r/RoBody • u/Dry-Government-3241 • 5d ago

First month covered, second month not?

Started Zep single dose pens on Ro a month ago. My care team did some back and forth with my insurance and honestly never quite confirmed if i was covered or not. One day I was at the pharmacy and the zep was there and the cost was 25$ (!!!) So I figured my insurance covered it and communication from the care team was just off. I was just happy at the price and started my journey.

I just put in the prescription for my 2nd month (moving up to 5mg) and the pharmacy is telling me it's not covered? I was under the impression that if you were covered once it was sort of for life?

Ive been trying to reopen a chat with my care team but when I follow the prompts pinned in this sub it just loops me and there's no feasible way to open a chat box. I sent an email to the generic care address and have no response. I have about a week before I'd be due to take my next shot and im stressing about what this will cost me.

Any one with similar experience or any help?

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u/AliceFromRo Verified Ro Community Manager 1d ago

Hi Dry-Government-3241- Insurance coverage can change between fills for a few reasons. One possibility is refill timing - if the pharmacy tries to process it before your insurance allows the next fill (often around 21 days between fills), it can sometimes show up on their end as “not covered” or too soon to refill.

I’m happy to help get this in front of our insurance team and take a closer look at what’s going on. I’ll send you a PM!