"Greatest Country in the world" (USA) residents (older folks ideally) have you all been "forced" to go gray cuz your prescription was too expensive?

bockscar

GLP-1 Apprentice
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Sooo....im super salty at the moment, and this is a semi rant if you wanna save your time LOL

My mom is in her 70s, diabetic, has sleep apnea and is overweight....aka the PERFECT candidate for GLP-1s. She was previously prescribed Trulicity and then the price JUMPED up so she stopped it. (2-3 months ago) Well she went for her quarterly Dr. visit and the doc prescribed Mounjaro. Took a few days and the insurance company finally approved it.........and it was gonna be $777 for a 3 month supply. Thats not a small amount for my mother (we arent rich) and she is on fixed income....so now im trying to talk her into gray with me (shes gonna be on board cuz shes seen what the reta has done to me). Right now my plan is to just load up on 4-5 kits for her (plus the 3-4 I was already gonna order myself) and just test them very thoroughly (much cheaper overall per vial when/if I buy that many kits).....buy once cry once type deal is what im thinking.

Has anyone been in a similar situation and "forced" to go gray? The health insurance system in the US disgusts me and im literallly ashamed of it since we Americans love to let everyone know how the USA is the greatest damn country in the world! This bullcrap isnt whats supposed to happen in the best country in the world! Posting this to rant...but also in hopes that maybe someone will have some solutions.
 
Unfortunately there isn't a solution. You could get her started on compounded, about $150 a month, beats $700 if she's afraid of gray. I belong to a 60+ Facebook GLP group and every single day there are multiple people posting that insurance just flat out no longer covers it, or denied coverage to start with. Even the new Medicare Bridge program is already proving to be a problem, if your insurance EVER approved you (like your mom) she's automatically disqualified from that $50 a month deal. Make it make sense.

I started with compound because it was all I could afford, senior also on a tight, fixed income. Moved to grey when EL and Novo actively started pushing FDA to stop compounders. Buy your mom a case load of grey when you can and offer to do all the recon each month. She'll be fine on it. (I would hesitate to sell her on Reta, jury's still out, at least for me, on its safety profile with older folks, increased heart rate and such).
 
We are on the same boat. My dad in Southeast Asia is also a 70 yo diabetic. Since the price of the medicine there is so expensive, I have introduced him to gray pep. I have started using tele for 6 months but eventually switch to gray due to the price. Since then, he has been on his way to reversing his diabetes. My mom and siblings started using Tirz as well, and we have been in the best health ever.
 
I made the jump (as a younger man than the demographic you're asking about) not necessarily because it was too expensive, but because it didn't make sense to me to pay more for the same peptides. What I spent in a month I got a years supply, it was a no brainer.

So when my mother and two of my aunts got an RX and told me the price, I told them I'd sell it to them for half price 😂... kidding, I take care of them at no cost. All three of them have enough Tirz to last the rest of their lives if needed.

Now that they've gone grey, guess who's wanting to try Wolverine and Glow and all the beauty peps lol.

Paying 1000x the price just for the illusion of safety (I say illusion because recalls happen all the time... Anyone seen the Netflix doc on Tylenol??) is ridiculous. I'm not paying for some pharma bro or his boss to buy a beach house so I can be healthy, damn all that.
 
59 yrs old. Dr prescribed Wegovy and I took it for 3 months on a coupon for $199 a month. Then it was going to jump to about $1400 a month. I went med spa compounded for a while till my fsa was wiped out and then made the change to gray. Same story for my sister who is 66. She's on gray market now also.

I have pretty good insurance. So does my Sister. Neither of us could afford it if it wasn't for the gray market. Greatest country? 😕😡
 
spanky2026 said:
Unfortunately there isn't a solution. You could get her started on compounded, about $150 a month, beats $700 if she's afraid of gray. I belong to a 60+ Facebook GLP group and every single day there are multiple people posting that insurance just flat out no longer covers it, or denied coverage to start with. Even the new Medicare Bridge program is already proving to be a problem, if your insurance EVER approved you (like your mom) she's automatically disqualified from that $50 a month deal. Make it make sense.

