BCBS yeMichigan yakarega kuvhara Zepbound, Wegovy, naSaxenda kune vanovharirwa zvizere nhengo dzakakura dzevatengesi kutanga Ndira 1, 2025. BCBS yeMassachusetts yakazivisa kusanganisa kwakafanana kutanga Ndira 1, 2026. BCBS yeNorth Dakota yakaitawo shanduko mukuvhara mishonga yekuderedza muviri muna 2026, ichitaura nezvekuwedzera kwemitengo.

Federal Employee Program (FEP) zvirongwa zvine yavo formulary. Parizvino, Zepbound inogona kuda tsananguro yefomulary yekuvhara. Kana yakabvumidzwa, ingadonha pasi peTier 3 (isina kutaurwa) kune akawanda marudzi ezvirongwa zveFEP.

Zvirongwa zveMedicare neMedicaid BCBS. Mazhinji eBCBS Medicare zvirongwa haavhare Zepbound pakuderedza muviri. Kuvhara kunogona kuitika kana mushonga urongedzwa kune obstructive sleep apnea. BCBS Medicaid kuvhara kunosiyana nenharaunda. Zvirongwa zvehurumende zveMedicaid zvinogona kuvhara Zepbound kune sleep apnea asi zvinoramba pakuderedza muviri.

Chii BCBS Inoda Kuti Vharwe Zepbound?

Kune zvirongwa zveBCBS zvinovhara Zepbound, kutenderwa pamberi kunogara kuchidiwa. Chiremba wako achada kuendesa magwaro eBCBS achiratidza kuti mushonga unodiwa pahutano.

Zvinodiwa zvakajairika zvinosanganisira BMI yakayerwa ye30 kana yakakwira, kana BMI ye27 kana yakakwira ine dambudziko rimwe chete rakabatana nehuwandu hwemuviri sekudeteseka kwemhando 2, BP yakakwira, kana obstructive sleep apnea. Mazhinji zvirongwa zvinodiwawo humbowo hwekuti wakapinda muchirongwa chakanyatsorongeka chekudzora muviri chine chikafu, kurovedza muviri, uye shanduko yemaitiro kwemwedzi mitanhatu.

Zvirongwa zvimwe zvinodiwawo step therapy. Izvi zvinoreva kuyedza nekutadza mishonga yakavharwa (seWegovy, Saxenda, Qsymia, kana orlistat) BCBS isati yavhura Zepbound. Uye kuchengetedza kuvharwa kunoenderera, zvirongwa zvimwe zvinodiwa magwaro ekuti uri kuenderera mberi nekuderedza muviri uchiri mushonga.

Zvakadini Kana BCBS Ikadzinga Kuvhara Kwako Zepbound?

Kudzingwa hakufanirwe kuva mhinduro yekupedzisira. Une kodzero yepaguru yekukwidza, uye mabatiro anopfuura zvakajairika. Ongororo yakawana kuti vanopfuura 80% ekukwidza kwekutenderwa pamberi kwakadzorerwa nekutsinzirwa kwakakodzera. Asi mashoma kupfuura 10% evashandisi vanokwidza.

Kana ukadzingwa, tanga nekutarisa tsamba yako yekudzingwa zvakanaka. Inotsanangura chikonzero uye inopa nzira dzako dzekukwidza. Basa nechiremba wako kuunganidza magwaro anotsigira, kusanganisira marekodhi ekurapa, nhoroondo yeBMI, zvabuda mumaborebhori, uye zvinyorwa nezve kuedza kwepakutanga kuderedza muviri. Kana Zepbound yakabviswa mufomulary yako zvachose, unogona kuendesa chikumbiro chekutsanangurwa kwemagwaro uchitsanangura kuti nei dzimwe nzira dzakavharwa dzisingakufanirwe.

Ndezvipi Zvako Zvingasarudzwa Kana BCBS Isingavhare Zepbound?

Kunyangwe pasina kuvharwa, kune nzira dzekuita kuti Zepbound ive yakadhura.

Zepbound Savings Card kubva kuEli Lilly inogona kuderedza mutengo kusvika kune $25 pamwedzi kana chirongwa chako chevatengi chichivhara Zepbound. Kana chirongwa chako chisina kuvhara, kadhi rekuchengetedza rinogona kuunza mutengo pasi kusvika ingangoita $499 pamwedzi kune imwe dose pen.

LillyDirect inopa Zepbound imwe dose vials pamutengo wecash uchitanga kubva pa $299 kusvika $449 pamwedzi zvichienderana nedosi. Izvi zvinobvisa inshuwarisi zvachose uye zviripo kune chero munhu ane mushonga.

BCBS inovharawo dzimwe dzakawanda dzemishonga yekudzora muviri zvinogona kukurukurwa nachiremba wako, kusanganisira Wegovy, Saxenda, Qsymia, naorlistat.

Maitiro Ekuongorora Kuvhara Kwako Kwakasarudzika KweBCBS

Sezvo kuvharwa kwakasiyana zvakanyanya, kuongorora chirongwa chako chakasiyana kwakakosha. Pinda paportal yako yenhengo yeBCBS uye shandisa chishandiso chekutsvaga mishonga kuti utsvage Zepbound. Iwe unogona zvakare kufonera nhamba yezvishandisi zenhengo pane yako inshuwarisi kadhi uye kubvunza kana Zepbound iri pane yako formulary uye kuti ndedzipi dzekutenderwa pamberi zvinoshanda. Kana uine chirongwa chekunotsigirwa nemushandirwi, taura neHR nezvekuti kambani yako inovhara here mishonga yekudzora muviri.

Chii Chinoreva Pazasi

Kune mazhinji marevha akajairika, kuvharwa pakuderedza muviri kwakanyorwa kana kusabatanidzwa. Asi zvirongwa zvevashandirwi vanozvipa mari, zvimwe zvigari zvenharaunda, uye mushonga we sleep apnea zvinogona kuvhura mikova. Kana wakadzingwa, kukwidza nekutsinzirwa kwakasimba kwakakodzera kuedza. Uye kana kuvharwa kusipo, kadhi rekuchengetedza uye LillyDirect zvinopa nzira dzechokwadi dzekuderedza mutengo.

Disclaimer: Izvi zvemukati zvinongorerana neruzivo chete uye hazvitsvambuki zano rekurapa kana rekuvharirwa. Mitemo yekuvhara inochinja kazhinji. Nguva dzose simbisa mabhenefiti ako zvakananga neBCBS plan yako uye bvunza chiremba anokwanisa kuti uwane sarudzo dzekurapa.