Don't get this Plan!
I was diagnosed with NAFLD (Non Alcoholic Fatty Liver Disease).This disease can cause cirrhosis, as well as the possibility of having to get a Liver Transplant. The way to cure this disease is weight loss. My Doctor prescribed Wegovy. The Prior Authorization, as well as the appeal was denied by Humana. Apparently the only way to get this medicine thru Humana is to have had a heart attack or a stroke. I have to diet and contacted a dietician to help me devise a diet plan. Although this company is In-Network, Humana's criteria for paying for the doctor visits is if you have Diabetes and once again a stroke or heart attack. Otherwise, you must pay out of pocket. And since I am disabled and on Social Security Disability, I am on a fixed income and cannot afford these visits, or the $1300.00/month for Wegovy. My income goes towards the cost of living. I cannot help but wonder if Humana plays the odds that you will not survive a heart attack or stroke, so they won't have to pay for weight loss. My BMI is 32 (Obesity level) and I'm also pre Diabetic. All legitimate reasons to prescribe Wegovy, but not at dangerous levels as far as Humana is concerned. Why else would they not help people before surviving a stroke or heart attack, which will wind up costing hundreds of thousands of in hospital stays, doctor costs, tests, possibly operation, medication, and rehabilitation therapy? Why not help people avoid this by approving Wegovy or even dietitian visits to help people lose weight to cure or reduce the chance of getting cirrhosis or a transplant. The reason is the almighty bottom line. Humana and other Medicare Insurers are just taking our payments and putting them in their Executives salaries. The only help I'm getting is research on the internet.
16 June 2025
Unprompted review