new job’s insurance doesn’t cover my medication, a 6 a.m. training, and more

by Alison Green on August 10, 2023

It’s five answers to five questions. Here we go…

1. My new job’s insurance doesn’t cover my medication

My husband and I take Wegovy, which is a weight loss drug that has stirred up a lot of controversy. My healthy diet is finally working now that I don’t have to deal with insulin resistance and I’m having excellent results. Because insulin resistance is a medical condition, I have to stay on Wegovy for life to treat it and am fine with that. My previous company did not need any type or preauthorization or medical documentation. I just handed the prescription to my pharmacy and they called me once it was in.

However, I recently started a job at a new company. Since the drug is quite expensive and unaffordable for us out of pocket and not all prescription plans cover it, I asked for a list of the new company’s prescription plan formulary during the interview process to make sure it’s covered. If it was not, that would be a deal breaker for me and I would have removed myself from the process. I was thrilled when I saw Wegovy on the list.

I started a few weeks ago and I love the job and the team. However, when I called the prescription plan last week to see if I need a preauthorization, I was told that Wegovy is NOT covered and it is specifically excluded even though it was on the list. I spoke with the HR person who onboarded me and she has repeatedly assured me that they will fix it.

Today I found out that their way of fixing it is to have me file an appeal with the prescription plan and see if their broker can get it covered in the meantime. I asked about making it covered and not excluded going forward and she said they cannot do that until the next plan year and the VP of HR would have to weigh in. In the meantime, I have to try to do this appeal.

I am so upset about this. I am terrified it will not be covered and I will gain all the weight back. I feel like I was hired under false pretenses. I am not sleeping well and have so much anxiety about whether it will be covered as promised. While I love the job, I don’t want to stay if it is not covered. I would never have left my last company if I knew this would happen, because it wasn’t intolerable or toxic and had great benefits. Complicating this is that I took a signing bonus that I’d have to pay back if I leave within two years.

Do I have any recourse? If I decide to leave over this, can I get them to let me out of paying back the signing bonus since the reason I am leaving is that a drug that they told me is covered is actually not covered? What else could I have done to make sure it was covered beyond what I did?

You took every reasonable action to make sure it was covered before you accepted the job! The only other step you could have taken was to call the plan to confirm the info listed was correct … but it’s understandable that you didn’t think you needed to when you saw it on the list.

If you do end up leaving over this, you have a good shot at getting out of repaying the signing bonus if you point out that you did your due diligence but were given wrong info. Not a guarantee, especially since health care plans can and do change and it’s possible for a drug to be covered when you’re hired and not covered later on — but you have a good argument and would be on solid ground in at least trying.

But before it gets to that point, try framing it to HR this way: “I was careful to request your formulary to confirm the coverage before accepting the job. I wouldn’t have been able to accept the job had it not been listed as a covered prescription in the materials you gave me … and realistically, I can’t stay if I need to pay out of pocket for this. Given that, what are our options?” Wait to see what happens with the appeal first, though, since your company is likely to want to see if that works before talking about other steps.

Read an update to this letter. 

2. My boss scheduled a 6 am training with little notice

My boss is the one who approves vacation and she has access to all of our work calendars, yet she keeps scheduling mandatory training when folks are on vacation or already in meetings, and she schedules things outside of normal work hours without checking that we don’t have other commitments first.

My workplace wants to do antiracism training, which I fully support. But our boss scheduled it without checking with anyone (or apparently her own calendar), so two out of five of us had already been approved for vacation or a personal day, and she herself had a conflicting meeting. She asked if we could move our vacations, but I was at my best friend’s wedding as the maid of honor, so it wasn’t something I could reschedule. My coworker had a plane ticket purchased. We both were able to attend the first day, but not the second. This was in June.

My boss was disappointed that less than half of the staff were at the full training (again, she was one of the folks who missed it) and decided to re-book us all on the online version. She didn’t tell us this was happening and it’s based in a different time zone, so we just found out today that we are expected to be at work at 6 am next Monday and Tuesday. Our usual workday is 9:30-5:30.

I had already scheduled work meetings and project deadlines during these days. One of my coworkers has a family commitment Sunday night and doesn’t expect to be home before midnight, so waking up early enough to look professional at 6 am is a hardship. Another coworker has a medical appointment during the training, which has been on her work calendar.

I care about antiracism and would have been willing to plan in advance to make this work, but it feels unreasonable to spring a 6 am start and take away 16 hours of our work week with so little warning. This month, I have already rescheduled something in my personal life once because my boss scheduled an evening event without checking the date with us. This is an ongoing problem. My coworkers and I are all feeling anxious about this, and we are looking for a professional way to assert a boundary about scheduling without implying that we object to antiracism training.

“We really want to take this full training, but these dates don’t work for a bunch of us and some of us will end up missing it again. Can we schedule it with enough lead time that we can all ensure we’ll be there — and can we check calendars and confirm the dates before it gets booked so we can be sure we can attend?”

After that: “Can we talk about how stuff gets scheduled in general? There have been a few times recently where important things got scheduled without much lead time and when folks were scheduled to be out. Obviously schedules won’t always line up and sometimes conflicts can’t be avoided, but especially if something is mandatory, could we make a practice of checking shared calendars to try to get the maximum availability?”

You’re probably feeling aggravated because this shouldn’t even need to be said — but use the same tone you’d use to raise a work problem that felt less charged (like if the printer kept jamming or you needed a workaround to a software limitation) and it’ll likely go over better.

3. Should I mention my divorce to my boss?

I work in higher education and manage a small staff team that supports an academic department. I report directly to the department chair, who is a wonderful boss. We have a good culture of accommodating folks where needed for medical issues, moving house, etc. though we try to do our best to schedule these things (where possible, especially for things like pre-planned surgery) for non-busy times of the academic year.

My issue is that I am in the process of filing for divorce, and it’s likely not going to be a smooth process. It is going to require me to have quite a few meetings with my attorney as well as court dates. These meetings will need to happen during the workday, and with court dates you don’t get a lot of flexibility in scheduling. Unfortunately we’re also entering a very busy time of year (start of the semester) but sometimes life events happen in a way that’s not convenient for anyone and we have to work with what we have.

Hw much of this should I disclose to my boss? I’m worried that if I suddenly am taking very short notice days off for legal proceedings that he’ll think I’m interviewing. I love my job and have no plans of leaving, but I’m also not comfortable getting into the details of why this needs to happen now and can’t wait until winter break or another similarly less-busy time.

If you don’t want to be specific at all, you could say, “Unfortunately I have a family situation unfolding that’s going to require a number of appointments during the workday over the next few months and I won’t have a ton of flexibility on times and dates. I know the timing isn’t ideal so I wanted to give you a heads-up. I’ll of course work around it as best as I can.”

But if you’re comfortable with it, it would also be fine to say, “I’m starting the process of a divorce and there are going to be some meetings and court dates that I won’t be able to move. I wanted to give you a heads-up since I know the time of year isn’t ideal, but unfortunately I won’t have a ton of control over the timing of some of it.”

4. Should I put a job I left quickly on my resume?

I was laid off in January, as part of a global workforce reduction (not a surprise, and nothing to do with my performance). I interviewed with a lot of companies and was able to land a new job quite rapidly.

Two months and a half ago, I joined my current company, and I realized I do not like it (beyond quite a few bad things I see in the culture, I want to be in a more hands-on position), and after being honest with my manager, they decided to lay me off this week (I’m still on a trial period). I had another offer in place before disclosing this to my manager, which I have now accepted.

Should I keep this company on my resume and on LinkedIn? I fear it might look bad having a hole of a few months, then two months in a company, then another company. If asked, I can be honest and open about it: I was not a good fit and did not enjoy the work I was doing, so I preferred to jump the boat faster rather than later. But I know it still does not look great, and not having it would mean that I just have the hole lasting a couple more months, which can be justified by “I was laid off and took my time to find the right place to work.”

Leave it off. Two and a half months of work won’t give you enough accomplishments to make it worth including. And a gap of a few months isn’t a big deal at all, particularly after a layoff.

You were laid off, you found a new job a few months later, end of story.

5. Is my schedule legal?

I am salaried at 37.5 hrs a week, Monday – Friday. Every fourth weekend I am on-call and need to respond to and fix any IT issues that occur. I am not paid extra for this and there’s always work to be done on both Saturday and Sunday. When it is my weekend, it means I work 12 days in a row.

Additionally, because the systems always have to be monitored, I regularly work on holidays. So the entire company gets a paid holiday and I am stuck working. I don’t receive additional pay or official comp time for this. My boss will let me take a day off in trade if I ask, but I don’t take advantage of it as much as I should. Nothing is tracked in payroll, so if I leave the company, I’d be forfeiting any holiday time that everyone else has received. Is this legal?

Assuming you’re correctly classified as exempt, it’s legal — exempt employees don’t need to be paid overtime, and no law in the U.S. requires special holiday pay. The exception to this would be if your offer letter or other employee documents are written in a way that guarantee you holidays off (although even then you’d need a lawyer to look at the specific wording; offer letters aren’t the same as a binding contract).

However, you can certainly try negotiating comp time and/or a raise in recognition of the amount of time you’re putting in. You might get it if you ask! And if nothing else, you should immediately start taking more advantage of the days in trade your boss will already approve.

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{ 406 comments }

{ 406 comments… read them below }

  1. Ask a Manager* Post author

    Please do not give medical advice to letter-writers (in this case, LW #1) … and please stay on topic with (non-medical) advice for the LWs, rather than broadening into weight loss drugs in general. Thank you.

  2. Pastor Petty Labelle*

    #3 I can guarantee if you are just now filing for divorce, not a whole heck of lot will happen during the busy time. Divorces don’t go quickly. Not sure what state you are in or even if you are in the US, but presuming you are at least in the US, its pretty standard to file, then have the person served, then they have 30 days to answer, THEN you start getting court dates. You aren’t having a hearing any time soon.

    It’s August so I should be getting the I need to get custody done before school starts calls. Then along about November I get the I want to be divorced by the end of the year calls. When dealing with court think months, not weeks.

    1. AnotherLibrarian*

      Yes, very much this. Back when I worked for a law firm (in a pervious worklife), I learned that nothing involving the courts happens fast.

      1. Moodbling*

        yeah, it wasn’t a divorce but my astonishingly simple court case took years.

        I did see one divorce happen in about 4 months once. they had no shared assets or dependents, didn’t live together, both agreed to the divorce already, no one had changed their name, and they’d been married for under a year.

          1. Pastor Petty Labelle*

            An annulment is they shouldn’t have been allowed to legally wed, divorce is it was legal but we don’t want to be married anymore. I have gotten exactly ONE annulment in my career. But I did do a divorce in six weeks, but no kids, no assets, everything agreed and the other party was standing right there to file their answer when we filed the complaint (very friendly divorce, they realized they were fine as friends, but not spouses) so no service and waiting for an answer.

            IF everyone is in agreement it can go fast. But if it is contested, all bets are off. Some places are scheduling final hearing a year out — from the settlement conference which is at least 6 months after the initial filing.

            1. RetiredCountryLawyer*

              I think I set a record on an annulment.

              The respondent was in jail on other charges. I represented the “wife” in petitioning for annulment on grounds of bigamy. Respondent agreed not to contest.

              I had to go to the chief deputy sheriff’s house to fetch the respondent for the hearing. (He was working in the yard.) We met my client at the courthouse.

              I filed the original, signed papers with the Register, along with the filing fee, and carried a copy with us down to the judge’s chambers. He swore in the parties, took their testimony and signed the annulment judgment. I took the order down the hall and delivered it to the Register, who handed me the receipt, and made copies for the parties.

              That case was exceptional in many ways.

              Over the course of my career, I found that fast-paced cases tended to be the ones with the most complicated legal and factual issues.

              Courts are supposed to move at a pace that allows all concerned to be heard and for issues to be considered deliberately.

          2. Clisby*

            Sounds like a dissolution to me. Not all states have that option but, for example, Ohio does. It’s basically a no-fault divorce where the 2 parties already agree on everything, and is much faster. If there are points of contention, you can’t go that route.

          3. Moodbling*

            they had lived together
            in the past
            they just had already moved to different places
            before they started divorcing

    2. Red Reader the Adulting Fairy*

      Yep. I had a simple divorce with no assets or custody or anything complicated where we both agreed on everything and it was still 3 months before I ever saw the inside of a courtroom.

    3. Kesnit*

      I did divorces in my last job. Most were uncontested, which went quickly, didn’t require many court dates, and took a few months.
      The contested ones went for years. Before you get to thinking about court dates, there will be negotiations between your attorney and your spouse’s attorney. Discovery (i.e. financial records and the like) will need to be given to each party. Yes, you will need to meet with your attorney, but a lot can be done over the phone.
      If you and your soon-to-be-ex do manage to negotiate an agreement, you may not have to go to court. (The attorneys will file all the documents and the judge will sign off.)

      1. Pastor Petty Labelle*

        Depends on state. In my state even if there is an agreement, there must be an on the record hearing.

        Also, a lot of meetings with your attorney can be via zoom. Which means you can plan your lunch hour or other breaks as needed. I tell my clients feel free to eat while we are meeting. Just be somewhere private. Your office doesn’t need to hear your business.

    4. OrigCassandra*

      My uncomplicated divorce (no kids, nothing contested, no spousal support, no lawyers even) still took five months from filing. The paperwork is no joke (my ex whiffed a court date because he couldn’t/wouldn’t get his financial disclosure done), and the courts fit you in when they can.

      OP3, I work in higher ed and have the same start-of-semester-rush issues. I decided to tell the department chair and say “this isn’t secret, but I don’t need it announced either” and that worked out fine for me.

      1. Emikyu*

        Seconding both aspects of this. I had a similarly uncomplicated divorce, and it still took time. Courts are slow.

        But also, I think it’s fine to just say up front that you’re getting divorced. I used almost the exact same wording as OrigCassandra, and it went fine in my workplace.

        Also, a potential bonus to disclosure: divorce sucks even when it’s what you want. No matter how hard you try to be professional, sometimes you might be distracted or get a little extra emotional about it. (I may have started crying at one point when my boss matter-of-factly pointed out a typo in my work because I was just so overwhelmed by everything going on. Totally out of character and mortifying.) If you have a reasonable boss, they’ll likely cut you a little slack if they know you’re going through something life-changing like this. (My boss was very cool about it – just slid a box of tissues toward me and asked if I wanted to continue the conversation or come back later. I think he would have been baffled if I didn’t know I was mid-divorce, though.)

    5. happily divorced*

      & if you’re in a state like Virginia, you have to live apart for a minimum of a year before you can move forward with divorce proceedings. Presumably the LW is past that point but JFC I hate this state.

        1. knxvil*

          I believe it’s 1 year if you have dependent children. Source: My parents divorced in Arlington County in the 1980s.

      2. Kesnit*

        If it’s a no-fault divorce in VA, the wait is 6 months if there are no children and 1 year if there are kids. If it is a fault divorce (ie abuse, neglect, abandonment), there is no waiting period.

    6. Anon For This*

      Yep. And if LW3 thinks the thing will be messy…buckle up for the process to be long, lots of time in between court dates. I had to change attorneys midway through, twice…no one’s fault, the first retired early due to health issues, the one who took over from there ended up leaving the firm and I decided to stay with the firm instead of him. These changes ALONE added 6 months due to a court clerk who kept sending the calendar notices to the FIRST attorney…you know, the one who is no longer practicing.

    7. Still an admin*

      I also support an Academic department and my chair could tell there was something up with me. She was relieved when she was told it was divorce because she was afraid I was quitting! She didn’t tell anyone until after I told people (and a lot of people knew my ex so I really wanted people to know!)

      Also, my no fault divorce took months and I am told that was smooth!

    8. Princess Sparklepony*

      I got divorced and never went to court once. Neither of us were fighting it though. I had a few lawyer meetings and we had a settlement meeting where we were both there with lawyers. But never went to court. My lawyer wasn’t great though, he never told me when the divorce was final. I was on fairly good terms with my ex and he let me know!

  3. CL*

    #2- I work with someone like this. It’s frustrating and they never change and never seem to think it’s their fault. Agree with Alison that you have to approach it like any other work problem. They schedule a meeting on Thanksgiving and it gets pointed out in the same factual manner as “the kitchen is out of dish soap”. Letting your head explode over it won’t change anything.

    1. John Smith*

      I’m astounded that a manager who is obviously not managing is classified in the same category as a minor inconvenience. Surely their own manager should be addressing this issue? If they’re otherwise a good manager, I’d be tempted to offer to take over scheduling. Otherwise, I’d be wondering why on earth this person is left in charge of a team. Maybe I’m jaded by my own managers’ many shortcomings but I can’t help wonder that if the LW was a manager making the same complaint of their employee, the advice would involve a talk, a PIP and eventual dismissal.

