I’m interested to know if your family member’s doctor says s/he will have to continue taking Wegovy to keep the weight off?
It’s all pretty new but a year or so on a working Wegovy dose was the suggested time.
If it’s working well, Wegovy is retraining your mind to not focus on food so much, in my relative’s experience. Ever tried to diet and spent all your time thinking of food? That food obsession was not there at all for my relative.
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According to another CE course I took the weight you lose on Wegovy is not regained. Most were able to maintain their weight even after they quit taking the drug.
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Well, not that surprised that HI is low in the obesity chart compared to other states. We don’t have a season where folks bundle up—those who want it can be active pretty much year round. Folks can flaunt their trim body most of the year.
I’m sure our state’s obesity rate has been increasing as it has nationwide and wokdeudr.
I have two relatives that are getting Ozempic through their respective insurance companies (one served in the military and is getting it through their VA benefits). Both are regular sized people and “just want to lose a few pounds”.
The issue is this - if those drugs are truly in short supply, no one who hasn’t been diagnosed with Type 2 diabetes, should be able to get them, period. Wegovy advertises itself as a weight loss drug - the ads appear regularly on TV. I’ve seen supposed “weight loss clinics” popping up that are offering Ozempic & Wegovy to its members at a discounted price, so they are obviously buying it in bulk from somewhere. Celebrities are easily getting it (Chelsea Handler said she had boxes of the pens in her home - but didn’t know they were a diabetes med 
) - so what’s the real story on supply (guessing it’s a “let’s keep the demand up and the supply low so we can charge $$$$” scenario).
We can debate the causes of obesity until we’re blue in the face (spoiler alert, not all of them are lifestyle-related) but if these meds work at helping people lose weight, insurance companies need to get on board because a multitude of other, long term (and costly) health issues could be resolved in the process, which would save the insurance companies a lot of money in the long run.
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Wegovy is approved for weight loss, but not Ozempic. (They are the same drug, sold in different doses under different brand names approved for different indications)
I agree there are medical reasons to lose weight which I’ve mentioned a few times above. For those of you with insurance thru your employer, the first step is to convince your employer to change what drugs they are willing to pay for…not the insurance company.
Except it’s not really what the employer is willing to pay for. Even though though most employers pay a large hunk of the premiums, the employees pay the difference. In some cases, like H, the employee pays for everything above a single person level. That’s why the family plan costs employees $2000/month. If these drugs are suddenly covered by the insurance companies, they’ll pass the $$$ onto the people via premium increases. So, I’ll be paying for everyone else’s weight loss drugs. Not sure how crazy I am about that, especially if it’s just people with a few pounds (30-50) to lose.
The first step is what the employer is willing to pay for because the insurance companies have certain product offerings (say a premium plan, as well as a mid-tier, and a less expensive option) that they market to the employers, and then the employers choose which plan they want. Employers can make changes to the product offerings, but the whole point of the defined offerings is they save the employer money.
Then, yes, some companies require employees to pay a share of their own premiums and/or that of their family.
I agree with you 100% that all of us will be paying higher premiums for people to take these new weight loss drugs. But, for some people losing 30-50 pounds is quite a lot, and could make a difference in the development of other, more expensive conditions to manage down the road.
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I would say most employers require a decent contribution to the premiums. Not some. And it should be noted that most employees at H’s workplace only make around $50K a year so $2000/month is a significant amount already. Plenty of people around me can’t afford health insurance already, and if it goes up, you will likely lose more. If your employer provides health insurance, you’re not eligible for subsidies on the exchange.
I work in an office with 10 people. 3 of us are normal weight. Another 2 are overweight and a couple of more are obese. I have 2 who are morbidly obese. One talks about it all of the time. The other dwarfs him. He’s about 500 pounds. But except for one guy who’s technically overweight, their health habits are terrible. Plenty of them could improve a lot with a little effort. The one guy still overweight - he lost over 200 pounds about 15 years ago. He happily tries to counsel the group how to improve. Deaf ears.
And then who knows what the side effects for this drugs will be. It just seems like fewer drugs that we are on, the better, not more. But I would be in favor of insurance covering it if people had to undergo a year long mandatory supervised eating/exercise plan of some sort and see what difference that made first.
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Except that most employers and insurance companies* may not have much incentive to prevent more expensive medical costs down the road, when the person has a high likelihood of being employed at a different employer (or covered under Medicare) and/or being covered by a different insurance company (even if at the same employer) a few years later.
*Kaiser may be somewhat of an exception, because people tend to be more loyal to their providers than their insurance companies, and those who like Kaiser providers will choose Kaiser plans when available as they move across different employers (and into Medicare (Advantage)). However, for an employer plan, the employer contracting for a Kaiser option may still not want to pay for the new expensive weight loss drugs.