I started with compound because it was all I could afford, senior also on a tight, fixed income. Moved to grey when EL and Novo actively started pushing FDA to stop compounders. Buy your mom a case load of grey when you can and offer to do all the recon each month. She'll be fine on it. (I would hesitate to sell her on Reta, jury's still out, at least for me, on its safety profile with older folks, increased heart rate and such).
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Appreciate the words and feeling soooooo Mangione at the moment! 😂 Sucks that my moms situation isnt rare or unique....sucks big time!

As much as i wanted to push reta on her....i havent because it is still experimental technically and i might fancy myself a "biohacker" when it comes to myself, but i dont fancy myself a doctor to be "biohacking" OTHER people. Same reason why I wont sell even though Im a pretty good poster boy (at the moment) and can sell it if i wanted. Im no doctor LOL ill stay in my lane

with that said, when I heard she was now a LEGAL Tirz bro(ette).....well now i feel like i got carte blanche LOL
pepibello said:
We are on the same boat. My dad in Southeast Asia is also a 70 yo diabetic. Since the price of the medicine there is so expensive, I have introduced him to gray pep. I have started using tele for 6 months but eventually switch to gray due to the price. Since then, he has been on his way to reversing his diabetes. My mom and siblings started using Tirz as well, and we have been in the best health ever.
Click to expand...
HELLLLLL YEA! Glad to hear that and I wish the best for you and your family in your health journeys
 
bockscar said:
Sooo....im super salty at the moment, and this is a semi rant if you wanna save your time LOL

My mom is in her 70s, diabetic, has sleep apnea and is overweight....aka the PERFECT candidate for GLP-1s. She was previously prescribed Trulicity and then the price JUMPED up so she stopped it. (2-3 months ago) Well she went for her quarterly Dr. visit and the doc prescribed Mounjaro. Took a few days and the insurance company finally approved it.........and it was gonna be $777 for a 3 month supply. Thats not a small amount for my mother (we arent rich) and she is on fixed income....so now im trying to talk her into gray with me (shes gonna be on board cuz shes seen what the reta has done to me). Right now my plan is to just load up on 4-5 kits for her (plus the 3-4 I was already gonna order myself) and just test them very thoroughly (much cheaper overall per vial when/if I buy that many kits).....buy once cry once type deal is what im thinking.

Has anyone been in a similar situation and "forced" to go gray? The health insurance system in the US disgusts me and im literallly ashamed of it since we Americans love to let everyone know how the USA is the greatest damn country in the world! This bullcrap isnt whats supposed to happen in the best country in the world! Posting this to rant...but also in hopes that maybe someone will have some solutions.
Click to expand...
Look up Will McAvoy ( Jeff Daniel's ) to Northwestern. From the show Newsroom. Sums it up nicely!!
 
spanky2026 said:
(I would hesitate to sell her on Reta, jury's still out, at least for me, on its safety profile with older folks, increased heart rate and such).
Click to expand...
This is my thinking too. Tirz is a great fit for her needs. Reta comes with some extra risk. Mom is worth minimizing risk. But she's also worth getting her Grey Tirz and helping her to get healthy. 🙂
 

"Have you all been "forced" to go gray cuz your prescription was too expensive?"​

Yes, pretty much what happened to me. I had 4 co-morbidities and yet my Blue Cross insurance declined to cover GLP's. Paid out of pocket for Sema for 1-2 months, but had no success, gave up.

Fast forward a year, and I learned about gray from a gun forum, and got started; fortunately I eventually discovered this place a few months later before I managed to hurt myself with bad advice/misconceptions.

I'm now down over 50 lbs and those comorbidities are fading into the past...
 