      1. Coverage Associate*

        It depends on the type of work and manager. In a law office, it’s usually non managers who set internal meetings, and the higher up you are, in my experience, the less it’s your job to consider others’ vacations and deadlines.

        In a job supervising hourly employees, it can be more of the manager’s job to deal with scheduling.

      2. Allonge*

        I’m astounded that a manager who is obviously not managing is classified in the same category as a minor inconvenience.

        This is not what is happening though. It’s being realistic: OP being upset, however legitimately, and expressing that to boss is not going to resolve the issue. Alison is being realistic when advising to use a tone of voice that is the same that would be used for lower level annoyances. Because going to a grandboss with the complaint of ‘my boss is bad at meeting scheduling’ is going to be a large investment of credibility, no matter how warranted.

        But I totally agree that taking over scheduling is a legit response, and may be the best solution! Looks like boss does not have an understanding of how it works.

      3. Awkwardness*

        I get what you are saying. But most of the time hectic approaches in adversarial tone will result in instant pushback through the manager.
        This is obviously not the goal. In approaching it like an inconvenience, the manager might hopefully remain most open-minded.

      4. I should really pick a name*

        It’s not in the same category.

        The point is to approach it the same matter of fact way.

        And if no one has stated brought this up as a problem yet, the boss would be the first person to go to, not the boss’s manager.

      5. CL*

        I see what your saying, but in my case any escalation of the issue causes the person to argue even more that they are right. This isn’t the battle I want to spend energy on. Meetings get moved eventually when the absurdity becomes obvious.

      6. Sunflower*

        The thing is, someone reasonable enough to be told how annoying this practice is in tones of appropriate frustration or frankness, wouldn’t have been doing it in the first place. Based on the fact that this boss is so wildly inconsiderate of her team, it seems like best practice to handle it as faux-casually as possible.

    2. NotJen*

      Also work with someone like this, who, unfortunately, is my manager, and who is at the top of the organisation and can’t see any fault in anything they say or do, not matter how rude/aggressive/inconsiderate they are.
      It doesn’t matter what anyone says, even spelling out issues outright, nothing has changed in my time at the organisation, and personally I’ve had enough of it and it’s one of the reasons I’m leaving shortly.
      If you speak to your manager and nothing changes or they can’t see it’s a problem, you need to decide if you’re ok to carry on with things as they are, or if you need to start looking for a job elsewhere.

      1. Orange You Glad*

        I also work with someone like this. They don’t schedule out anything in advance, everything is in the moment when he feels like doing it. He will never change. I’ve been here 14 years and have learned to cope the best I can.
        Yesterday he emailed a group of us at 1:45 for a 2pm meeting. One person never saw the message because she was at lunch when it went out and she didn’t get back until 2:30. Boss was mad but if he had sent the meeting invite in the morning, then everyone could have planned their day around it.

      2. not nice, don't care*

        My spouse is ‘managed’ by someone like this. Insert shocked pikachu face when served with a union grievance after years of boss/grandboss conversations and requests for help. No matter how nicely the issue was framed, butthurt retaliation ensued.
        So offensive when the little cogs expect humane treatment.

    3. JM60*

      I once had those in power schedule a software release for Memorial day. When I pointed that out, they rescheduled it to Juneteenth (another holiday observed by my employer). It wasn’t a big deal, but it was thinking, “Is it that difficult to look at a calendar first?”

      1. Toaster Oven*

        How international is your employer?

        I’ve worked professionally in countries A, B, and C (all three of which, but especially country C, having highly regional holidays), and do a lot of work with country D. My job also doesn’t exactly follow a 9-5 schedule to begin with, so it wouldn’t be unusual for me to be working on a holiday that I am personally observing. I *always* forget to check holidays, and/or check the wrong country’s/cultural’s holidays, when scheduling things with folks outside my team.

        2. JM60*

          We’re pretty international, with perhaps a little under half of total employees outside the US. However, I’m sure it’s more than one person who signs off on a release date, and all company holidays for all regions are on our internal calendars. It’s the sort of mistake that I can easily see making on occasion, but not usually consecutively. I’d think that rescheduling because the original date was a holiday would serve as a reminder.

          1. Smithy*

            I hit this issue around Easter every year. We’re an international employer, and I know that different countries have different blocks of dates – but keeping all of them straight doesn’t always work.

            That being said, if I ever get it wrong once or schedule a meeting too close before or after one country’s Easter holiday periods – I am inevitably more careful when I go to reschedule.

        3. Pastor Petty Labelle*

          It’s no so much that it was scheduled on a holiday but that no one looked at a calendar before scheduling. It could also be it was scheduled for a week most people are on vacation. Or a week that there are a ton of other deadlines. A manager should be looking at the calendar while understanding what else is going. Like if you have a deadline that day, maybe scheduling even a one hour meeting is not the best thing (yes everything should be done before deadline, but humans are gonna human).

      2. cabbagepants*

        I’m sorry but this is hilarious.

        Someone saw those vacation days where everyone’s calendar was open and was the living embodiment of the “is it for me?” meme.

        1. Anja*

          I did this with a colleague back in July. Had to book a meeting with him and checked his calendar. Saw one day that only had like two meetings! So exciting! Quickly booked something!

          He messaged me going “hey, that’s a statutory holiday.” Immediately moved it to another day. In my defense…it wasn’t actually the stat holiday, as such. Canada Day (July 1) fell on a Saturday. We office workers all had Monday, July 3, off in lieu of the stat that fell on the weekend.

      3. Orange You Glad*

        I feel it’s normal at my workplace to roll out software and technology updates over holiday weekends because it’s the closest they can get to guarantee no one else is working. We have a major rollout that has been delayed because we weren’t ready for Juneteenth and need to wait for another holiday weekend when we are closed. My software vendors also usually push updates on Saturdays (with a lot of notice) so no one will be in the system.

        1. Clisby*

          Before I retired as a computer programmer, big releases always were scheduled over a weekend (and any of us involved in said release were on notice that we’d be called if there was a problem.) I don’t specifically remember this being done over holiday weekends, but it doesn’t sound particularly egregious to me. In our case, it wasn’t so much that only a few people would be working – it was more that if there was a problem, it would impact far fewer customers.

        2. JM60*

          In our case, the day the software is released (to our customers) isn’t the same day that it goes live to their customers (which will vary by customer).

        3. Just Another Zebra*

          Back in my retail days, our company decided to move all of the servers from PA to FL over a 4 day holiday weekend. It was perfect, they reasoned, because the store would be slow.

          The holiday was Thanksgiving, and so we had no registers for Black Friday or the following weekend.

          We could not run any credit cards, verify any checks, or print any receipts. We had to have every customer complete a credit authorization form, or put their cash into individual sealed bags attached to their order form. That Monday, the system (which was still coming online) crashed twice, so no orders could be placed until the following Wednesday. We all agreed it would have been better to do during the week leading up to the holiday, since the store was very slow.

          If you think this is indicative of higher dysfunction, you’d be correct.

    4. el l*

      Yeah – and don’t be fooled by the “they’re my boss, they have the power.” All kinds of people have bad habits when it comes to scheduling – short notice and not checking availability are common sins. Name those:

      “I’ve seen a pattern with scheduling. When we’ve received meeting notices, they’ve been on short notice and and without checking for basic availability. Please plan ahead and check people’s schedules before going ahead. Because we all want successful meetings, this will help make those happen.”

    5. Unkempt Flatware*

      Yes I had this exact situation and when I pointed out that all these things were before I started work each day, I was told I wasn’t a team player.

    6. Janeric*

      How do you talk about this with outside people who don’t have a lot of exposure to your internal scheduling issues? Like for instance the anti-racism training team — How do you say “this isn’t MY fault but realistically it’s going to happen most times you work with us”?

      btw I really appreciate the insight provided in this thread for an issue like this — I feel like “it DOES make your head explode! But that’s not going to help.” is exactly what I needed to hear.

    7. Cheshire Cat*

      I’m surprised that Allison didn’t address the 6AM meeting time. If I received a meeting invite for a time so far outside my normal work hours without a very, very good reason for it, I would decline and request an alternate date/time.

      We had antiracist training at my company a few months ago. Normally the trainers scheduled two full days for the training. We have people on the East Coast as well as the West Coast, and the trainers’ usual schedule would have meant that multiple employees would have to work outside their normal work hours. The trainers were willing to work with us and spread the training over 3 days instead of two. That meant that our West Coast employees were able to start at their usual times, and our East Coast employees didn’t have to stay late. It worked well for everyone! Maybe your manager could try something similar.

  4. Can Can Cannot*

    LW#1, even if a drug is listed on the formulary, it might not be approved in all circumstances. With regard to Wegovy, some plans authorize it for treating diabetes, but don’t for weight loss. If it’s listed on the formulary, you need to verify that it is covered for your specific medical needs.

    1. Ellen N.*

      The original poster stated that since using Wegovy, they are no longer dealing with insulin resistance.

      1. Dahlia*

        That doesn’t mean diabetes, though. Insulin resistance is very common with PCOS which also causes weight gain and difficulty losing weight. It’s still considered off-label for PCOS treatment.

        1. BB*

          Ozempic is the brand name for the drug that is labeled for people with diabetes and pre-diabetes.
          Wegovy is labeled for use with any patient having weight related issues. Which would cover PCOS underlying causes.
          If Op qualifies for Ozempic criteria it might be worth a look, because it might be on the list even though Wegovy might not.

          1. br_612*

            This was my exact issue. I have PCOS with insulin resistance and metformin is less effective than the GLP-1 agonists. My doctor tried prescribing Mounjaro at first, that was a no go because I’m not diabetic, just in the pre-diabetic range. So she switched to WeGovy, because I am overweight and that one is for “weight management”. Insurance approved it, but only from June to November.

            The problem? It’s out of stock. And has been since June. I don’t have the time to sit here and call every single pharmacy in my area on a biweekly basis just hoping someone has it and Walgreens can transfer my prescription, but I’ve called multiple different chains at various times over the last couple months. Apparently the shortage should ease up in September, but by then I’ll have to go through the pre-authorization again just two months later.

            Also for my insurance to know my weight (and BMI, though that’s not a great marker of health it’s what the label is based on) and think that 5 months of WeGovy will bring it out of the range the label is for is frankly hilariously delusional.

            My PCOS went undiagnosed for a LONG time, despite me regularly bringing it up. I should’ve been on spironolactone and metformin a decade ago but have only had them for a year or so. It’s so frustrating that now I finally have a doctor who listens and doesn’t blame literally everything on my weight there’s a drug shortage.

            1. Ellen N.*

              Due to my phobia of needles, I take the oral form, Rybelsus.

              I haven’t had the supply problems or the side effects others are reporting.

            2. Mary*

              I sympathize with you – I went on Wegovy (low 0.5 does in June). Once my month was up, I could not find the next dosage. My doctor put me on Saxenda for six weeks. It is okay, but you have to inject yourself every day. The good news about that is, in using Saxenda, I have skipped over the lower does of Wegovy (the manufacturer put a hold on them) and can now order the Wegovy 1.7 dosage with no problem.
              My concern is I am on my husband’s insurance and he wants to retire in a year or so. My best guess is Medicare will not cover me then.

          2. Spero*

            Before they switch they should see if their doctor can offer a sample to get them through the month, or if the manufacturer has a coupon that can bring the cost down. Either of those are options while they go through the appeals process that wouldn’t result in needing to switch meds.

            1. bunniferous*

              This! Docs do have coupons for this stuff. I know because hubby is diabetic and he is on one of these classes of drugs.

            2. Voxtar*

              Without insurance coverage, after using the manufacturer’s coupon, Wegovy at my local pharmacy is $825 monthly.
              Doctors do not have samples. These medications are so in-demand that the manufacturer is intentionally reducing the availability of starting doses and telling doctors not to prescribe to new patients.

      2. buckminsterfullerene*

        And if they go off of it the insulin resistance will return. Insulin resistance, like diabetes, is a life long disease. Being on this medication helps her manage it, but there is no cure. Taking someone off of this medication means the symptoms will come back. This is what drives me insane – oh your blood pressure medicine is keeping your blood pressure in check? That means you no longer need to take the medicine! Oh your antidepressants are making you no longer depressed? That means you no longer need the medication! NO. Wrong. The medication is what keeps the disease at bay. Any sane doctor would know this. I have type 2 diabetes that is well managed by Ozempic. My blood sugar numbers indicate technically that I am no longer diabetic. But my doctor continues to note that I am diabetic because if I go off the med my sugars will go sky high again. I have a disease. OP #1 has a disease. The disease doesn’t go away. It’s not the flu.

        1. Anastasia Beaverhousen*

          The insurance companies don’t look at this way. Wegovy is being used off label for weight loss and they avoid paying for it with a pre-authorization which is rejected because diabetes isn’t a dx. It’s a numbers game for them.

          1. Not Tom, Just Petty*

            Numbers game. 100%.
            I read the comments below mine about how this med is “overprescribed.”
            Meaning that insurance companies covering are losing money because they have to do what they are contracted to do, manage medical payments.
            So they change the rules.
            There must be some key number that sets off, “no longer formulary” once coverage reaches X number of users.
            Like a kid taking his ball and going home when he’s losing the game.

            1. Wilbur*

              It is absolutely wild that we allow this. I’ve heard the arguments on Doctors overprescribing treatments/tests, but the idea that the counterbalance to that is companies with an interest in cutting their costs regardless of your health/quality of life outcome is bonkers.

            2. I am Emily's failing memory*

              Yep. Rather than post a link that will get stuck in moderation, I’ll just advise that folks Google “How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them” to find a deeply upsetting ProPublica exposé released a couple of months ago. It focuses on Cigna, but Cigna’s automatic denial system was developed by a consultant who has also developed similar systems for other U.S. insurance companies.

              1. TR*

                My insurance does have Wegovy on its formulary. My doctor submitted a prior authorization form based on obesity and some associated medical conditions (but not diabetes). I waited months for the beginning dose to be available at my pharmacy. When it finally was, they submitted it to my insurance… which denied it on the grounds that I couldn’t prove I had been on a formal weight-loss plan like Weight Watchers for six months.

                I think they’ll do anything to keep from paying for these expensive drugs.

              2. haylinf*

                Holy moly guacamole that article is infuriating. I have Cigna and they love to play games. My favorite is when they require prior auth on a drug *after* I have already started taking it!

          3. Voxtar*

            Wegovy is FDA approved for “chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol).” That’s literally what it’s for, not an off-label use.

    2. Not Tom, Just Petty*

      Came to say that OP the company’s information was wrong, but insurance companies can change their formulary list every quarter.
      An appeals are an ex revise in futility in my experience.
      November, open enrollment for following year: discover my daily meds were on a lower tier. Confirmed with HR that I was reading it right and rep agreed going down one was better for me.
      cool.
      January, refill my scrip.
      February, “that’ll be $800. It is no longer covered.”
      Call HR. “What happened?”
      HR: “I’m so sorry. They can change their formularies quarterly. To appeal, contact your doctor and have them say it’s medically necessary.”
      Call my doctor who agrees to contact insurance company.
      My doctor: “Not Tom needs this med. “
      Insurance; Try this third med instead
      My doctor: “Hey, Not Tom, you can get this one.”
      Me: Tried that ten years ago. Doesn’t work for me.
      Repeat for two other meds. Have two office visits with copays. It’s now May. I’ve been on the first replacement for these months and insurance comes back with number three med that didn’t ten years ago.
      Give up. have been on original replace my med for five years now.

        1. Sola Lingua Bona Lingua Mortua Est*

          My spouse goes through the same ordeal, repeatedly. Not Tom’s experience is nowhere near unique, unfortunately.

          1. lostclone*

            I feel deeply that there needs to be some kind of medical/insurance reform where insurers can’t just refuse to cover something medically necessary and prescribed by an actual doctor. It’s madness that you might have to change something that works for you because someone somewhere decided it would, presumably, save them a few dollar.

            1. Parenthesis Guy*

              If you’re fully insured, i.e covered by the insurance company, then there are state orgs that can help you appeal. If your company is self-insured, i.e company takes all the risk and the insurance company just administers the plan, then you’re stuck.

              I think that org should be allowed to take care of appeals regardless, but…

            2. Chocoholic*

              Unfortunately, drug companies incentivize doctors to prescribe their meds which then cost a fortune for consumers. The whole system is a racket.