Yes, this churn absolutely impacts how insurers create, package, and price their offerings.
In the absence of data, I’m not sure.
Yes all of the above is true, but to add a minor clarification, in some states CHIP and sometimes Medicaid will subsidize employer insurance for eligible families, reducing the monthly premium --in other words, the state will help pay the insurance premiums.
Depending on how generous the state is, these programs can include subsidies for families who earn the state’s median income (or even higher). So depending on the state, an employee with children who earns 50K could be eligible for a subsidy to help cover their employer’s insurance. However the subsidy would not be through the exchange or Obamacare but through CHIP.
I just looked it up and it seems like over half of the states do offer potential subsidies for employer’s insurance; the issue is that in least generous states, the family has to be well below the poverty line to be eligible while in the most generous states, even families earning 200-350% of the federal poverty line can still qualify for some tapering assistance with their employer’s insurance (approx 60K-100K for a family of 4). I am under the impression that there is no such assistance for childless people in all states even the most generous ones.
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They’re paying half of their income for medical? That’s appalling! My D’s family’s wasn’t THAT much, though a lot, but I believe the kids were on CHIP till their income went up some.
Also, Obamacare would be considerably less. Would make way more sense to do that, if employer is not covering family at all.
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If they are on a family plan yes. If a spouse has better coverage (like us) then that is good. But I know several double teaching household families. I don’t know how they manage. And it’s not even a great plan.
And I wouldn’t say my $5000 per person deductible plan is great, but at least it’s only $400/month for us. My employer picks up the rest ($1450/month)
And it was like this long before Obamacare. It was $850/month for a family when H was earning. <$30K and that plan didn’t include any wellness. And wellness baby/kid visit was 100% and didn’t even go toward the deductible. Hence why I couldn’t even think about not working when my kids were little.
Benefits are not very good in many places around the country.
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There is no plan called “Obamacare” Oamacare is the medicaid expansion available in some states, CHiPs, and the state exchange with subsidies. You have to qualify for all of those and if each family member is paying a separate premium, then it might not be cheaper.
My friend’s husband turned 65 so he went on medicare. Their disabled son qualified for medicare under his father plus medicaid. She had to pay the premium for her solo insurance (I think it was a continuation after her COBRA ended )and it was $900 just for her.
$900 sounds about right. My post-COBRA, pre-Medicare solo coverage through my employer is a little less. But is high deductible plan, where I opted out of dental. Thankfully I have a few years worth of money in an account the employer set up for the over-40 employees, when they discontinued retiree medical coverage. I’ll still have a gap where Colorado Marketplace coverage may be helpful.
Obamacare, as I’m sure you know, is the nickname of the marketplace plans that exist in every state. They are available everywhere, and are subsidized for lower income folks. Medicaid expansion was turned down in some states (which I think was idiotic) but the plan as a whole is nationwide.
Every state does have an insurance exchange. Every state also has financial subsidies to help middle-income Americans to help buy private coverage.
Only 28 states are participating in the Medicaid expansion — the part of the law that was meant to cover 17 million people who earn less than 138 percent of the federal poverty line (about $15,000 for an individual or $31,000 for a family of four).
Shame on those states who refused to expand Medicaid.
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Also, a family on an income of 50K certainly qualifies for subsidies. It is almost beyond belief that those families are literally paying 24K for insurance. Anything in the state marketplaces will be less than that.
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But there is not one plan called ‘Obamacare’ and the subsidies offered through the state plans are not available to everyone. I don’t think you can just apply for one if you have a plan offered by an employer. Sure, you can quit your job or maybe a spouse could sign up for a plan but it is usually not cheaper to have families all getting insurance though different sources. Sometimes there is a ‘family deductible’ which is cheaper than have 5 separate deductibles.
Some states only offer one or two plans on the Marketplace. I think it is North or South Carolina that had a lot of insurers drop off and the plan that was left wasn’t very good, very hard to find doctors that would take the plan, etc. When I lived in Florida, there were only 4 dentists in the Jacksonville area that took medicaid so there were a lot of kids who were effectively uninsured.
I think there should be a single payer plan, available to all who qualify for free or for a premium to those who ‘make too much.’ If an individual wants a better policy, that should be available for purchase too What we have is a hodgepodge of private insurance, government insurance, HMOs, PPOs, And it all costs a fortune. The ‘employer provided’ model started after WWII as a benefit. It has long been out of control but none of us want to pay for insurance since we’ve had 70+years of it being subsidized (including me).
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Florida was not and still is not a Medicaid expansion state.
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