Not exactly the same situation as my mom can afford it. She even brought it up with her doctor and got his blessing but she's been dragging her feet for almost a year. It is very annoying but I guess she's just too old, confused, and scared.
 
anhydrous said:
Not exactly the same situation as my mom can afford it. She even brought it up with her doctor and got his blessing but she's been dragging her feet for almost a year. It is very annoying but I guess she's just too old, confused, and scared.
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I remember being scared the first time. I have a phobia of taking anything. But holy cow, it was love at first pin. I'd prolly be dead already if I never tried.
 
bockscar said:
Sooo....im super salty at the moment, and this is a semi rant if you wanna save your time LOL

My mom is in her 70s, diabetic, has sleep apnea and is overweight....aka the PERFECT candidate for GLP-1s. She was previously prescribed Trulicity and then the price JUMPED up so she stopped it. (2-3 months ago) Well she went for her quarterly Dr. visit and the doc prescribed Mounjaro. Took a few days and the insurance company finally approved it.........and it was gonna be $777 for a 3 month supply. Thats not a small amount for my mother (we arent rich) and she is on fixed income....so now im trying to talk her into gray with me (shes gonna be on board cuz shes seen what the reta has done to me). Right now my plan is to just load up on 4-5 kits for her (plus the 3-4 I was already gonna order myself) and just test them very thoroughly (much cheaper overall per vial when/if I buy that many kits).....buy once cry once type deal is what im thinking.

Has anyone been in a similar situation and "forced" to go gray? The health insurance system in the US disgusts me and im literallly ashamed of it since we Americans love to let everyone know how the USA is the greatest damn country in the world! This bullcrap isnt whats supposed to happen in the best country in the world! Posting this to rant...but also in hopes that maybe someone will have some solutions.
Click to expand...
There was no price increase for Trulicity between 2025 and 2026. Since she’s on Medicare you’re describing the deductible Medicare recipients pay (max $615), after which meds are no (or very low) charge. Since you’re so involved with her care, I’m sure you’ve seen this every year for the last 8 years since she’s been on Medicare since she was 62.

With the commercial insurance most Americans have it’s $25 a month using the Eli Lily copay card.

For the tiny percentage of uninsured, or low income and can’t afford the deductible, there’s the “Lily Cares” program that provides the medication free of charge to tens of thousands of patients with a simple application.

I suggest you move to one of the many wonderful countries with “free healthcare”, that control costs by not offering many of the most advanced meds commonly available here, would put her on multiple injection a day insulin instead, and when she needs a hip or knee replacement, instead of getting it done the following week, she can wait on the near multi-year waiting lists common in places like Canada and the EU.


Congratulations, another ignorant American brainwashed into hating their country.

PS: GLPs for weight loss aren’t covered by Medicare yet, because of a law banning it from paying for weight loss meds (after the deadly phenphen weight loss med scandal in the 90s). It will be covered in a few months, capped at $50/mo max for Wegovy or Zepbound, any dose.
 
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This time, the French social security does not offer better coverage. Liraglutide and semaglutide are covered at 100%, and the price is negotiated with the drug companies. However, tirzepatide will be reimbursed at 65% starting June 15 for patients with a BMI over 35, subject to numerous conditions and only if prescribed by a handful of specialists. The cost to the collectivity is estimated at several hundred million euros per year.

It is estimated that approximately 8% of the U.S. population is currently being treated with GLP-1 analogues. That amounts to more than 25 million people. At a cost of $200-$300 per month, that comes to $5-$7.5 billion per month. The figure is likely of the same order of magnitude for the rest of the world. This is the total market size, but it is dominated by two players.

Financial analyses of Lilly's accounts estimate R&D investments at over $7 billion and manufacturing investments at nearly $20 billion.

But if I'm not completely senile yet, that means their return on investment comes in just a few months. Let's say they use that profit margin to self-finance other projects, that's still a lot of money to feed the greed.
 
GLiPtest said:
There was no price increase for Trulicity between 2025 and 2026. Since she’s on Medicare you’re describing the deductible Medicare recipients pay (max $615), after which meds are no (or very low) charge. Since you’re so involved with her care, I’m sure you’ve seen this every year for the last 8 years since she’s been on Medicare since she was 62.

With the commercial insurance most Americans have it’s $25 a month using the Eli Lily copay card.

For the tiny percentage of uninsured, or low income and can’t afford the deductible, there’s the “Lily Cares” program that provides the medication free of charge to tens of thousands of patients with a simple application.

I suggest you move to one of the many wonderful countries with “free healthcare”, that control costs by not offering many of the most advanced meds commonly available here, would put her on multiple injection a day insulin instead, and when she needs a hip or knee replacement, instead of getting it done the following week, she can wait on the near multi-year waiting lists common in places like Canada and the EU.


Congratulations, another ignorant American brainwashed into hating their country.
Click to expand...
Hmmm, let's just take Great Britian as an example, where do they rank on longevity vs U.S.? Or how they rank in terms of healthcare coverage? Doesn't matter if you have all the gee whiz toys in the universe if you built a system to make SURE many can't get to it. Health care isn't health care if you can't afford it. Or get denied it's use. It's just a ponzi scheme for the healthcare companies.
 
I’m on prescribed Mounjaro 5 mg, and I can see how much my insurance is being charged—about $1,250 for a one-month supply of four pens! If my insurance stops covering it, I’m in trouble because it works incredibly well for my type 2 diabetes. If I lose my job, I’m in the same situation.

It’s really frustrating because this medication has been amazing for glucose control, appetite reduction, and satiety. But who knows when it will finally become generic—maybe another 10 years? If my insurance stops paying for it, I’ll have to look at compounded options, and if those become too expensive, I’ll have to explore grey for tirz...
 
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Same boat. But i dont think weve made grey easily approachable enough, specially for old farts. Very gatekept. Very shaded. i know its because of the legal ramifications but still. Avaant throwing kit/turkeys to the poor like frank lucas in the 70s. Be in the right group and your bill is thousands cheaper. Then dont even get me started on the more obscure shit. Think we did the math on some of the follistatin derivatives and youd have to have something around a million to run what the trials did in humans for a year ? I guess Even in tortuga some pirates make out better than others. When you know how much wholesalers and resellers are getting it for, then bold face lying to the unknowing... you wouldnt need reta being so sick to your stomach.
 
For me, going grey was a no brainer...I did doctor prescription, to compounder, to single vial sellers all marching towards grey. I knew from the beginning, that if GLPs worked, I would figure out the greys and lay in enough supply to be 'future proof'...
 
GLiPtest said:
There was no price increase for Trulicity between 2025 and 2026. Since she’s on Medicare you’re describing the deductible Medicare recipients pay (max $615), after which meds are no (or very low) charge. Since you’re so involved with her care, I’m sure you’ve seen this every year for the last 8 years since she’s been on Medicare since she was 62.

With the commercial insurance most Americans have it’s $25 a month using the Eli Lily copay card.

For the tiny percentage of uninsured, or low income and can’t afford the deductible, there’s the “Lily Cares” program that provides the medication free of charge to tens of thousands of patients with a simple application.

I suggest you move to one of the many wonderful countries with “free healthcare”, that control costs by not offering many of the most advanced meds commonly available here, would put her on multiple injection a day insulin instead, and when she needs a hip or knee replacement, instead of getting it done the following week, she can wait on the near multi-year waiting lists common in places like Canada and the EU.


Congratulations, another ignorant American brainwashed into hating their country.

PS: GLPs for weight loss aren’t covered by Medicare yet, because of a law banning it from paying for weight loss meds (after the deadly phenphen weight loss med scandal in the 90s). It will be covered in a few months, capped at $50/mo max for Wegovy or Zepbound, any dose.
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I don't believe anyone mentioned a year.
The Bridge Program (which will cover GLPs through Medicare) is set to start on July 1st.
The OP is frustrated that her mother's medication is costing almost $260 a month due to corporate greed and crappy prescription coverage.
Stop assuming this is about hating our country, and start understanding that it IS about lack of decent healthcare and coverage. US citizens can be mad about the system without lacking love for their country. Don't turn this into something political.
 
bockscar said:
The health insurance system in the US disgusts me and im literallly ashamed of it since we Americans love to let everyone know how the USA is the greatest damn country in the world! This bullcrap isnt whats supposed to happen in the best country in the world!
Click to expand...
Anyone who does any international travel knows that this is a myth Americans perpetuate just like high school kids who dislike the high school across town.
Many other countries are way ahead of us in health, education, and etiquette in their nations and towards other nations.

There are many older seniors on this forum who are into grey and mentoring their younger family members.
People over 65 are on Medicare -- most people I know on Medicare are self-pay with GLPs or they have gotten into grey.
 
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GLiPtest said:
There was no price increase for Trulicity between 2025 and 2026. Since she’s on Medicare you’re describing the deductible Medicare recipients pay (max $615), after which meds are no (or very low) charge. Since you’re so involved with her care, I’m sure you’ve seen this every year for the last 8 years since she’s been on Medicare since she was 62.

With the commercial insurance most Americans have it’s $25 a month using the Eli Lily copay card.

For the tiny percentage of uninsured, or low income and can’t afford the deductible, there’s the “Lily Cares” program that provides the medication free of charge to tens of thousands of patients with a simple application.

I suggest you move to one of the many wonderful countries with “free healthcare”, that control costs by not offering many of the most advanced meds commonly available here, would put her on multiple injection a day insulin instead, and when she needs a hip or knee replacement, instead of getting it done the following week, she can wait on the near multi-year waiting lists common in places like Canada and the EU.


Congratulations, another ignorant American brainwashed into hating their country.

PS: GLPs for weight loss aren’t covered by Medicare yet, because of a law banning it from paying for weight loss meds (after the deadly phenphen weight loss med scandal in the 90s). It will be covered in a few months, capped at $50/mo max for Wegovy or Zepbound, any dose.
Click to expand...
you know whats great about America? Everyone is entitled to their opinion....regardless of how baseless and full of assumptions they are as seen in your reply.

My mom hasnt been on GLPs for the last 8 years. My mom doesnt qualify for any "Lily cares" programs same as she didnt for Trulicity since we explored those "coupon" and rebate options with her doctor.

Wild that your defending a pharma company and our completely broken healthcare system with ridiculous mark ups on drugs that they ONLY charge to the US of A. Lily and other companies gouge us, while a quick trip to Mexico shows you that drugs arent really as expensive as big pharma makes you think. Probaly why the US is LITERALLY 1 OF ONLY 2 countries in THE ENITRE WORLD who allow pharma advertising. I really wish people that you ignore would also be blocked from seeing your posts cuz it sure would help with you and 1 other guy that loves to comment on all my posts and its of no value.

Keep explaining how I'm a USA hating citizen while spewing nonsense.
 
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txnj11 said:
I’m on prescribed Mounjaro 5 mg, and I can see how much my insurance is being charged—about $1,250 for a one-month supply of four pens! If my insurance stops covering it, I’m in trouble because it works incredibly well for my type 2 diabetes. If I lose my job, I’m in the same situation.

It’s really frustrating because this medication has been amazing for glucose control, appetite reduction, and satiety. But who knows when it will finally become generic—maybe another 10 years? If my insurance stops paying for it, I’ll have to look at compounded options, and if those become too expensive, I’ll have to explore grey for tirz...
Click to expand...
You have already found it🙂 "level up" achieved🙂
 
spanky2026 said:
Hmmm, let's just take Great Britian as an example, where do they rank on longevity vs U.S.? Or how they rank in terms of healthcare coverage? Doesn't matter if you have all the gee whiz toys in the universe if you built a system to make SURE many can't get to it. Health care isn't health care if you can't afford it. Or get denied it's use. It's just a ponzi scheme for the healthcare companies.
Click to expand...
That person doesnt make much sense, and really makes me wish we had full blocks in this forum. I get not fully agreeing with me....but for him to lean into it so hard and take the approach he did....wow is all i can say. Critical thinking doesnt seem like a big player and they just parrot out what their favorite charlatan on fox news says. theyre probably a big Shkreli guy

FNG33 said:
This thread well go just swimmingly. Nyet🤣
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im sorry for the discourse comrade.

Vriende said:
Anyone who does any international travel knows that this is a myth Americans perpetuate just like high school kids who dislike the high school across town.
Many other countries are way ahead of us in health, education, and etiquette in their nations and towards other nations.

There are many older seniors on this forum who are into grey and mentoring their younger family members.
People over 65 are on Medicare -- most people I know on Medicare are self-pay with GLPs or they have gotten into grey.
Click to expand...

Its wild how all in he went with that reply.

CJsMom said:
On 1 July, Medicare will cover it at a co-pay of $50 per month. Your mom sounds like she meets all the criteria. You might want to look into it for her.

Coming Soon: CMS to Provide $50 Monthly Access to GLP-1 Medications for Medicare Beneficiaries | CMS

Coming Soon: CMS to Provide $50 Monthly Access to GLP-1 Medications for Medicare BeneficiariesProgram Begins July 2026, Expanding Affordable Access to Innovative but Costly Treatments for Seniors
www.cms.gov www.cms.gov
Click to expand...
HELLLLLL yea and what I was hoping for. Let me start exploring this because im gonna sit down and do some maths when I get home to see about placing a gray order for us. Thank you!
 
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GLiPtest said:
There was no price increase for Trulicity between 2025 and 2026. Since she’s on Medicare you’re describing the deductible Medicare recipients pay (max $615), after which meds are no (or very low) charge. Since you’re so involved with her care, I’m sure you’ve seen this every year for the last 8 years since she’s been on Medicare since she was 62.

With the commercial insurance most Americans have it’s $25 a month using the Eli Lily copay card.

For the tiny percentage of uninsured, or low income and can’t afford the deductible, there’s the “Lily Cares” program that provides the medication free of charge to tens of thousands of patients with a simple application.

I suggest you move to one of the many wonderful countries with “free healthcare”, that control costs by not offering many of the most advanced meds commonly available here, would put her on multiple injection a day insulin instead, and when she needs a hip or knee replacement, instead of getting it done the following week, she can wait on the near multi-year waiting lists common in places like Canada and the EU.


Congratulations, another ignorant American brainwashed into hating their country.

PS: GLPs for weight loss aren’t covered by Medicare yet, because of a law banning it from paying for weight loss meds (after the deadly phenphen weight loss med scandal in the 90s). It will be covered in a few months, capped at $50/mo max for Wegovy or Zepbound, any dose.
Click to expand...
I’ve had to fight my insurance at every turn. I have people with business degrees making decisions about what medical care I need. And their income and bonus structure is tied to how effective they are at saying no. This is asinine.

To pick a single example, I was hospitalized for a month, and moved to inpatient rehab for another three weeks. I had one particularly good day when I managed to move from the wheelchair to the bed without assistance. My team was obligated to report that and my insurance took a week to make a decision, and that decision was not only to immediately send me home, but to retroactively revoke their payments back to the day that I had made that one physical action. One which i had been unable to reproduce since then.

Claiming our insurance system in this country is effective for anything aside from lining pockets of people who are already wealthy isn’t anything I can agree with.
 
Our GLP-1s are compounded, $450 a month for both of us. Of course all our other peptides are grey because they cannot be compounded because of the FDA. Not sure how much longer it will be before the FDA manages to shut down compounding of Tirz and Semag. And Reta will be banned from compounding for probably the next 10 years, until Lilly makes their trillions.
 
Same for me. My insurance covered Ozempic for about 6 months then upped my co pay to $700. I went compounded for three months until I found the grey market and haven’t looked back. Currently on Reta ,mots c , 5 amino1 mq, Nad+, GHK cu ,and PT141 for fun. I have gone down the rabbit hole but I’m in the best shape of my life.
 
Insurance wouldnt cover anything for me. Luckily have a friend that was on reta and got me all set up with buying it from a seller in the US. Of course I paid way to much for the first few months until I found this place!
 
Rosco P. Coltrane said:
Insurance wouldnt cover anything for me. Luckily have a friend that was on reta and got me all set up with buying it from a seller in the US. Of course I paid way to much for the first few months until I found this place!
Click to expand...

I have private insurance, but don't really use it any longer. It's a total scam. And then you find out if you pay cash for many things, you pay less.
 
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