Comment by graeme
Does your country cover ozempic for obesity? In Canada we don't for non diabetics.
Americans get more drugs covered on average is my impression.
Does your country cover ozempic for obesity? In Canada we don't for non diabetics.
Americans get more drugs covered on average is my impression.
Over 65, outside drugs delivered in a clinic, hospital or doctors office you don’t get drug coverage UNLESS you pay for it through Part D Medicare, have a Medicare Advantage pan (the privatized version of Medicare that now 50% of the Medicare population has stupidly picked), or a retirement medical policy that acts like a Medicare supplemental policy that many government employees and some company’s offered their retirees.
That said it’s still a good deal and you can switch Part D policies year to year in case there are formulary issues. Plus with the IRA changes the max out of pocket is 2K which before you had no cap on—some new drugs are so crazy expensive that without this even the co-pay would wipe people out. That’s only recent fixed.
In our own case, my wife who 3 years ago our out of pocket for some daily cancer pills went from 15k in 2023, to 8K in 2024, to 2K this year as the IRA fully kicked in.
To be clear you also need a health insurance plan for medication in Canada generally. The difference is that drug prices are regulated by the provinces, so they cost less. However, this also affects which drugs are available.
Some provinces such as Quebec have a public drug insurance plan as well which you pay into via income tax if you haven't got a private plan.
Of course the overwhelming majority of American do have one of those forms of coverage. You might as well argue American don't have housing or food either since most people need aren't on welfare programs to pay for them.
Over 90 percent of people on ACA plans get subsidies too. Also emergency treatment is guaranteed.
It's certainly a mess of a system, but every time the government does something to "fit" it, the price goes up faster and it becomes a bigger mess.
I don't take it but did look into it.
If anything getting it for diabetes got harder now.
Canadian employers sunlife insurance.
If you were prescribed it before the influx(not specific date) it was covered for diabetic purposes and still covered.
Now if you want to apply sunlife says NO, but you can get your doctor to send us these forms with additional info about the diabetes diagnosis and need and may be covered.
On the flip side theres a local diabetic that has been getting multiple high dosage units covered, but doesn't actually need them or take them
Flips them for $200 cad each to people looki g for weightloss.... (230-280cad in a pharmacy with prescription no insurance)
Only for diabetes. Wegovy is authorized for weight loss. There are other GLP agonists that are also authorized for diabetes. I'm not sure if there are other formulations for weight loss.
The US does allow for "off-label" prescriptions. The question then is : will your insurance pay for it. In my case, even though I am diabetic, they wouldn't cover Ozempic, or, apparently even Trulicity, which is just absurd (or Rybelsus which is the oral form of Semaglutide which they DID cover for a full year before putting me on Ozempic for like 2 months, and then denying (after the "new formularies" are approved and I get to be forced and switch to a med they still claimed to cover but not, apparently - I'm assuming they want me to appeal and give a whole run around on that.
But yeah... Technically it's for Diabetes only, but if you have good insurance, they'll probably hand out for any reason (see: "Hottest Celebrity Weight Loss Drug" for example; maybe that's changed now that Wegovy is released/authorized for weight loss)
Americans get no drugs covered--at all--unless you're over 65, have insurance through your employer, or pay thousands for insurance yourself (and often thousands more to meet your out-of-pocket deductible each year).
I would take the default of "some" coverage over "no" coverage any day.