              1. Felicia Fancybottom*

                It is actually illegal to do this. While it might still happen in some cases, most companies are too scared of the repercussion to risk it anymore

            3. Hannah Lee*

              And that medical reform also needs to address the practice of some pharmacies, that if the doctor prescribes something and the insurance company covers it … the pharmacist can second guess them and just refuse to fill it, or hold up filling it while they contact the doctor and argue with them about the drug, the dose, etc.

              Sure, there are sometimes when a pharmacist should raise a clinical issue – ie they see in the patient’s record that one med would interact, cause issues with another one the customer is already taking. But the times I’ve experienced the Rx Nosy-Parkers screwing things up, or heard friends, family talk about it, it’s 100% the pharmacy chain just coming up with a policy and overriding the doctor’s judgement with their own I’ve got a friend who has to argue every single month to get her standard maintenance medication (that she has been taking safely for years) because large-pharmacy-chain decided they would throttle back dosages … so instead of the 2 x per day 500 mg she’s prescribed, she’d go to pick up her monthly supply and find thirty 250 mg pills (1/4 the dose) Or they just wouldn’t have it ready, saying “the Rx is wrong, your MD needs to re-write it” when the Rx is absolutely NOT wrong.

              Unfortunately, for LW, I don’t have much advice. I’ve worked in benefits administration and insurance company formularies are often inscrutable black boxes of baffling decisions, subject to change frequently. So the employer could point to that to get the monkey off their backs and the insurance company could dig their heels in arbitrarily (or out of pure greed)

              Maybe try the appeal route, but also seek direction from your doctor’s office or even the manufacturer themselves – sometimes there are samples, or free trials or reimbursements available on a case by case basis.

              1. Retired Accountant*

                CVS and Walgreens are paying about $5 billion each in opioid settlements for, filling prescriptions as written that (in retrospect) “should have been flagged as inappropriate”. They may have implemented new policies in response to that. I don’t think they have any financial incentive to have their pharmacists spend time arguing with doctors

              2. Burger Bob*

                Pharmacist here, and no. Pharmacists absolutely should continue to have the right to not fill a prescription. We are legally and ethically culpable in what we dispense. We are not mindless vending machines there to spit out whatever the doctor ordered up. And frankly, I think people might be a little shocked if they saw the number of flat out mistakes and other stupid prescriptions we get sent (prescribers and their staffs are not perfect, to say the least). I guarantee you that 99% of the time, if a pharmacist is refusing to fill a prescription and saying the doctor needs to rewrite it, they have a legal or ethical reason for doing so. And yes, that’s frustrating when you are the patient. But it is also extremely frustrating being the pharmacist in that situation. Our licenses and livelihoods are on the line, to say nothing of our integrity.

            4. Burger Bob*

              This is why we need universal healthcare instead of private, profit-driven insurance companies. These medications are incredibly expensive. Of course insurance companies are going to do what they can to avoid paying for them. They are not charities. Their end goal is profit.

      2. Also-ADHD*

        I’ve been able to get an off formulary med approved before, though it till trying a replacement and reporting no, and a lot of follow up from a doctor, but I’ve also given up before. It’s not always impossible but it is a PITA.

      3. umami*

        This. Unfortunately, the company cannot guarantee anything as it relates to insurance, things change all the time, and I think OP is going to find that pretty much anywhere she goes. No one acted in bad faith here, and her best route is the appeal route right now. My partner has been going through this, he can’t take statins and is now on a different drug that was authorized, and when they called in the refill, it was denied. It took some doing to get it re-authorized, and we anticipate it will be an ongoing issue, but he and his doctor have to advocate for what he needs.

        1. Sloanicota*

          What’s really tough, watching my friends go through this, is they run out of pills before the refill comes in (and can’t always order early or request more), which throws them all out of whack. I had a friend end up in the ER over these games with mental health meds. Sometimes you can request a few emergency extra pills from the pharmacy, from what I understand, but if it’s a daily pill and you’re out of them, you don’t want to be waiting weeks for insurance nonsense :(

          1. Pay to Breathe*

            This is why I put off starting my inhaler for a few months so I could build up an emergency stash, just in case. I don’t trust insurance.

          2. umami*

            That happened to my husband, the refill was called in when he still had pills, but he didn’t find out they didn’t fill it until he went to pick it up a few days later. It took almost a week to sort out, so he had to go a few days without his med. Luckily his isn’t life or death, but still.

      4. ReallyBadPerson*

        Sometimes, on exceedingly rare occasions, the formulary can change in your favor. This miracle happened to a medication prescribed for my son. When he first went to pick it up, he was told it would be $1100. Nope, not on a teacher’s salary. Three months later, it was covered and he got it for $62. Unfortunately, it wasn’t as effective as he had hoped, but he felt a lot better wasting $62 than $1100.

      5. Teapot Unionist*

        I have had good experience with appeals. I write them myself and have the doctor submit it. my son’s pediatrician jokingly offered to hire me to write appeals because none of them get them approved as quickly as I do. I told the pediatrician I get paid to fight with people professionally. My formula:

        Not Tom needs to be prescribed (xyz medication) that is not covered by his plan. He has tried (abc med) and (def med) and neither worked. ABC caused (insert unpleasant side effects) and DEF caused (insert less unpleasant side effects) but was only partially effective. He still had (insert evidence of medication not working). When he tried a month of (xyz) through a sample provided to my office, he did not experience the side effects of either ABC or DEF, while still experiencing significant symptom relief.

        1. Melody Powers*

          I’ve also been successful with appeals backed by my doctor, so I want to encourage the OP not to write it off as hopeless even though it’s far from a guarantee.

        2. Voxtar*

          Depending on the employer’s insurance plan, they may not cover weight loss treatment at all. If that’s the case, then it doesn’t matter what drugs are effective: they are not available for coverage.

    3. BekaAnn*

      Removed. I know you meant well here, but I don’t want commenters giving medical advice (in this case, telling the LW to switch to another drug). – Alison

      1. margarita water*

        Insurance companies are starting to filter all of the drugs, so if you don’t have a Diabetes diagnosis from your doctor all of them are going to or already are going to be denied. The drugs are usually approved for Diagnosed diabetics but not for Un-diagnosed or no longer Diabetics.

        1. Hot Flash Gordon*

          Diabetes is not curable. Type 2 can go into remission with effective treatment, but one you have it, you will always have it.

          1. Ho-ho-holey hose*

            Similar to what the poster said above, I think that comment was referring to more semantics of how things are charted and the insurance company interprets them. There was the poster who said their bloodwork technically showed they were no longer diabetic, but their doctor made sure to continue to list them as diabetic as it was only the diabetes medication that was keeping their bloodwork so good. If a different doctor had marked the patient as no longer diabetic, insurance could use it to get out of covering.

            1. Hannah Lee*

              “There was the poster who said their bloodwork technically showed they were no longer diabetic, but their doctor made sure to continue to list them as diabetic … ”

              But even that phrasing is factually wrong. And it’s mis-phrasing like that which some bad actors or uninformed staff use to deny access to life-saving medications and supplies. Type 2 diabetes (as it is currently understood) is not like an infection that once it’s treated it’s gone. It is a chronic often progressive metabolic disease that once someone has it, they always have it (aside from reports of insta-cures following certain gastric surgeries) There is no blood work that can show someone is “no longer diabetic”. If someone has had a repeated clinical tests that showed them as having Type 2 diabetes, they have that disease. Even if later bloodwork shows the disease as being controlled (through use of monitoring tools which enable someone to effectively use medications and lifestyle choices day after day after day to keep their blood glucose in the normal range)

              So basically, a competent doctor would never flag a person once diagnosed as having diabetes as “no longer diabetic” and a competent good-faith insurance coverage review committee should question it if they ever see that clinical note.

              It sounds like LW could be in a different but parallel situation, but instead of “bloodwork” being used incorrectly as the marker of ‘no longer has condition x” it’s “weight” ie LW is no longer in the weight/BMI range to receive coverage under the formularies’ guidelines.

              If the med is effective in treating them and resolving their life hampering symptoms, and those symptoms return when the med is stopped, there is an underlying condition/disease that is still present. And it makes no sense to stop treating that disease, whatever it is. That’s the part they need to work with their medical team on to advocate for coverage for them through the insurance company’s appeals process.

      2. Hot Flash Gordon*

        Yeah, this is going to be the new norm for Wegovy. It’s very expensive and driving up costs for insurance carriers. It’s incredibly effective, but you have to stay on it forever if you don’t want to gain the weight back. It’s also been approved as a first line treatment for people with Type 2 Diabetes, so scrips are increasing. You’re going to start seeing insurance plans start to require prior-authorization for any use other than diabetes.

    4. Shiba Dad*

      Ran into a similar situation when I started my last job. Needed a refill for a medication for gout. Insurance turned it down stating that they didn’t cover that med but covered a different one, even though their website listed the med I was taking as a covered medication. When I pointed that out to the customer service rep I spoke to, they simply reiterated that the medication wasn’t covered. Not the end of the world as the other med works fine, but really annoying.

      Same insurance company also made my change to a slightly different dosage of another med. My pharmacist explained that happens because the insurance company has a deal with the manufacturer.

      This insurance company also reset our deductible “contributions” to zero on January 1st even though our plan ran from July 1 to June 30. They said they couldn’t undo their screw up but gave us extra steps to submit our claims so our previous contributions counted.

      BTW – this company is one of the largest, if not the largest, in the US. I’m not a fan.

      1. Shiba Dad*

        this company is one of the largest, if not the largest, health insurance companies in the US.

        For clarity’s sake.

    6. Happily Retired*

      General comment, not a specific reply to all: I’m seeing some internet-doctoring here (advising to try Ozempic.) Please, let’s don’t do this.

      1. Sloanicota*

        I almost wish the commenter had just given the situation generally without mentioning the name of the drug / condition, because everyone knows people will have trouble not commenting on that element otherwise. In this case, though, it is pretty important to understand that there’s some controversy around the medical requirement – but maybe they could have just said that. Of course, having OP hear that this is a field-wide issue is probably useful context; it’s probably not something weirdly specific to just this plan, unfortunately. So, mixed bag.

        2. Aggretsuko*

          People would probably deduce what drug it is anyway, like the holiday religion question the other day.

      2. amoeba*

        I mean, as it’s literally the same drug with a different name, I don’t think there’s any doctoring involved!

      3. Today is Thankful Thursday*

        It’s literally the same medicine. No doctoring needed to note that. Long time PCOS and diabetic here.

    7. Jenny Jingles All the Way*

      Oftentimes expensive drugs such as this have “savings cards” you can sign up for when you can’t get coverage through insurance. Co-pays in the $25 range.

      1. Jenny Jingles All the Way*

        Just looked up Wegovy’s Savings Offer and it says: “If you pay cash for your prescriptions or your commercial insurance does not cover Wegovy, you can save up to $500 per 28-day supply (1 box) of Wegovy.” Might be something to look into!

        1. Wowza*

          When the cash price of the drug is almost $2,000.00, saving $500 isn’t going to help much though.

          1. Random Biter*

            And if you’re on Medicare you don’t qualify for *any* of those “…your cost could be zero dollars…” offers.

      2. Burger Bob*

        It’s extremely rare that those savings cards give those kinds of prices unless your primary insurance is picking up most of the cost already. Most come with maximum payouts on them.

    8. AnotherOne*

      yeah, it sounds like the issue is more that LW1 may have gotten put on under their previous insurance so early that there weren’t any hoops to jump thru so they got grandfathered in.

      now, maybe there are hoops. you can only get approved if you first did X, Y, and Z. whatever. (I know that’s what a friend heard about going on wegovy.)

      i’m on botox for migraines and you can get if your doctor’s office first shows that you tried all sorts of things AND they didn’t work. (and that was only after insurers in my state were essentially sued to cover botox in any form.)

      It’s all sorts of annoying. And requires your doctor has a person dedicated to jumping thru those hoops.

    9. Atty at Health Insurance Company*

      OP, ask your company if they are “fully insured” or “self-insured”. If they are fully insured, they pay the insurer to cover you, and the insurer is on the hook whether expenses are low or high. If self insured, they are the ones paying the bill and the insurer is just managing the claims for them according the selected plan benefits. Many people don’t even know that their employer is self-insured.

      If Fully-Insured: The employer can ask for a rider to cover the drug in this type of situation. (I’m guessing this is the case because of how they want OP to submit an appeal.) The insurer may already offer a standard rider, but if not, they can always request a non-standard one be set up.

      If Self-Insured: The employer is the one paying so the employer can choose to pay for more than in the benefits if they want. You can lean on them to cover it, noting your personal facts (requested formulary in advance prior to accepting, etc, with caveats described above that while the drug may be covered for some indications, it may not be covered for yours.). All they need to do then is tell their insurer they want to cover the claims. They can also change the rules for what they want to cover via non-standard riders more easily.

      Weight-loss drugs are incredibly expensive, so while my company covers them, more insurers and employers are looking for ways to cut them. It’s an incredibly complicated situation, as covering them will likely cause premiums to go up (they have that big of an outsized impact as a new drug normally wouldn’t have that impact), but many? all? states also will regulate how much insurers can charge (RI just rejected premium increase requests) and employers are pushing back on premium cost increases. Here are two quick google links on the topic: https://www.advisory.com/daily-briefing/2023/08/07/weight-loss-coverage
      https://www.fiercehealthcare.com/payers/cost-isnt-only-reason-payers-hesitate-cover-ozempic-weight-loss-drug

    10. Christmas Cookie*

      LW #1- before you resign, consider proposing that the company make up the difference for you. I don’t know what the OOP for Wegovy is but depending on your role and compensation, another $1-2/month may not be an issue.

    11. Today is Thankful Thursday*

      Wegovy is semaglutide. It’s the same as Ozempic and Rybelsus. However, Wegovy is prescribed specifically for weight loss only. If OP is insulin resistant, ask to be switched to one of the other meds if your plan covers them. If not, check the manufacturer website for discount coupons and copay assistance programs. The most expensive drugs usually have them. I have saved a small fortune on Trulicity and other brand name only drugs using manufacturer assistance along with my insurance. Good luck OP! Your employer sucks for failing you after you did your due diligence.

  5. Captain dddd-cccc-ddWdd*

    OP1 (needed drug not covered on insurance) – how far away is the new plan year? I wonder if the company could cover (some of?) the out of pocket cost until then if the appeal isn’t successful. From a quick search it looks like the cost of this drug is around $1500 a month, which is a lot to you as an individual but not so much to the company – presume they are not short of cash if they are paying joining bonuses etc.

    1. Captain dddd-cccc-ddWdd*

      Or another idea – does your husband have his own insurance? (I wondered because OP said “I” a lot rather than “we” even though they both take the drug). If so, is there any possibility to get onto his insurance as a spouse?

      1. RedinSC*

        I was thinking this. Get on spouses insurance. This would need to be done quickly, if they’re in the US, there’s something like 30 or 60 days for a qualifying event to allow someone to add to an insurance plan outside of enrollment.

        1. ThatGirl*

          Depending on the company this can also be a problem – a few places I’ve worked charge an extra premium to add your spouse to your plan if they have health insurance coverage available through their job. (So if my husband were unemployed or his job didn’t offer insurance, no problem, but I’d need to prove it; since he has his own coverage available it’s an additional cost per month on TOP of the “employee + spouse” premium.)

          1. AnotherOne*

            yeah, but maybe LW1’s office would give her a “bonus” for not using their insurance.

            my office doesn’t do it. but apparently some companies do that. (someone at my office mentioned it because as good as our insurance in, some people’s spouses insurance is better.)

          2. Salsa Your Face*

            And mine flat out doesn’t allow a spouse to be on our insurance if they’re able to get their own.

        2. Dry Erase Aficionado*

          But in most cases in the US, OP will still be primary on their plan and secondary on the Spouse’s plan. If Primary insurance denied as patient responsibility, it is extremely unlikely that the secondary insurance will pay it as a plan expense. OP, if you decide to go this route, call your spouse’s pharmacy benefit plan and ask them about their coverage rules for something denied by primary insurance.

          1. Christmas Cookie*

            That is not true. I work in HR/insurance. OP can term her coverage and join husband’s plan, if it exists. OP getting a new job is a “qualifying life event” so coverages changes can happen mid-year.

            Specifics will vary by company but in many cases this is completely normal.

      2. Metier*

        I know at my company, putting a spouse or partner on insurance means footing the entire premium myself. It’s not a cost-saving solution even when drugs are covered, at least for me.

    2. Sloanicota*

      My only other thought, and I have no idea how realistic this is, is that some past companies offered to set up an HSA plan, where you can withhold pre-tax dollars for medical expenses. These still have restrictions but seem to be more flexible, for example they covered my lasik surgery when insurance wouldn’t. OP’s company could perhaps do this during the period they’re trying to straighten out this coverage (or is there an individual way to set it up, the way you could set up your own Simple IRA if there was no 401K option? I have zero idea). However, this may be a moot point if the drug is super expensive, and I know there are medications that are unbelievably high cost (and of course these are the ones insurance companies particularly don’t want to cover).

      1. Shiba Dad*

        Usually HSA is available for high deductible plans. There are also some lower deductible plans that have FSAs available. I’ll provide a link in a reply to this comment with a comparison of the two from a financial perspctive.

        My experience with an HSA wasn’t good. Long story short – I paid full price for an injectable med that I paid a Tier 3 copay on under the previous regular deductible plan. That pretty much sucked. With the med OP needs, I would assume something similar.

      2. Dilly*

        You can’t “just set up an HSA”. You must have an HSA-qualified high deductible health plan (this is a specific designation, not all plans with high deductibles are HSA qualified). And even if there is an HSA, the OP is still paying out of pocket, they are just getting a small tax break on it.

        1. PotteryYarn*

          Our company’s HSA reimburses us after the first $500 of the deductible until the deductible is met (effectively making our deductible $500). However, this is only for the medical claims, not for prescription.

        2. Garblesnark*

          This, and I’ve had “high deductibles” that were $2000 and “low deductibles” that were $7000.

      3. Smithy*

        Using this period so close to open enrollment for the OP to figure out if they can join their husband’s insurance as well as FSA/HSA options I actually think might make the most sense.

        I do know that trying to find a completely out of pocket option likely feels wildly unfair given that the drug had been covered under the last insurance plan and was on the list – but as others have said, the OP’s last plan could have changed the rules at any time as well. However, this is a way that gives you a lot more control going forward.

        Research/medical issues aside – the social issues around Ozempic/Wegovy are far more hot button – and so the risk of any one insurance policy not providing you that health coverage security long-term is likely more volatile in the near term. I was hearing someone in the medical field talk about a “negative side effect” of Ozempic recently that it wasn’t causing patients to eat healthier…..as though that was supposed to be part of what the drug achieved?? When I pushed back as to why that was specifically a negative effect of the drug, the person got huffy and then said we were just supposed to be having fun and things ended oddly.

        All to say – figure out a way to protect the medication that you need to live your healthy life. Cause this could get weirder and harder for a bit before it levels out.

  6. Et cetera*

    LW #1 – I’m in the middle of a very similar situation, so I fully understand how stressful it is. In my case, I’m Type 1 diabetic and a freelancer, so I’m currently paying an arm and a leg for AWFUL, barely adequate insurance because it’s one of the only ones on my state’s ACA exchange that covers the insulin I need (and have used for 2+ decades). A company I work for wants to bring me on full time in the next few months, but their insurance (which is better in every other way than my current insurance) doesn’t cover my insulin. They know this is a dealbreaker for me, so during a recent conversation they proposed tacking on an extra amount to my salary to cover the out of pocket cost of the insulin (which is similarly NOT SMALL). There are still kinks for to be worked out (for example, I plan on asking them to put in writing that this is a permanent benefit and also that the extra amount will not be factored into any future raise conversations), but… maybe that might be an option for you as well? I was pretty floored when this company even made the offer and there’s a part of me that won’t believe it’s real until I see it in writing (which is kindof a theme with this hiring process, TBH), but it’s a way out of an otherwise unsolvable problem for me. Dealing with this stuff on top of the stress of having a chronic condition is the absolute fucking worst, and I hope you get this solved quickly!!

    1. LJ*

      Can they structure it as FSA money? There might be some tax advantages and they won’t think of it as part of your normal salary

      1. Seeking Second Childhood*

        I’d say HSA though–the version that goes with you not with your employment.

        Unless I’m reading it wrong, it looks like FSA contributions are only available to you during the plan year AND while you work for the company.

        1. Hlao-roo*

          My understanding is that HSAs are only available for high-deductible health insurance plans. If the company has a high-deductible plan offering, I agree that an HSA is better than an FSA because the money is good for more than one year and stays with you when/if you leave the company. But if the company does not have a high-deductible plan than an HSA won’t be an option.

          1. Dilly*

            It must specifically be a HSA-qualified HDHP as not all high deductible health plans meet the criteria to be HSA-qualified.

            1. Retired Accountant*

              Yes, my ACA plan with an $8,000+ deductible is not HSA qualified. I think the deductible is actually too high to qualify. So I’d have to pay even more for an HSA high deductible plan with a slightly lower deductible (which is meaningless in practice). Sigh.

    2. Boof*

      Since you’ve got your own insurance, can you continue that + work for company? Maybe ask for a bit more since you won’t be on their insurance plan (which I presume incurs some sort of extra cost to the company)

    3. Anon for this*

      I really feel for anyone dealing with this! I have a chronic condition that requires an expensive medication — the generic costs $3000.00/month — and my insurance currently covers most of the cost. (The brand name version cost over $10,000.00/month. And there aren’t any cheaper alternatives.) Every year at Open Enrollment time I check that it’s still included in the formulary; I don’t know what I would do if it disappeared!

  7. coffee*

    #1, I’m struck by your use of the words “anxious” and “terrified”, and I encourage you to get some additional support for your mental health around this time, because it’s so hard when you feel like that. Your new job may have an employee assistance program, or your GP may be able to refer you to someone. There’s also anti-anxiety medicines which may (or may not) be helpful, and your GP is a good place to start for that. There have been some previous posts on this site about other resources you may be able to access, too.

    1. E*

      #1’s use of those words make sense, though — there are so many (most, if we’re being honest) medical professionals in the US who equate being overweight with basically any other health problem possible, to the point where people who are chronically ill get dismissed with, “lose some weight and you’ll be fine” and then sent on their way. This isn’t just about their anxiety — this is about how unfortunately the US medical system fails patients on a regular basis.

      1. coffee*

        I’m not saying they don’t have any reason to be anxious though! I’m saying that they are currently experiencing anxiety in a way that is negatively affecting their day to day life, and mental health support can be useful in that situation – they can help with strategies to manage the amount of anxiety so you can function better, e.g. being able to sleep.

    2. Junior Dev*

      Not every time someone experiences the emotion of anxiety is a psychological disorder. OP1 has a medication they need and they might not be able to get it; that’s inherently stressful. This frankly feels kind of invalidating.

      1. coffee*

        You don’t need to have a psychological disorder to benefit from mental health support. LW is feeling so stressed that she’s having trouble sleeping, and therapy can be a really helpful resource on how to manage that anxiety until the situation resolves.

        Let’s move away from the idea that mental health is only for people who are “properly sick” and towards the idea that mental health is for everyone.

        1. ceiswyn*

          That’s a great idea in theory, but in practice it tends to result in ‘mental health’ becoming synonymous with mild stress and mindfulness, and people with serious mental health issues find them minimised and dismissed. That happened a lot during the pandemic :(

          Suggesting mental health interventions for normal stress responses to stressful situations does read a bit like a step in that direction.

          1. Heather*

            But mild stress and mindfulness is part of mental health. it’s not a mental health crisis, of course, but it’s still valid. similarly to how someone who has a minor backache from sitting too much can benefit from stretching and exercise and suggesting that doesn’t invalidate the existence of someone with physical trauma from a car crash.

            1. ceiswyn*

              Sure, but it’s important to acknowledge that those are two very different kinds of backache and that the first is a normal consequence that does not need the same kind of interventions as the second.

              Someone with a backache from sitting too much does not need to see a professional to address it; they need to sit less (as you describe when you talk about stretching and exercise). And someone who is stressed due to a stressful situation does not need anti-anxiety medication, which can come with all sorts of side effects; they need for the stressful situation to be resolved. It is true that they will probably find extra support helpful, but that’s really friends-and-family levels of support rather than medical-professional-intervention kinds.

              1. metadata minion*

                “Someone with a backache from sitting too much does not need to see a professional to address it; they need to sit less (as you describe when you talk about stretching and exercise). ”

                I mean, they don’t *need* to, but I don’t see anything wrong with them asking their primary care doctor or a physical therapist for recommendations on what might be the best stretches to help prevent back pain.

              2. Orphea*

                Er, what? People absolutely do occasionally need medical treatment for situational anxiety and stress, especially if the stressor is persists for a while and/or is outside their control.

                And while every treatment has pros and cons, personally no anxiety medication I’ve ever taken has had side effects that weren’t absolutely dwarfed by the relief it provided. Prolonged stress has pronounced impact on mental and physical health regardless of whether it’s situational or not.

                People have so much shame and fear around seeking support for anxiety (whether it’s talk or drug therapy) because they don’t feel like it’s “bad enough” to deserve it, or they’ll be labelled drug seeking, or whatever. I suffered several years too long before getting treatment because it felt like something I “should be” able to manage on my own. Turns out I wasn’t, and I’m much healthier now that I have meds.

                Let’s please not gatekeep stress and mental health treatment.

                1. Anon For This*

                  I have low level anxiety for which I take a low dose medication (and even at points in the past have tapered off of because I didn’t need it), but twice I have had very stressful events that have sent me into a serious depression. Maybe someone without the underlying anxiety issues wouldn’t have needed additional medication, but I needed to go on antidepressants (both times, under 3 months) because I was just unable to function. Once the events causing the crisis had abated, I tapered down and off the antidepressants. Short term crises are real and some people might need additional help. Doesn’t mean they will always need it, but they shouldn’t feel wrong about reaching out and trying to get some–be that meditation, talk therapy, medication, or whatever works for them.

          2. Make it anon*

            I disagree that “consider whether professional support might be helpful to your mental health in a stressful time” has a diluting effect on the seriousness of chronic/severe mental health conditions. I’m someone who was greatly helped by therapy in a time that was very stressful for good reasons. If I had asked around instead of directly seeking therapy, I would probably have been told that my feelings were normal. They were, but they were also terrible and affecting my quality of life. Would discouraging me from seeking care in any way have benefited someone else trying to have their chronic or severe issues addressed?

            1. MigraineMonth*

              Yeah, I have a diagnosed chronic mental health condition that I don’t usually need therapy to manage. I’ve also had incredibly stressful times in my life when I’ve needed therapy.

              This is basically the reason EAP therapy exists: it’s for short-term stress, anxiety, disordered thinking, etc. You can’t even get long-term treatment from it.

          3. PlainJane*

            That’s why there’s an issue with “mental health” being used as a synonym for “mental illness.” They are not the same thing. Routine mental health care does not diminish serious mental problems that need medical attention. We shouldn’t blow off garden variety anxiety as just a “deal with it” situation. Granted, it doesn’t need major therapy, but, like a mild cold, you probably want to take a few measures to alleviate the symptoms.

            1. PlainJane*

              That said, I’m not sure therapy and pills are called for–there’s a real cause for the anxiety, and dealing with the problem is more of an immediate thing than a long-term work-out-your-issues thing. It’s more like finding some techniques to help you sleep and keep your mind calm… again, more mental health practices than mental illness treatments. All of which should be part of our regular repertoire, but for whatever reason, aren’t.

              1. Orphea*

                Insurance appeals can take a while, though, so even if this is a temporary stressor, OP might be dealing with it for a while yet.

                It’s a bit odd to me that so many people seem to think that the cause being something concrete and reasonably anxiety-inducing means that treatment isn’t going to be necessary/helpful. I’ve found mental health treatment immensely helpful when going through stressful events in my life — both talk therapy and drugs.

                1. PlainJane*

                  It depends on what kind of therapy. Something like psychotherapy would probably not be good, since that would be about discovering truths and examining things you might not understand well–in this case, OP knows exactly what’s wrong and needs help dealing. CBT or other behavior stuff would be good.

        2. Today is Thankful Thursday*

          coffee you are right on. It’s just support people, trained professional support.

    3. KEG*

      I get anxious and terrified when my employer’s insurance broker says the new plan won’t cover my child’s medicines. Therapy doesn’t do jack sh*t.

      1. Tones*

        Yeah and to me, seeking therapy feels like yet another costly insurance obstacle course to navigate, and i just don’t have the bandwidth *cry laughs*

        1. Sloanicota*

          I was just thinking, you know what’s NOT easy – finding a therapist that takes your insurance! And I assume those anxiety meds run into the exact same types of coverage issues from time to time! Our system really is so messed up.

          1. metadata minion*

            Yep. And even if they cover it, periodically they need your doctor to tell them that yes, the patient still has anxiety/depression/adhd/etc.

        2. J*

          I literally did therapy after having cancer and part of the therapy involved discussing insurance and the financial toxicity that came with treatment and the therapist had no idea how having me deal with insurance for each visit with her was contributing. Every single visit I’d get a slightly different billing code or something and it just got so stressful dealing with insurance that I gave up on therapy because it was actively harming me more than helping. The instant the second month passed without so many bills and EOBs arriving at my door, my stress was reduced more than any session’s homework.

        3. Turquoisecow*

          Yeah, I think the last thing the OP needs here is MORE complex medical issues with doctors and bills and insurance.

          Therapy is sadly not any less stressful to pay for and get coverage on than any other medical treatment in the US.

      2. uncivil servant*

        Sometimes terror and anxiety is just the appropriate response because it’s a situation with a really bad potential outcome. :/

        1. Macrina*

          This is true, but that doesn’t mean that everyone experiencing anxiety or terror about a tough situation has to go through that alone or without support. The world is full of things that are rightfully anxiety inducing, which is why we should work towards making mental health support more available for anyone who would like a little bit of help with it.

      3. NewJobNewGal*

        I’ve gone through this when insurance changes/drops coverage of my meds and my husbands meds. It’s a feeling of complete helplessness. Years of working with doctors to get meds ‘good enough’ goes out the window. You have a choice between poverty or sickness.
        There’s the crazy googling to figure out the best non-insurance price. Can I get these from a non-US pharmacy? But it always comes down to sacrificing a 2 week paycheck to the US Healthcare gods, or being sick and in pain.

      4. Dona Florinda*

        Right. No mental health support in the world can help when you’re worried that you may be evicted next month, or that you won’t be able to afford food next week. Or, in this case, that you may see yourself without much needed medication.

        That is not to say that mental health is not important (quite the opposite!), but let’s not sweep basic human needs under the rug of mental health support is enough.

        1. Today is Thankful Thursday*

          Yes it can help. Anxiety can prevent thinking well and making good decisions and taking action to mitigate the bad situation however you can.

      5. Anon for Now*

        I recently tried therapy (after being on multiple wait-lists for multiple months) and after two sessions realized that the things that were causing sometimes crippling anxiety and depression were external factors about which I was right to be anxious and depressed. Also, rehashing them with someone wasn’t particularly therapeutic. Obviously just my personal experience, and I didn’t entirely click with that therapist…but still, it’s not a panacea by any means.

      6. The Gollux, Not a Mere Device*

        Doctor: “are you unusually anxious?”

        Me: “I don’t think it’s ‘unusual,’ because [health problems we’d just discussed] and the world is on fire.”

        Doctor: “You have a point.” No mental health care intervention is going to fix my orthopedic issues, nor the world-is-on-fire ones.

    4. Liisa*

      lmao have you tried getting insurance to pay for mental health costs in the US lately?

      OP1’s feelings are completely understandable, and saying “oh, ‘just’ go get some therapy and/or drugs” is wildly unhelpful and, given how often doctors write off completely legitimate illnesses as “just anxiety” if you’ve EVER been diagnosed with a mental health condition, is possibly actually harmful.

      1. Aggretsuko*

        I’m trying to get insurance to pay for mine since I’m forced to get another therapist. Fun times, man. I have to use an alternate insurance and that confuses people.

      3. Orphea*

        I think what coffee is trying to say is that *while* OP is dealing with the situation and the stress it’s causing, it might be worth seeking out interim mental health support so they don’t have to tank the anxiety and sleep disruption unassisted. “This is stressing me out so much I can’t sleep” is a reasonable thing to take to a doctor or EAP, imo, even when the stress is reasonable and (hopefully) temporary. It’s not like running on empty makes filling out insurance paperwork any easier.

    5. MigraineMonth*

      I don’t know that it will be easy to access long-term therapy, but help dealing with temporary stressful situations is what most EAP therapy is set up for, if your company offers it.

  8. RedinSC*

    LW#1, This is totally stressful.

    One thing you could also ask is since your last company’s policy covered the medication, if your current company will pay for you to have COBRA (again, if in the US) to keep your old policy until the new enrollment year starts for them. They would, essentially, pay you what they would be paying for your insurance coverage and you put it towards COBRA.

    Again, this would need to be worked out quickly, as there’s 60 days I think (maybe it’s 90?) from separation to get your COBRA coverage.

    1. WellRed*

      I’m wondering if OP can get her job back? Long term, I’m afraid this problem will keep cropping up. Formularies change and not typically for the better.

      1. insurance woes are my life*

        I doubt going back to the old job would help here. As you say, formularies change regularly – if the new insurance company, which is a big one, is denying it for this purpose, it’s highly likely that the others will follow, including the old insurance. It may be a temporary fix until the next formulary list is released, but long term it’s not a solution. OP left their old job for a reason. COBRA would at least be a short (to 18-month) fix while still being able to stay at the new job. Presuming something could be worked out where the new job pays for it, it would be an ideal solution for at least until the old insurance requires an appeal as well (which really is bound to happen with drugs like this one).

        1. Relentlessly Socratic*

          Yes, if you look at any news page, you’ll see that a number of third-party payers are dropping coverage of semaglutide (Wegovy and Ozempic) as quickly as they possibly can. Just because OldJob covered it doesn’t mean that they will still be covering it now or in 4 months or whatever.

          1. SimonTheGreyWarden*

            This. I’m still covered for semaglutide because I still have prediabetes on my chart. My partner had it, but her levels dropped enough that she’s no longer prediabetic, and wham! no longer covered.

            1. Today is Thankful Thursday*

              Actual diabetics should still be able to get it. These meds were developed as diabetic treatments that just happened to have weight loss impact. We diabetics still need our new-generation meds!

    2. Anastasia Beaverhousen*

      Also look at ordering from Canada or Mexico through their pharmacies if it is not covered. You can get it at reduced cost there. You shouldn’t have to but it is an an option. It is absolutely infuriating that the insurance we pay for is able to determine what treatment we get when they are not medical professionals.

      1. Newp*

        Don’t bother looking in Canada for it – most provinces (might be all by now) have stopped sales of GLP-1 class drugs to US residents because it was causing shortages in Canada.

  9. Allonge*

    LW2 – would it be an idea for one of you to offer to take over scheduling these types of events and trainings from boss?

    She is obviously bad at it, most likely does not like doing it that much, and if the calendars are or can be made visible to all / at least one of you, it might be a win-win. I dont’t want to excuse what she is doing either way, and I know it’s extra work for you!

    1. Elsa*

      I was also thinking that someone else should be doing the scheduling. Anyway, scheduling is a very technical job and not the best use of the boss’s time. If there is a secretary or office manager then they could do it. If not then employees could take turns scheduling meetings for the team, or one employee could take on the role of scheduler.

      1. DataSci*

        I don’t think of scheduling as being even remotely technical, but maybe you mean something different by it than I do – it does require attention to detail and an awareness that timezones exist. But I disagree very strongly that it should be the job of the team if there isn’t an office manager or executive assistant available – that’s a management job. ICs are not interchangeable cogs, much as bad managers may want to think so, and someone in finance or software engineering is neither going to be good at scheduling other people’s meetings nor happy to have this dumped on their plate. I know I’d start looking for a new job immediately if my manager ever asked me to be in charge of scheduling meetings I wasn’t running.

        1. Allonge*

          Eh, depends on company culture but it’s something a manager should be able to delegate as long as people have or can be given the same access to calendars.

          I hate scheduling but once in a while it’s not that much of an issue (especially as our culture is more ‘check calendars and send a meeting request’ than ‘ask everyone in advance’).

    2. Ama*

      I don’t love scheduling — I delegate my team’s meeting scheduling to my own direct report most of the time — but I hate meetings at ridiculous times more, I’d be willing to volunteer to take the scheduling on just so I could have some control over when the meetings are set.

      1. House On The Rock*

        When I started my current job, I was initially thrilled to find out that I could have our department admin schedule meetings for me…until I realized that she’s already over-taxed and her solution to not finding meeting times that work is to schedule things at unreasonable times. Now I’d much rather do the legwork than keep asking not to have meetings at 7am, noon, and 5pm.

  10. Lilo*

    I know 6 AM would be problematic for me because I take public transportation and while the trains start running at 5, they come a lot less often, so getting there at 6 would take a lot longer. My kid’s before school hours don’t start until 7 AM so if this was during one of my spouse’s travel days this would be impossible.

    I will say most of these trainings I’ve done (which I would say were woefully inadequate so probably not the best programs) were just mostly a video. Why does this have to all be done at the same time instead of doing a learning module?

    1. Captain dddd-cccc-ddWdd*

      Actually that has just made me think. The training is “based” in a different time zone, but they are expected to be ‘at work’s which sounds like the normal workplace. So is the training actually “remote” from the trainer’s perspective? If it really can’t be moved fro. 6am I wonder if there’s an option to take it remotely from home instead of in the workplace?

      1. Ferret*

        I don’t think “at work” indicates that they are expected to be in office, and LW2 explicitly outlined why even remote attendance wouldn’t work for the team

      2. Allonge*

        I understand the importance of this particular training, but I find it really unlikely that 6am is the only time it works. It’s just not reasonable in a normally 8-5 job, even if you can attend from home.

        I get that there are companies that work in multiple time zones and some flexibility is needed for some meetings, but DEI training is something that should be offered in standard office hours. Chiefly because the audience being awake helps a lot for the success of the training.

        1. birch*

          This. It’s BECAUSE the training is important that 6am doesn’t work. It’s frankly ridiculous to suggest having work trainings outside of work hours regardless of what time that is, what training it is, or how much it does or doesn’t inconvenience particular people. Work trainings happen at work. Period. And pushing DEI training to odd hours just puts more power on the wrong idea that it’s optional or extra.

        2. Captain dddd-cccc-ddWdd*

          But I think it’s 6am because the trainer is in a different state/country (e.g. the trainer is in NYC and OP is in California, which are 3 time zones apart). I expect it is an external company, and that’s the time the training is offered. In that sense it’s the only time that works (without changing to a different training provider) because it’s an external dependency, the options are just take the training at this time or don’t take it. I think the DEI part is a bit of a red herring, as it would be the same situation if it was technical training needed for OPs job.

          1. Allonge*

            I see what you mean by the DEI being a red herring, but to me it’s actually a bit relevant in that while you need a specialized-in-this trainer, it’s not a subject where trainers are likely to be that scarce (she said hopefully).

            I still think that if I was invited to any training at 6 (in a regular office job), I would expect the trainer to be someone extra-super-special. Otherwise a training is a training is a training. I give trainings and I would be horrified to hear that the audience is starting at 6 am their time!

            1. Slow Gin Lizz*

              Yeah, you’d think it wouldn’t be that hard to find a DEI trainer in their time zone who could do their time. Come to think of it, even if the trainer is in NY and they’re on the west coast, does the trainer not have…you know…afternoon hours when they could do the training? Start the training at 1pm NY time and it’s 10 am CA time and everyone’s happy? (If that means the training lasts a few days instead of just two, that doesn’t seem to be a big deal.) This boss is a total dope. My only thought on this is that the boss gets a panicky “WE MUST COMPLETE THIS TRAINING ASAP” notion and schedules it for the absolute first possible time the trainer has available, which is ridiculous. Why not find a reasonable time a few weeks out that everyone can make it to that’s not at 6am? DEI training is very important, I agree, but in general there’s nothing about it that can’t wait a few weeks for everyone’s schedule to line up.

              OP, after you speak to your boss about this, if nothing changes, see if there’s someone above her in the organization who could speak to her about it. And if I were you and your team, I absolutely would not go out of my way to make sure I attend this training; don’t reschedule vacations, doctor’s appointments, etc. It’s on your boss if she schedules the training when someone can’t make it.

        3. Elspeth McGillicuddy*

          Honestly, unless it’s a LOT better than any corporate training I’ve been to, a lot of the staff would be zoning out at a reasonable hour. 6 AM? A corporate training? On something abstract? Everybody’s going to be propping their eyelids open with toothpicks.

        4. AngryOctopus*

          Well, it sounds like it *IS* being offered in standard office hours, where the trainers are. If someone schedules a meeting with my group that’s at 6AM their time, I’m not going to be asking if that really works for them. I’m going to assume that they work a 6-2 schedule and they want the training at 6 their time. This is assuming if I even notice, I may not be paying attention to their location. This is an issue of the meeting scheduler (the boss) being the one who didn’t think about the time zone complication.

          1. Ama*

            Yeah, given what else OP says about boss’s scheduling difficulties, I suspect boss didn’t even bother thinking about time zones, she probably talked to the trainer and the trainer said “oh I can do 9 am my time” and boss didn’t think about what that was in her actual time zone.

            It is not unreasonable to insist this training needs to be moved. If the trainer actually is the problem, they need to find another trainer. But I suspect the boss is the actual problem here.

        5. DataSci*

          I assume it’s that there’s one trainer, and they’re in US Eastern Time while the LW is in US Pacific Time. Maybe the company is based in Eastern Time and LW works from a satellite office? I’ve been on both the “no this meeting is at 7 am my time, that doesn’t work unless it’s critical” and “no this meeting is at 8 pm my time, etc” sides when working from different locations. Still, even shifting to start at 10 am Eastern and run a little later so that both locations are somewhat inconvenienced would be better than this!

    2. The Emperor*

      Because a remote learning module could be leaked to the likes of Christopher Rufo much more easily.

      1. GythaOgden*

        The other possibility is that there’s a component better facilitated by in-person interaction. I’ve done these kind of workshops before and it’s been easier to be in person for the sort of activity and duration that was planned. It was done as morning or afternoon sessions and it would have been hard-going to be on a three hour Zoom call.

        1. amoeba*

          But it’s virtual anyway, hence the weird time (different time zones)!

          I mean, 6 a.m. is obviously bananapants anyway, but I’d expect *at the very least* to be allowed to do it from home! I’d definitely still push back, but it’s marginally better than having a commute on top of the early start time…

          (If it’s fully online, full day, I’d ask about doing it from home anyways – I really dislike WFH usually, but this seems to be something where coming to the office would indeed be completely useless!)

    3. umami*

      Yes, I was wondering if OP can just suggest it be made available on demand rather than at a set time.

      1. Today is Thankful Thursday*

        This. I am missing anything schedled for 6 am, training or otherwise. That’s just rude and inconsiderate.

    4. Just Another Zebra*

      6am would be problematic for me, as well. My daughter’s daycare doesn’t open until 6:30am… what am I supposed to do? I don’t have childcare routinely set up to begin at, what, 5am?

      This manager just sounds completely out of touch, imo.

  11. NforKnowledge*

    LW2, I would in no way reschedule anything in my life, much less a vacation, to accommodate my boss’ failure to check a calendar! Let it be entirely her problem to reschedule and/or cry about how nobody attended the meeting.

    1. Noodles*

      Yes, exactly. I wouldn’t even try to see if rescheduling was possible. It’s entirely boss’s problem.

      I’d also not attend a 6 am training unless significant compensation was offered. Like the rest of the day off or something. It’s ridiculous. Just set the training for six months in advance at a normal time.

      1. Captain dddd-cccc-ddWdd*

        I think the training is actually a full day in itself! OP talked about 16 hours of training, and mentioned that there are two days that make up an ‘instance’ of the training. So they are looking approx 6am-2pm for this training. I suppose an early start makes for an early finish (hope the boss doesn’t say oh you have 3 hours left of the workday!).

      2. Eldritch Office Worker*

        I agree, but it sounds like OP would like to attend the training if they could. “I can’t make this and your scheduling is why” might have a different outcome than “no one showed up so boss assumes they blew it off”.

    2. Colette*

      Yeah, I think the OP needs to make the boss’s poor scheduling more of a problem for the boss. That means doing things like saying “Oh, I’m off that day so I won’t be there” or “I can’t start until 9:30, but I’ll join the training then”, but it also means being clear when rescheduling (“I’m sorry, we’re going to have to move this, I’ve been registered in a mandatory training that conflicts”)

    3. days of our lives*

      Lmao YES. My favorite part of this is she was upset over missing something that *SHE HERSELF* scheduled. Once, my toddler threw a coveted piece of cake she had asked for onto the ground intentionally, and then started to sob and wail. This reminds me of that.

    4. umami*

      Right? Just decline the meeting if it conflicts with your schedule, that’s why those options are there!

    5. A Simple Narwhal*

      Yes 1000%! The gall to ask someone to reschedule their PTO because they refuse to click the “Scheduling Assistant” button. And for something non-critical and non-urgent? Absolutely not.

    6. nm*

      Yeah, this is totally the kind of thing that drives me up the wall. “Well boss, since you approved my PTO *and* scheduled the meeting I thought you intended for me not to be there.”

    7. Polaris*

      I was once asked to re-schedule a surgery.

      I did manage to decline with a straight face. No, it was not a life-or-death situation necessarily, but being able to walk without pain is not a trifling thing either.

      1. Former Employee*

        I had a boss once who was a lovely person but who simply had zero emotional intelligence. She thought that if something worked (or didn’t work) for her, it would work for everyone.

        There was a week period where my spouse and I were, essentially, providing hospice care to our elderly cat and determining (with our vet) day by day if it was time to say goodbye. I’d told her that I might need some time off that week depending on how things played out and that I’d likely be a bit distracted. She was also an animal lover and totally understood, but her solution was to tell me to bring my dying cat to the office so I could monitor her there! She said something like “if she’s sick, she can just be quiet under your desk, right?”. I was so flabbergasted I think I sort of laughed/choked and then excused myself and decided to take whatever time I needed and ask forgiveness later.
        (she was very understanding when I needed to take a day off after we lost our sweet girl…again, she was a kindhearted person who just had weird ideas about some things).

  12. bamcheeks*

    LW2, I don’t know it this is helpful, but one of the things that you learn in time-management training is that IMPORTANT and URGENT are different things, and it feels like your boss is conflating them. Anti-racism training is IMPORTANT– but that doesn’t mean it has to be scheduled for the next available opportunity. In fact, for important stuff, it usually makes sense to schedule it for two or three months out precisely so everyone can plan around it and make sure they are available.

    This depends very much on how reasonable your boss is, but my script would be: “Hey boss, we all recognise the importance of this training, but the short notice and the fact it’s out-of-hours means that several of us can’t do it. Given it’s important but not urgent, would you be happy for me to check dates and find a time in October or November and book us on to it? If we put it in with some notice, we can all make sure not to schedule anything against it and we’ll all be in a much better frame of mind to get the most out of it.”

    To be honest, putting something in your calendars at 6am is so egregious that I don’t think your boss IS reasonable, but hey ho, it’s worth a try.

    1. bamcheeks*

      (Also, part of me doubts your boss’s commitment to the value of the training: she is behaving much more like someone who is being leaned on to Make Sure Her Team Has Done This Training and is trying to get it off her desk ASAP than someone who genuinely wants you to engage with it, IMO. How many people are able to focus when they’ve had to get up at 4.30am?)

      1. Allonge*

        I was also thinking this is a sign of, like, C-Suite deciding that all departments need to do this training by end of August or else, but even then the appropriate action from boss is
        – explaining this to everyone,
        – finding the day(s) where the least number of people are out (or delegating this if boss is not good with calendars),
        – telling everyone to cancel everything else work-related
        – and asking, nicely, the people who are scheduled to be on leave to change that (while offering some kind of compensation).

        Scheduling a training for a time that does not work for the boss themselves and being upset about attendance is pretty out there, though.

      2. Captain dddd-cccc-ddWdd*

        Yes, it seems clear to me that someone in HR (or whoever oversees it at this company) is leaning on managers to ensure everyone is ‘compliant’ by some fixed date.

        They probably have had plenty of time to fit it in, but I suspect boss is disorganised in all sorts of ways, so has kept putting it off (or just forgot about it) for months.

    2. Peanut Hamper*

      Thank you for this distinction. It is one that I think a lot of people have missed. (Adds sticky note to my monitor.)

  13. Retired Vulcan Raises 1 Grey Eyebrow*

    #2 If an organisation places any value on a particular training, then they must schedule it within normal working hours, as a mandatory part of the working day.

    1. münchner kindl*

      Yes. Originally I thought boss was undermining the anti-racism training by scheduling it a bad hour, so people will complain about the training, and not her bad scheduling.

      But if she generally schedules trainings at wrong dates, she’s not deliberately malicious, she’s unaware neglectful of her impact.
      Still, regardless of intentions, the result is bad.

      I wonder if a general approach of “Can Wakeen do the scheduling instead?” would work better than pushing back on specific instances, but that depends on how reasonable boss, and how much everybody already has on their plate.

    2. Pat*

      Yes! My company’s DE&I committee requires that the committee work be one of our official goals for the year. We had a half day strategy meeting a few weeks ago, and it was perfectly fine (and expected) that I would attend and be unavailable for anything else during that time.

      1. I Have RBF*

        That’s smart.

        I’ve worked for places where I got dinged on my review for mentoring junior team members because it wasn’t spending all my time doing “goals” that my boss demanded, but were impossible.

    3. Angstrom*

      We(USA based) have quarterly live training sessions with our colleagues in Europe and Asia, so they’re always going to be outside someone’s normal working day.
      We do them live because team members in all locations have said that they value the discussions and live Q & A. They are scheduled months in advance. And they are recorded for those who can’t attend.

      1. Retired Vulcan Raises 1 Grey Eyebrow*

        FinalJob was a large German engineering multinational with workers in several timezones.

        DEI and all other training was always scheduled for separately for each country or continent, to ensure:

        – noone was outside their normal working hours.
        – everyone was as refreshed and fit to learn as on a normal working day.
        – attendees didn’t resent the timing – which might have made them less willing to accept & implement the training.
        – the training was provided using the native language of each group.

        However, work-life balance is much more the expected norm in Germany, so that any request to work outside standard hours was VERY rare and only for emergencies, never for planned events. The Works Council and unions would not have allowed otherwise.
        Despite/because of these workers’ rights, we produced great products, on time, at a profit.

    4. Antilles*

      Do they place value on the training?
      The boss can’t be bothered to schedule the training more than a week in advance or check calendars. To me, that reads like the boss is just viewing this as a mandatory task, nothing more. Corporate sends an email of “your team needs to complete this training”, then the boss wants to get that box checked ASAP so she rushes to schedule it at the earliest possible opportunity to just be done and over with.

  14. Panda*

    OP #1 here. I did try to call the insurance company but they wouldn’t help me without a member id number.

    I also just discovered another medication that I take for asthma was on their list that is not covered. :-( Their sub for it is something I tried before and did not work as well. Ugh.

    1. Insert Clever Name Here*

      Ugh. I am so sorry you are dealing with this! What an absolute cluster.

      (LW1* here for those who search)

    2. Marmalade*

      I have a lot of sympathy for you – I left what had seemed like a dream job after 6 months because there was a 3 month lag to get on their insurance, and a month in I found out that a majorly expensive medical issue was completely not covered, the same day I got bad news related to that issue at an appointment. I applied for a job in the department on the other side of the wall from the one I had left that day, and started there 2 months later. It’s been 11 months since that day I found out and I have zero regrets about going back. (Turned out for the best since the monthly payment for my spouse, and our family deductible and out of pocket costs were comical and even with the pay cut, we came out WAY ahead when my spouse needed surgery on a herniated disc a few months later. I honestly don’t think we would have been able to afford it with the other insurance). I didn’t realize just how good the insurance we had was until I tried to use other insurance.

      1. Marmalade*

        I also went through their appeal process and basically was told that the state new job was based it didn’t require that to be covered, so they wouldn’t. My boss there was shocked to find out that something that is pretty basic and “easy” (but expensive!) wasn’t covered at all, so hopefully by the next time they were shopping for insurance a few other people quit over the same issue…

      2. Sloanicota*

        Isn’t it bananapants that people literally can’t leave their jobs and have to forego raises and career promotion because of these things?? So stressful and such a drain on our whole society. I realize most people here already believe healthcare should not be tied to employment but … it really shouldn’t.

    3. Pat*

      I did try to call the insurance company but they wouldn’t help me without a member id number.

      I ran into this when I was deciding whether to take a job. I kept having to repeat that I don’t have an ID number because I’m trying to get enough information to decide if I want the job. And I wasn’t dealing with stressful health issues at the same time. I’m so sorry you’re having to go through all of this!

      1. Sloanicota*

        Keep in mind, OP, several commenters here are suggesting this is a field-wide issue with these drugs, so without a diagnosis of diabetes it’s possible your old insurance was going to cut this coverage also :( Not helpful I realize.

    6. Data/Lore*

      It’s early for me and I haven’t made it through all the replies. I take several very specific and hard to get covered medications that are really expensive. Manufacturer savings programs are my go-to for anything I am unsure about my insurance covering. We go y has a discount program you should look into.

      With the asthma med, I have a similar thing where only one med works. Insurance asks me to try a different one every year or so, I try it, it fails a week or two in, and then they cover the one that still works.

      There are also companies your employer can work with that manage lowering cost for medications that are not always covered- my employer uses PrudentRX for specialty medications like immune suppressants (those things are *pricey*)

    8. Lalch11*

      I commented elsewhere but I really would encourage you to look into whether your employer has liability under ERISA. They cannot provide inaccurate benefits information to employees.

      1. AngryOctopus*

        It’s unlikely that the company was providing inaccurate information. It’s highly likely that the insurance company covers the drug for a very specific diagnosis, but not the OPs diagnosis. Or that the insurance company was in the process of changing things, so HR had their benefit list and gave it to the OP, and then two weeks later, surprise, it’s not on there! They are working with OP at the moment to see what can happen within the confines of the plans they have, so there’s not actually much else they can do at the moment. Just another example of how the system sucks.

        1. B*

          I don’t understand how you can conclude it’s unlikely that the information was inaccurate or, at least, substantively misleading? OP specifically asked about this issue before accepting a job. OP seems to have conveyed in at least general terms to HR that their acceptance of the job might be contingent on the terms of the health plan. OP received the answer they were looking for and therefore accepted the job. OP then was informed that the information they were given was NOT correct.

          There’s a lot of details we don’t know, but the broad outlines of this situation are egregious.

          We all get screwed on health insurance all the time and we do have very few rights in this area, but it’s reckless to claim that OP has zero recourse with such confidence that they shouldn’t even consult with an expert.

      2. nonprofit director*

        The OP is in a very unfortunate sitauation. One I can see from both sides, as the director of our benefits manager and as the partner of someone with a serious medical condition who has to get a prescription through a specialty pharmacy.

        I would give the company the benefit of the doubt, particularly if it is a smaller company and is in a take-it-or-leave-it relationship with insurance companies. Insurance companies do change formularies all the time and employers have no say in the matter. We are not notified of formulary changes and usually only update our records at annual open enrollment. In addition, many drugs appear on a formulary, but need prior authorization depending on the tier.

        In my experience with my partner, a drug that requires prior authorization is automatically rejected until an appeal with all sorts of justifications, including new medical tests, are provided. And then one has to use a specialty pharmacy, which is a miserable experience itself. And this authorization is only good for one year, when we have to do the entire frustrating process all over again, which means there is usually a gap of several months when he is not on his medication.

        I am beyond frustrated and very sympathetic to the OP. I don’t have an answer, many have provided good advice, and I agree with a well-reasoned and fact-supported appeal signed on and submitted by the doctor. Along with finding manufacturer co-pay assistance to help pay for it once approved, which makes the entire situation a lot less painful.

    10. CommanderBanana*

      I’m so angry at the HR person on your behalf – it’s horrible that they’re so cavalier about this!

    11. B*

      Nthing two suggestions made elsewhere. Contact EBSA at the US DOL and consult with a knowledgeable ERISA attorney.

      As shitty as health insurance in the U.S. is, there ARE rules governing employer-provided health benefits—a lot of them, in fact. And they are routinely violated. You may or may not have any recourse here, but do not decide without consulting with the legal experts, ESPECIALLY because you relied to your detriment on the representation that this drug would be covered.

    12. Rocky Mountain (not) High*

      I’m currently in a very similar scenario. I’m Type 2 and started Ozempic earlier this year, which has been immensely helpful in getting my diabetes under control quickly, as well as addressing a likely undiagnosed insulin resistance* that has allowed me to now lose weight that I’ve struggled with for years.

      My new insurance does cover it (with pre-authorization), but the plan is structured differently and I’m now paying almost $1K/month instead of the $25 copay I had at my last employer. This is the cost until I hit our deductible, then it goes down to a max of $125/month. I’m very lucky that I can absorb that cost, but it was a painful discovery that eats a good chunk of the pay increase I got in coming to this job. The cost of these class of drugs is immorally high, and that is the fault of both the insurers and the manufacturers.

      All that to say, I feel for you and I hope you’re able to come to a solution with your current job or return to your previous one without issue.

      *Of course, if I’d been able to get recognition and treatment for the insulin resistance issue earlier I probably wouldn’t have diabetes now, which is why it’s frustrating that insurance carriers (and many doctors) won’t consider these kinds of drugs BEFORE someone has a lifelong, possibly life-threatening, chronic illness.

      1. Today is Thankful Thursday*

        If you have insurance, get the manufacturers copay assistance! Has saved me a small fortune.

        1. Rocky Mountain (not) High*

          The manufacturer’s coupon is a maximum of $150 off whatever insane price is being charged. In my case, it takes it from $900 to $750 a month.

    13. Dry Erase Aficionado*

      The appeal process can takes months, so I would not wait until that is exhausted before starting a conversation with your employer about alternatives for covering your medication.

      One small upside though is that an appeal (or even a prior authorization) for your asthma mediation is likely to get approved since you have tried and failed the recommended substitution, and your healthcare provider will have medical records to support it.

      But it is going to likely be a time consuming and frustrating process for you. I am sorry you are dealing with it. Healthcare in this country is completely broken.

    15. Atty at Health Insurance Company*

      Call and ask them to send you any “step therapy” or “fail first” policies. If you’ve already tried it unsuccessfully, your provider should provide that information in appealing the decision.

  15. Cat's Paw for Cats*

    (…offer letters aren’t the same as a binding contract.)

    This is interesting. Is this because it’s part of an ongoing negotiation? Allison, I would love it if you could expand on this idea at some point if you have time.

    1. Eldritch Office Worker*

      It’s because they don’t say anything legal. They outline the position, salary, benefits, etc – but any of that can be changed moving forward. They don’t promise to keep you employed for a certain period of time, they don’t promise that the offer or employment itself won’t be rescinded for any reason, they’re vaguely equivalent to a letter of intent.

      Just like the employee has no legal obligation to stay at a job or honor the terms of an offer letter, neither does the employer. For that you’d need an employment contract.

    2. Cj*

      also, in the US it is very, very rare to have an employment contract. even if you get something in writing from the company, whether it’s in the offer letter or elsewhere, it’s not binding if it’s not a legal contract.

  16. Dog momma*

    While I feel bad for LW#1, the employer is correct, you just can’t change something in the contract re health insurance in the middle of the year. And if they aren’t able/ willing at all, they should be upfront about it. I agree with the appeal; however, it’s important to know if this medication is being denied as NOT MEDICALLY NECESSARY or is a CONTRACT EXCLUSION. She’s taking it for weight loss and there’s mention of insulin resistance. so there may be a chance here.. but the prescribing physician needs to write a letter of medical necessity stating why she needs to stay on this particular drug. Thus goes to the insurance company’s medical director for review and MIGHT BE, but not necessarily, overturned. If its a contract denial, its denied and that’s the end. The company may not want to cover this type of drug if its extremely expensive.
    If she’s on Medicare, same scenario but there’s a third line of appeal above Medicare that you can go to, however be advised this is a long process.
    retired RN here, who worked Utilization Management for commercial insurance ( under 65); Medicare and Medicaid; in various scenarios, for over 20 years. Hope this explains it easily for everyone.

    1. margarita water*

      With the amount of people taking the diabetic drugs for weight loss (which is an insane amount) Diabetes drugs went up by plan thousands of %’s. So Insurance companies are identifying them and and paying out on non-diabetics at the same rate they pay for weight loss drugs (which is usually zero %).By January when the new plans come out there will likely be none of these drugs covered on any Insurance coverage for them outside of people with a diabetes active diagnosis.

      1. Anastasia Beaverhousen*

        The insurance companies are charges thousands for insulin which hasn’t change in formula for decades. They are not doing this to be altruistic and protect those with diabetes. They are doing it because they are money hungry and don’t want to pay for a high cost rx that is helping people improve their health (weight is not just cosmetic it can have long term health effects).

        1. Happily Retired*

          Actually, it is a manufacturer who jacked up the prices. Similarly with Epi-Pens. Both life-saving treatments.

          1. Relentlessly Socratic*

            This. There’s no reason that semaglutide in an injector pen needs to cost as much as it does. Novo-Nordisk is raking in as many bucks as possible before the drugs go off patent.

            Novo is trying like heck to get payers to cover it–the press release about reducing cardiovascular events is just that, a press release, no peer-review data or even a conference presentation to back it up. But if they can point to CV reduced risk, then they hope payers will cover it.

          2. nonprofit director*

            Manufacturers and insurance companies are working together to bring us this “wonderful” system we have here in the U.S. I recently started listening to An Arm and a Leg podcast, all about medical costs in the U.S. Here is a link to an episode about pharmacy benefits managers, groups contracted by insurance companies to manage pharmacy benefits.

            https://armandalegshow.com/episode/pbms-2023/

      2. Cat Tree*

        Obesity is also a serious health condition though. We shouldn’t be saying that one chronic condition shouldn’t be treated because a different condition is more important. We’re constantly told that obese people are unhealthy, but now when they use a medication to treat their health condition, it’s framed as taking medications away from others with a more deserving health condition. Supply issues are real! But denying treatment to people with obesity doesn’t seem like a good solution.

        1. AngryOctopus*

          I think we all agree that “medically correct things to do” and “what the insurance company” says are two different things though.
          The bottom line is that the company is actually making a good faith effort to help OP, but the appeals process is truly the first thing, and then they can see about what plans might be available to add for next year. OP you do have to keep in mind that it might not be feasible for them to add a plan that covers what you need, so you do have to have some contingency plans ready to go if the appeal is rejected and they’re unable to offer anything that works for you.

        2. Sunflower*

          Obesity is not a serious health condition (beyond the health effects of biased treatment from doctors and the general public.) Maintenance Phase covers a lot of myths in this area.

        3. Today is Thankful Thursday*

          Many type 2 diabetics like me are also obese. But many folks taking diabetes drugs to lose weight are not obese or diabetic. It’s a fad and should not cause shortages for those with a true medical need.

        4. Burger Bob*

          Obesity is not always a serious health condition, at least not in the ways the pop culture conversation has led us to believe. There do exist obese people who have clean labwork, eat healthy, and engage in fitness activities but who nevertheless remain obese, and there are not-obese people who are the exact opposite. Weight and its relationship to health is a lot less clearcut than we are often led to believe.

    2. Nightengale*

      As a doctor, I wish I could just write a letter to the medical director of the insurance companies!

      Instead I have to fill out their specific prior authorization form either by hand or on the computer, which asks a lot of irrelevant questions. There is usually a text box somewhere that I can provide a brief narrative of why the patient needs the medication I am prescribing and their other options don’t make sense.

      Then it gets denied by someone with a checklist and no medical information who didn’t actually read my explanation

      Then I might be permitted to do a peer to peer call with a physician or pharmacist who usually listens to my explanation and approves it. At least one insurance company now is making me do an online appeal step (another form, not a letter) before getting to talk to a medical person.

      Writing a letter where I can explain my reasoning in full in the first place and know it would be read by a clinician would be AMAZING.

      1. Hot Flash Gordon*

        You’re lucky that you’ve been able to get it approved on a peer-to-peer. Some insurers employ physicians that essentially act as rubber stamps to uphold plan policies for non-covered treatment.

        1. Nightengale*

          my peer to peer success rate is certainly not 100% but often when I explain my reasoning (the kid didn’t take this formulary medication because they can’t swallow capsules whole but DID take the short acting version of the same thing) I do get the approval. Of course I had already written all that out already but no one with clinical knowledge had read it.

    3. fhqwhgads*

      It’s really annoying that the plan itself can change what drugs are/aren’t covered quarterly but the company engaged in the contract for the plan can’t change anything til the next plan year. Seems like a contract that one-sided shouldn’t be a thing, and yet here we still are…

  17. Grith*

    LW5 – I don’t like to be overly harsh to letter writers but – there’s an informal system in place to compensate you for the holidays you work and it’s your choice not to have been using it. Step 1 here is to actually use the process that exists, I’m honestly a little surprised that needed to be said.
    It doesn’t even particularly sound like your boss puts any pressure on you not to, just that you choose not to for no particular reason? And then are unhappy about it? As a minimum, I would just get in the habit of booking every day after a worked holiday off by default.

    The weekend coverage thing is a little different – if this was part of the deal you signed up for the you have no legal recourse, but that’s no reason you can’t have a conversation with your boss. It’s likely you didn’t realise when taking the job that “on call” is effectively the same as “working”, and it’s possible your boss doesn’t realise this either. Your boss needs to be told that the current setup is a problem and what will fix that problem, it’s then up to them how reasonable they want to be about it.

    1. 3DogNight*

      My thought around this is if this is every 4 weeks, LW1 isn’t missing EVERY holiday. Just a few. And there is the option (unofficially) to take a day off in lieu of.
      If you’re actually working the entire weekend, rather than just a random call here or there, then you need to bring that to your boss as well. I’d leave out the part about “if I leave”.

      1. Grith*

        I think they’re two separate issues?

        1) Has to work holidays, where it’s set up for LW to take days off in lieu, they’re just not doing so. That’s on LW and should be an easy fix – just do what you’re entitled and expected to do and have the next day off.
        2) Has to be “on call” every 4th weekend, which was probably sold as “have your phone on you these two days” and in reality, is more like “you will have to sit down and do a significant quantity of work for both of these two days”. That’s a less easy fix and basically hinges on if the boss realises this is the case and how receptive they are to doing something about it once told.

    2. DJ Hymnotic*

      Regarding the weekend coverage, more broadly this is a huge issue with being salaried and exempt. My team is also expected to provide 24/7 coverage, and some of us are hourly (including me) while others are salaried. Whenever I’ve been asked whether I’d be interested in pursuing one of the salaried exempt positions, I say no, and this is in large part why. Once you take into account the amount of free labor I’d be expected to provide while on call, I wouldn’t really be making that much more.

      All of which is to say, LW5, the weekend coverage sucks and I think that’s partly because, broadly speaking, we still have a work culture where providing that level of free coverage is considered acceptable. Alison even wrote a column a couple years ago about just how this sort of thing is endemic in American workplaces, I’ll find it and link it below.

      1. Parenthesis Guy*

        It’s not free labor if they’re paying you $200k to work 60 hours a week instead of paying you $50 an hour and only having you work 40 hours a week.

        1. Firecat*

          It’s adorable you think the OP is getting $200K. IME the people stuck with these schedules in back office settings are getting paid $45-$62K maybe $80K if they are lucky/negotiated.

          1. Parenthesis Guy*

            I was using the numbers for illustration purposes, not as actual fact. Maybe they ended up being more confusing than I intended. Even if the difference is $10k, my point still stands. Of course, if they’re offering you $110k to be full time and work 60 hours a week, but $50 an hour, then that’s a different case – but not the one I understood you as saying.

            Fully respect not wanting to work 60 hours a week. I’m just saying that it isn’t free labor.

    3. Orange You Glad*

      My experience is it is very common in the IT field to be working the “off hours” of the rest of the business in order to monitor systems and respond to any issues that come up outside of the 9-5 workday. I know we have an IT team that supports a specific software application – they have to work overnight at the end of each month to close the books. This is just part of their job, but they are never scheduled to work the day after an overnight shift and have a lot of flexibility to WFH and log in late/flex hours as needed for coverage and fairness. We also have a whole group in IT that I will never see in the office because they are doing the overnight and weekend support.

      If the workload is an issue, I agree LW should talk to their boss. Maybe they have some tips for managing the weekend issues or maybe they didn’t realize how much work it really is. LW does need to accept that this just may be how this job works and then decide if it’s the right fit for them. There are IT jobs out there that are strictly 9-5 but I think most would have a coverage/on-call component depending on the size of the company/team.

  18. HonorBox*

    OP1 – Definitely wait to see how the appeal ends up working. It may be that there’s a reasonable solution. But if not, ask HR. Like Alison said, you did everything you should have done to ensure the medication is covered, were told it was, and now it isn’t. Someone(s) provided you information that isn’t accurate. If nothing else, the signing bonus should be yours to keep. And maybe there’s a different solution they’re willing to look at to keep you there.

    OP2 – Maybe I’m reading this too early and maybe because I haven’t had any coffee yet… but your boss is either just completely out of tune with technology or an ass. Or maybe both. While you want to be reasonable in your tone when you speak with them, they absolutely need to be reminded that your calendars are all visible and giving people enough lead time for training allows them to perhaps shuffle their meeting schedule and be available. The most ridiculous part of this is your boss scheduling a training and THEY couldn’t even be there. That’s the dumbest-ass thing I’ve read in a long time. And then expecting the team to arrive 3.5 hours early for training is asinine. Have they considered the fact that you’ll also be wrapping up about 2:00 in the afternoon? Will they be expecting people to stay til 5:30? There are so many things wrong here. I hope after a conversation they figure out a better system because they’re going to start losing members of their team otherwise.

    1. NotRealAnonForThis*

      Nah, I’m sufficiently caffeinated and fully agree that the boss is either completely out of tune or an arse, or both.

      1. HonorBox*

        I’ve had my caffeine and still find myself leaning toward the boss being an idiot – both for the inability to look at a calendar and for how they’re expecting such an early start.

        And the more I think of it, if someone is asking their team to start 3.5 hours early for training, they’re really out of touch with how the team will benefit from the training. The team isn’t going to get the most out of the VERY IMPORTANT training because they’re all so far out of their routine and tired.

      2. MigraineMonth*

        Sounds like the boss scheduled a mandatory training at a time that didn’t even work for her. I’m chalking it up to incompetence at this task.

        1. I went to school with only 1 Jennifer*

          I think it’s what our British friends are calling “CBA” (can’t be arsed, meaning, bothered).

  19. Another Academic Librarian too*

    I had exactly this situation with a medication I take. It keeps me walking and talking. It’s not optional. It is super pricey and there is no generic. They switched the list between the time I was hired and the time I started. With a specialists doctor’s letter and a history of why THIS form of medication was medically necessary and an intercession by the administrator, (and lots of being on-hold with the insurance company) I was able to get my meds covered through the appeal process. It was a pain in the ass but it worked within 30 days.

    1. JustaTech*

      When I was having trouble with getting my medication (there are ongoing supply issues) the thing that ended up probably making the most difference for me was having earbuds so I could be on hold for hours at a time while I took care of my newborn.
      When the insurance people realize that you can and will wait them out, sometimes (not always) they’ll get you at least a temporary fix.

      But that’s a lot harder to do when you’re also working a new full time job.

      It all sucks and I’m so sorry LW1 (and everyone else who can commiserate!).

  20. Peanut Hamper*

    LW#5:

    My boss will let me take a day off in trade if I ask, but I don’t take advantage of it as much as I should.

    You need to start taking advantage of that. I know it can feel weird to ask for time off, but if this is part of your compensation for working those extended hours, it really is on you to take advantage of this so that you can stop feeling so resentful about your schedule.

    You’ve earned it! Use it!

    1. Sloanicota*

      I wouldn’t even “ask” so much as expect this to be given. It’s not the norm to work 12 straight days in a row and they probably don’t want to lose you (sounds like they’d have to replace you with two people!). Say to your boss that you have realized you need to make a change and then start scheduling your comp days immediately after “extra” days you work, wherever feasible. Maybe if there’s an important meeting you reschedule but generally, you take the next day off from now on. I say act like this is a reasonable request that of course they will be happy to provide, because they really should.

    2. umami*

      I would even suggest not ‘asking’ per se, just stating that ‘Hey boss, I worked on X day, so I’m going to be out on Y day.’ You can always tack on ‘please let me know if you have any issues with me being out that day’ if necessary.

    3. JustaTech*

      Yes1 Set up a little tracker that lives somewhere you can see it, like a corner of your screen, so you know “oh, I have 3 comp days, I should take them”.

      Or even better, when you are earning them (working holidays), plan *then* for when you’ll take them, like a 3 day weekend to go camping or to a concert or whatever.

      Says the person who is forever forgetting to use their PTO.

  21. NYNY*

    I feel very bad for LW1, but the insurance company may not feel that insulin resistance is a medical condition necessitating Ozempic (or one of its equivalents). Traditional recommendations by doctors for insulin resistance were diet and exercise. If LW1 is also pre-diabetic, that may get coverage.

    My plan is covering an equivalent, Monjourno, but every month I expect it to change.

    Most large employers self-insurance, so in effect they pay, but they go through an insurance company to avoid getting involved with employee health issues. No easy answers.

    1. Jaunty Banana Hat I*

      Honestly, what the insurance company “feels” shouldn’t matter. If your DOCTOR thinks you need it, the insurance company should do its damn job.

      Traditional recommendations by doctors before insulin was developed/widely available for pre-diabetes/diabetes were ALSO diet and exercise. The entire point of new medications is to treat these problems more effectively than they have been in the past/traditionally.

      1. Pescadero*

        “the insurance company should do its damn job. ”

        They are.

        The insurance companies job is making money for their stockholders.

        2. Burger Bob*

          Yes, this. Way too many people think insurance companies exist to be charitable. They don’t. They exist to turn a profit. Their entire business model hinges on a gambling game where they are hoping that you wind up paying them more than they have to pay out for you. They are not there to keep you healthy or make your medication affordable. They’re there to make a buck. And that’s how it will be until we finally decouple healthcare coverage from profit in this country.

  22. Harper*

    LW#2 – This doesn’t solve your long-term scheduling issue, but for the 6:00 AM training on Monday, can you all log in from home, since it’s an online training? Then work from home the rest of the day, or come to the office for a shortened workday when the training is over?

    1. Rosacolleti*

      Why should they even consider that? This is outside paid working hours! I would never expect my staff to work outside their contracted hours without asking them personally and negotiating time off in lieu.

      1. HonorBox*

        I don’t think the suggestion is entirely off-base, but that also assumes a reasonable and thoughtful manager like you seem to be. In the case of this particular LW, I think making that request would be a starting point for a larger conversation about how the boss is stepping on previously-scheduled appointments.

      2. amoeba*

        Yeah, I’m not sure whether the LW has flex hours or not – if she does, in principle it would be fine to start earlier and then finish earlier as well! And I’d say that would be the easiest way to resolve the issue if it were, say, 8.30 instead of 9.30. 6.00 is crazy though!

        But yeah, if it was offered, in general, I’d expect to be done with work after the 8 h training that day, not to work until my usual stop time!

  23. AnonymooseToday*

    I just want to say I’m so sorry you’re dealing with this OP1. This is probably one of my worst nightmares. I’m T2, on insulin and ozempic and one reason I’ve stayed at my horrible low paying government job is the health insurance. Insulin is completely covered and ozempic is like $30/month. Every other job I’ve been offered over the year, their health insurance is absolutely horrible and even if the salary was more money would be worse off of financially because of it. Wish I had some advice! But like Alison said, you totally did your due diligence, the company f-ed up.

  24. Rosacolleti*

    #1 where else in the world ties healthcare with employment- it’s insane! In the meantime can you opt out and arrange your own health insurance so you choose what you want coverage for – like in every other country?

    1. CoffeeIsMyFriend*

      that gets very expensive in the US especially if you need a plan that actually covers a reasonable amount

    2. I should really pick a name*

      We do partially in Canada.

      Direct interaction with doctors is covered by public healthcare, but drug plans are through your employer’s health benefits (unless you pay for one directly).

      1. Anon in Canada*

        Not every employer in Canada provides health benefits. If your employer (or your partner’s) doesn’t offer a drug plan, you’re on the hook to pay a certain percentage of your income on drug costs before your province’s “catastrophic drug plan”. For example, in Ontario, you’ll have to pay 4% of your income on prescriptions before you can apply for the Trillium Drug Plan to cover the rest. Prescriptions are covered for those on ODSP (disability support).

        Quebec has a universal drug plan (which is paid through an “income tax”, calculated on your tax return, separate of the standard income tax. it’s EXTREMELY expensive.)

    3. Prospect Gone Bad*

      I don’t think that’s how I’d frame this letter. It reads more like “they want me to take an alternative/generic drug instead” which can happen with any insurance plan. TBH that’s not the end of the world, been there/done that. You just need to ask your doctor for an alternative pill, the last time I did this it took a few minutes on the phone and that was it.

        1. ScruffyInternHerder*

          Its sometimes not as easy, either. I have to request (name brand) for one of my child’s prescriptions, because the generic uses a filler that she is (well documented) allergic to. Like not “upset stomach” allergic, full on anaphylactic shock allergic.

          And yet its an insurance debate, frequently.

        2. Just Another Zebra*

          Ugh, don’t remind me. I’m on a medication that I need to live. There is Brand Name drug, and there is Generic drug. Generic drug worked much better for me. I go to pick up my script, only to find out that Generic is no longer made. But I’m charged for the Brand Name drug, because “there’s a generic available”.

          Cue my yearly round-robin with insurance every January, when they charge me an insane amount for a Brand Name drug because I “opted” for it instead of the generic. Ok, please give me the generic. Sorry it is no longer made. Then don’t charge me full price for the Brand drug! But there’s a generic, so we have to…

          Every. Year.

        1. Burger Bob*

          But, there *is* Ozempic, which you mentioned, and Rybelsus as well. All the same active ingredient, but approved for different treatment purposes. It’s possible the insurance plan covers one of the others, and if so, it would be worth trying them if the letter writer never has before. Might be an easier fix than the appeal process.

          (Of course, there do exist drugs for which there truly is no real alternative at all, brand name or otherwise.)

      4. Nightengale*

        as a doctor

        99% of the “alternatives” suggested by the insurance are completely inappropriate for my patient or I would have prescribed them in the first place. They are not reasonable interchangeable equivalents. As far as generics, the pharmacy is already required to substitute the generic, if available, unless the prescriber specifies “brand necessary.”

        In some cases, the patient already tried the alternatives but I have to spend 20 minutes documenting this to the insurance. In other cases, while the alternatives are, on paper, other approved medications for the condition, there are reasons why they don’t make sense for this specific patient. Again, 20 minutes documenting this to the insurance.

    4. NotRealAnonForThis*

      I swear its an honest answer and its nowhere near as sarcastic as it looks: Yes, you could in theory opt out and arrange for your own insurance, so long as you’re independently wealthy.

      I live in a state where healthcare is considered fairly affordable (per Forbes, 11/2022). Average cost for a family of four on their own independent plan is pretty close to a mortgage payment in my area.

      Our system sucks and is completely broken.

  25. Lalchi*

    LW1 – it wasn’t clear from your letter what exactly was shown to you before you accepted the job, but your employer has obligations under ERISA to provide accurate information to employees. I would consult with an ERISA attorney about whether your employer needs to pay for the medication if they misrepresented the coverage to you. No guarantee, but maybe worth an initial consultation.

  26. pcake*

    LW#1 – you may get further faster if you stop referring to “insulin resistance” when talking to the insurance company and refer to it as “type 2 diabetes”. It’s a term that’s much better known, and it’s not a good look for your company to use an insurance company that doesn’t pay for a diabetes medication, regardless of whether it’s somehow become a fad weight loss drug.

    Can your doctor help by contact the insurance company and telling them his patient (you) is having great results and that other less-pricy medication didn’t have this effect?

    Funny that an insurance company wouldn’t cover it, though. You’d think they’d want less weight and diabetes-related illnesses to pay for.

      1. Lalch11*

        Ugh meant you can have insulin resistance without Type 2 diabetes. The idea is to treat the resistance before diabetes develops.

    2. GERDQueen*

      I also think it’s darkly amusing what insurance companies balk at vs pay no problem. They paid for less of my antiemetic than my dr. prescribed: I get that, the cost to them seems to be ~$700 US for 30 pills. I was shocked, however, that I now I can’t fill my birth control until I only have a few left for the month. I think they know the cost of the alternative is much higher.

    4. Broadway Duchess*

      This is bad advice. OP is likely referring to “insulin resistance” because she doesn’t have a diabetes diagnosis. It would be inappropriate to say she has diabetes just to get coverage and her provider would likely need to prove that with medical records before it would be approved.

    5. NeedRain47*

      Wegovy is specifically approved to treat obesity. The other, similar drugs are approved to treat type 2 diabetes. I don’t think any of them specify insulin resistance. I also don’t think the OP should lie, and her doctor will almost certainly not be willing to lie to the insurance.

      (not to mention that these meds have a black box warning and I know for a fact that this country hates fat people more than it likes making sure drugs are safe. )

    6. I'm Just Here For The Cats!!*

      Insulin resistance and type 2 are two different diseases. Untreated insulin resistance can lead to prediabetes and type 2, but they are not the same thing.

    7. InsulinResistanceIsNotDiabetes*

      huh? insulin resistance and diabetes are completely different medical conditions. Insulin resistance is a fairly rare condition where your body has to produce extremely high levels of insulin to keep blood sugar in line but is able to do so. Diabetes is when your body cannot produce enough insulin naturally to control your blood sugar. they are, by definition, mutually exclusive. Some people progress from insulin resistance to type II diabetes, at which time they are no longer considered insulin resistant.

      1. JustAnon*

        If your cells are insulin resistant, they need much more insulin to allow for blood sugar to be metabolised. That means that if your cells are insulin resistant, your body may not be able to produce enough insulin to keep the blood sugar in a healthy range. So yes: you can be insulin resistant and diabetic (type II).

  27. Bookworm*

    #2: No advice, just sending you sympathy. I would also totally support antiracism training but at 6 AM? Considering you have what is probably a “normal” work schedule (you know, business hours!) this sounds extreme.

    It sounds like your manager definitely has issues with time management and maybe boundaries? I haven’t had your experience but I have had a manager who would call/message people even though their time off had been approved and was on the calendar and would go “oops, LOL.” I do hope your manager is open to understanding why this is a problem for staff and wishing you good luck!

  28. Parenthesis Guy*

    If it’s in the prescription plan formulary, it should be covered. The challenge is that insurers can change that at any time. If I were you, I’d ask whether your plan is self-insured or not. If you’re not self insured, then you can complain to your states insurance administration about this. If not, you probably need to file an appeal.

  29. Shieldmaiden793*

    LW2: As a West Coaster in a fully remote org, it’s apparent to me that by majority only West Coasters have to learn about time zones. I kid, but East Coast bias is real.

    I usually try to negotiate anything before 8 am (when I start) and outright decline anything earlier as the situation affords (depending on the politics of doing so). My boss is forgetful so this happens occasionally. They will try to fix the mistake, or excuse me out of the meeting if it can’t be moved. I’m not sure if your boss is incompetent or malicious, but there’s an axiom about that.

    1. AngryOctopus*

      We always feel bad on the east coast in my job because it’s almost impossible to schedule meetings with San Diego and Switzerland at a time that is decent for both of them. Alas, they make it work and I’m sure take comp time!

      1. amoeba*

        Hah, yeah, we have the same problem in Europe whenever we have people from both the US (mostly east coast, luckily!) and China! And then add to that that people here *really* don’t like having their lunch hour scheduled over…

    2. Aggretsuko*

      I get so tired of everything being listed as East Coast only unless it’s specifically located on another one.

    3. Orange You Glad*

      As an East Coaster, I try my best to accommodate my West Coast colleagues. I’m not a morning person at all so any excuse to have a meeting later in the day works for me.

      I recently completed a training program run by a company on the East Coast but with most participants in California. I was surprised how many 10 am EST meetings were scheduled without any pushback. Whenever we met as small groups, I always offered later meeting times but everyone I worked with out west was morning people so the early meetings continued.

    4. Harried HR*

      On the flip side it is very frustrating to be assigned an Account Manager on the West Coast when I’m on the East Coast. I can’t schedule meetings before noon and have to stay after my normal hours if I want to get anything done. I didn’t request the West Coast Account Manager and I’m not “allowed” to change managers for this reason – **smh**

    5. JustaTech*

      One time some folks at our East Coast site tried to weaponize the time zone difference to prevent some West Coast people from participating in a project (that we were really needed on).
      “Sorry, West Coast, 9am was the only time we could all meet!” *chuckle*
      (My boss) “No problem, I’ll call in from bed!” (And he did! But audio only.)

    6. dryakumo*

      People at my org are generally understanding about time zones, but corporate is on the West Coast and so often they schedule company-wide stuff right before lunch for them, which ends up smack in the middle of lunch for those of us in Mountain time…fortunately they’re not usually camera-on type things and most of us just eat during the meeting.

  30. This_is_Todays_Name*

    LW1: If they end up landing on “we can’t/won’t cover Wegovy” and you WANT to stay, ask for an annual bonus that would cover your out of pocket expenses! At one of my former companies, the annual deductible changed and one of my employees had a wife with a chronic condition (MS) and since the deductible ALL had to be paid up front before insurance would kick in at all, they’d have had to pay $3K for her meds for the first 2 months of the year before insurance kicked in. I was able to get an annual “retention” bonus approved for him to be given January of each year so that he could use it for his portion of the medication. YMMV, but it’s worth asking about if you really do want to stay …

    2. LJ*

      Good for your employee, but isn’t every employee in the situation of having to pay their deductible first?

      1. LJ*

        I guess I’m saying the company shouldn’t be in the business of judging who’s health condition qualifies for extra help. It really is a retention bonus in this case because employee would leave without more money

        1. This_is_Todays_Name*

          Yes, and that’s how I approached it with Leadership as “employee will leave us … can we incentivize him with a retention bonus of $XK?” It was the medical plan that started the ball rolling, but it was his threat of leaving that got the bonus.

      2. This_is_Todays_Name*

        Yes. But his was an unusual circumstance and he brought it to me with a “I will have to look for another job if this is going to be our medical plan because it’s not sustainable for us with my wife’s MS.” He was a very niche skillset and our govt. client LOVED him and he would have been hard to replace, hence the “retention” bonus to keep him from leaving. It wasn’t phrased as “we’re paying your deductible for you,” but rather as “here’s a bonus as an incentive to stay for another year.”

  31. RagingADHD*

    I now work in the corporate offices of a healthcare company, and there is a huge push by insurers to reduce costs, and the criteria they use largely follow the parameters set by Medicare.

    Ozempic, Wegovy, etc. are now only approved if the doctor uses very specific combinations of billing codes that document an “allowed” diagnosis. Weight loss is not generally one of them, even if there is insulin resistance involved. Moreover, the doctor must re-document the correct set of codes at every single visit and prescription refill. So if they document an initial diagnosis of a chronic illness, but then in later visits list record it as “history of” the illness instead of “active”, well then whoopsie – the patient no longer qualifies for the drug, even if they still have the illness.

    There is a whole swath of the industry just based around reviewing medical charts to make sure are coded correctly, because it is so freaking complicated that even the doctors don’t always understand the right way to do it.

    1. ScruffyInternHerder*

      I have a very dark sense of humor, I know, but I find it ironic that though doctors continually default to “just lose weight and everything will be fine” instead of looking at chronic conditions that actually need some care, here we have insurers taking something that’s actually proven to help people do just that, and are denying coverage.

      1. Friendo*

        The thing is that what RagingADHD is talking about is the parameters set by Medicare, and Medicare is just following what’s gotten FDA approval.

    2. Relentlessly Socratic*

      MDs also typically do not stay on top of insurance coverage issues (Like they would have time to do that anyway). One of my MD friends was shocked at a charge on her own medical bill and asked us “Do people really get charged for this??” Yes, Blossom, we do. Welcome to the other side of the mirror.

      1. Firecat*

        Yeah especially since it’s feasible for a single Dr. to have over 100 insurance plans for their patients which each have their own coding and charting preferences.

    3. virago*

      “There is a huge push by insurers to reduce costs, and the criteria they use largely follow the parameters set by Medicare.”

      I wonder if Medicare will look on Wegovy differently now that Wegovy has been shown to drastically reduce the risk of heart attack and stroke.

      Google “Wegovy heart attack stroke” (without quotation marks) and you’ll see stories about a Novo Nordisk trial of Wegovy that resulted in a 20% reduction in risk of cardiovascular complications compared to a placebo.

      The findings were based on a double-blind late-stage clinical trial involving 17,000 adults ages 45 and up who received Wegovy or a placebo in addition to standard care.

      Granted, there are some qualifications to these findings:

      1. This is a drugmaker reporting on a trial of its own product.

      2. Novo Nordisk hasn’t released the full trial results yet.

      3. Experts say it’s too soon to draw any major conclusions — such as how Wegovy works. They say that it would be surprising for weight loss on its own to reduce cardiovascular risk factors by as much as 20%.

      *But* if further study does bear out these initial study results, this could be very good news for a lot of people — especially if Medicare (not to mention private insurers) decide to cover Wegovy.

      1. Relentlessly Socratic*

        Yeah, this was a press release and they haven’t had the data peer reviewed and published. It’s not even been presented at a conference (which still doesn’t meet the bar for evidence in most cases).

        Google Novo Nordisk’s Ethically Questionable Wegovy Publicity Stunt and read Ragen Chastain’s post.

  32. Student*

    #5: In addition to what AAM said, double-check that you’re still making above minimum wage when considering the actual hours worked in a week and your salary, especially for the weeks where it sounds like you are working every day of the week.

    Look at your state minimum wage rules in addition to the federal rules. That can be a violation of the minimum wage law, even for exempt folks, but it generally requires working a whole lot of hours in a week and a relatively low salary within the bounds of exempt work.

  33. NYNY*

    For all the people complaining about US healthcare, I have a friend in a country with socialized medicine, and they will only cover Ozempic/Wegovy/Mounjaro in VERY few cases, unless diabetes.

    1. londonedit*

      Yeah, there’s been a lot about it in the press here recently because the NHS has just started prescribing it in certain cases for people with type 2 diabetes (alongside changes in diet and exercise) and for severe cases of obesity. There’s been a lot of hand-wringing about the whole thing and whether people will abuse it because of the TikTok influencers etc, but you definitely can’t just rock up to your GP and get a prescription.

      Also, I put this under a now-deleted comment, but anyone from the UK who’s tempted to make a ‘US healthcare sucks and is insane’ comment should sit up and take note of the fact that if we allow the current government to continue their systematic demolition of the NHS, this is what we’ll end up with. And then we won’t be quite so smug.

    2. Retired Vulcan Raises 1 Grey Eyebrow*

      a country with “socialised” medicine

      You mean a country that doesn’t weirdly tie health insurance to employer.
      So that’s just any other Western / industrialised country, many not soicialist at all.
      Some countries’ systems will cover certain new drugs and some won’t, often because of a conservative assessment of effectiveness vs risks/side effects of those drugs and wanting to wait for more data. The US does tend to roll out the newest drugs more quickly, but that’s not always beneficial to patients.

      Main difference in everyday life is stability & continuation in healthcare: patients don’t have to fear losing access to their current meds or their families’ meds whenever they change jobs – or whenever their employer changes to a cheaper insurer.

      1. Jaunty Banana Hat I*

        Socialized medicine is the correct term for health insurance covered/administered by the government. The government itself doesn’t have to be socialist to have a socialized healthcare system.

        1. Burger Bob*

          This. And there are a lot of countries with some version of what we in the U.S. would call “universal healthcare” that do NOT have it provided by the government, so it isn’t “socialized medicine” in the true sense of the term.

    3. Sloanicota*

      I had a comment on the deleted thread to this effect also. There are a ton of problems with our system but this specific issue is not necessarily one that other countries avoid. The NIH could also decide certain treatments are too expensive when they consider the alternative (in this case, the ole “diet and exercise” – but in other cases might be a generic or something) – to be sufficient per dollar . This sucks hard for someone like OP who has found something that really works for them but it’s not unique to us.

      1. Retired Accountant*

        There’s a book called “The Healing of America”, the premise of which is that the author, a journalist, develops a shoulder problem (I assume arthritis but can’t remember) and seeks treatment from an ortho in the U.S. The ortho tells him “you need a shoulder replacement, let’s get you scheduled and you’ll be good as new.” The author took his shoulder problem to doctors in various other Western medical systems. He saw an NHS doctor when he was working in England, and the doctor told him “just learn to live with it mate”. The book was not an apology for the U.S. system and the author said that was not the worst advice in the world.

        1. londonedit*

          I mean, people absolutely do have shoulder replacements on the NHS. But it’s true that the NHS is more likely to try physio or other treatments first, rather than going straight to surgery. Also that was obviously just one doctor’s opinion. All I know is that every member of my family (including me) has had fantastic treatment from the NHS, and I can’t imagine the amount of money we’d all be paying for the various medications we take and the ongoing treatment and care we receive.

    4. RagingADHD*

      Right, it’s not as if nationalized healthcare doesn’t try to control costs. There are a lot of things that aren’t approved / allowed because they are too expensive. Now, the vast majority of fundamental healthcare isn’t dependent on the newest drugs, so it is a huge benefit to individuals and society to be able to get your insulin or your appendix or your cancer taken care of without having to worry about it.

      But guaranteed healthcare for all still doesn’t mean everyone gets every single treatment a person might possibly benefit from, with no limits.

      1. Retired Vulcan Raises 1 Grey Eyebrow*

        Yes, every system has to control costs (or go bust).
        However, healthcare availability/cost should not be a roadblock, or even a consideration, when someone wants to change jobs within the same country.

        The difference in almost all other Western countries is that whatever meds/healthcare someone can access remains constant, instead of changing with a new job or indeed their current employer switching or even completely dropping their insurance. One less thing to worry about.

    5. NeedRain47*

      sounds like they’re using it appropriately there, instead of off label b/c everyone hates fat people.

  34. Parenthesis Guy*

    #5 – I’m highly perplexed by your letter. This is usual for system admins. They need the systems up 365/24, so they need someone on call at all times.

    Since you’re expected to work extra hours regularly, your base salary is higher because of it. In other words, they won’t pay you overtime for working these hours, but they will pay you a base salary of $150k instead of $120k.

    Your offer letter probably should have stated that you’re expected to work 37.5 hours a week, plus a weekend every four weeks on call. But yeah, the trade off is that system admins make a lot of money in return for working crazy hours. If you’re not making a huge salary, you should probably look for a new position.

    1. I Have RBF*

      What is not usual is that his weekend on-call ends up being full time hours doing petty stuff every time.

      I am a sysadmin, primarily Linux, and have been for nearly 25 years. I have had normal on-call rotations, one week in 4, 24×7, that seldom called me out of hours.

      I have had other on-call rotations that were only 12 hours a day, but that 12 hours was sitting in front of a fire hose of alerts, most badly designed and not actionable, for 12 hours a day for 7 days, unable to get anything else done since they wanted all alerts answered within 15 minutes. They actually tried to get us to sign a paper saying we would answer all alerts within 5 minutes. I refused, because I would have had to wear diapers to do it (supposedly you could ask a teammate to take over while you’re in the bathroom, but that didn’t work outside of normal working hours) and go without meals.

      So basically, most on-call is lightweight, without non-emergency “emergencies” on the weekend. But some places are unreasonable, or encourage people to abuse the time of the person on-call.

      The better places, IMO, give an on-call bonus for each on-call week. This helps when some doofus calls you at 6 am on Sunday because they can’t get their email to send from home. Not an emergency, but some people have no ability to wait for reasonable hours. (This is why I will no longer do end user support on Windows.)

      1. Parenthesis Guy*

        “I am not paid extra for this and there’s always work to be done on both Saturday and Sunday. When it is my weekend, it means I work 12 days in a row.”

        I’m not convinced this means that the LW is working full time Saturday or Sunday each time. I was presuming it seems more like they have an hour or two of work. If they are working him 16 hours on the weekend, then I concede your point.

        1. I Have RBF*

          Yeah, it read to me like his on-call days were as full as regular work days. If it’s just an hour or two of actual urgent stuff, then no, it’s not abnormal. I’ve had both types of on-call happen to me. The fire-hose place I definitely wanted the on-call bonus we got.

  35. Former Retail Lifer*

    OP #1, have you checked to see if you can get a discount through Good RX or Cost Plus Drugs (Mark Cuban’s discounted drug venture)? My mom has had success with both for prescriptions her insurance doesn’t cover, and something she was taking was cheaper than her insurance through Good RX.

  36. Pikachu*

    I’m sure I’ll get flak for this advice but it might be worth a trip to Mexico. Ozempic is freely available without a prescription. I don’t know how the cost compares to the US, and I’m not sure about Wegovy equivalent, but it’s an option worth exploring.

    1. Firecat*

      Wegovy/Ozempic expires when refrigerated after 4 months so it’s not like you can do an annual year supply run.

      1. Pikachu*

        Ohhhh didn’t think about that. I don’t know anything about the meds themselves. The person that I know gets it in pill form. Maybe it’s a different variety, but it has the same active ingredients. A real doctor would have real answers I suppose, and I certainly am not one!

        Even if a supply doesn’t last forever, it could lessen the blow in the short term. But really it’s just a crap situation for anyone to be in.

  37. EA*

    LW5- this is totally legal and part of the position and field that you’re in. It’s like someone becoming an ER doctor and then getting annoyed they can’t work a 9-5 schedule… the 24/7 on call coverage is part of the gig. If you think you’re underpaid, you should negotiate a raise and definitely take advantage of the holiday replacement days.

  38. PRM*

    #3 I started a new job in Dec. 2017 14 months into a divorce filing (contested; litigation in two countries; don’t ask). I also work in higher education manage a small staff team that supports an academic department/report directly to the department chair/have a good culture of accommodating folks. I was completely transparent, even though the chair didn’t know me from Adam. Life happens. My chair knew that my need for such flexibility would pass.

  39. anononon*

    I’m a trainer, and I work all kinds of weird and wonderful hours to ensure that my course attendees don’t have to start stupidly early or end stupidly late (I’m in the UK, so 4am starts classes in Asia, or 10pm finishes for classes in the USA, for example). But that is my choice (and I work flexibly to make sure I don’t end up doing stupid hours.

    I’m amazed that any *reputable* training company is expecting course delegates to be online AND IN A FIT STATE TO LEARN at 6am…

  40. CSRoadWarrior*

    #4 – