Telehealth companies act as gatekeepers for insurance coverage of obesity drugs
By
By Sydney Lupkin
Summary
Telehealth companies like Vida Health are playing a gatekeeping role in determining whether patients with obesity can get insurance coverage for expensive weight-loss drugs like Zepbound. Patients like David Davis must complete lifestyle coaching programs through these telehealth providers before their employers' insurance plans will cover the medications. This creates a tension where telehealth companies are meant to support weight loss success but also serve as cost-control mechanisms for employers trying to limit spending on obesity drugs, which can cost over $1,000 per month.
Source
bskyTelehealth companies act as gatekeepers for insurance coverage of obesity drugsnpr.orgKey quotes
· 3 pulledI thought, 'All right, I'll go through their hoops — I'll jump through their hoops.' The more they wanted, the more frustrated I would get.
Every time David Davis talks to a nurse at Vida Health, he thinks he'll finally get the OK for Zepbound. And every time so far he has been wrong.
Telehealth companies offer lifestyle support so people taking obesity drugs can have the most success losing weight. But employers also want the telehealth providers to limit spending on the drugs.
You might also wanna read
Medicare begins covering weight-loss medications: who qualifies and how the new program will work
Senators Investigate Pharmaceutical Companies' Direct-to-Consumer Telehealth Platforms for Steering Patients to High-Cost Drugs
U.S. senators are investigating direct-to-consumer (DTC) telehealth platforms operated by pharmaceutical companies like Eli Lilly and Pfizer
arstechnica.com·5mo ago
Experts warn easy access to GLP-1 drugs may increase eating disorder risks
Experts are raising concerns that the widespread availability of GLP-1 drugs (like Ozempic and Wegovy) through telemedicine and oral formula
mdsc.pe·15d ago
How EviCore Helps Health Insurers Deny Coverage by Outsourcing Medical Reviews
This investigative article exposes EviCore, a company hired by major health insurers like Aetna and UnitedHealthcare to conduct medical revi
propublica.org·1mo ago
Conflicts of interest threaten integrity of GLP-1 therapy guidance, experts warn
This article discusses the risks of conflicts of interest in clinical guidance for GLP-1 receptor agonists (like Ozempic, Wegovy) used for o
bit.ly·15d ago
Insurance Denials for Eating Disorder Treatment Persist Despite Mental Health Parity Law
This investigative report examines how insurance companies are exploiting loopholes in the Mental Health Parity and Addiction Equity Act to
Rolling Stone·25d ago
Comments
Sign in to join the conversation.
No comments yet. Be the first.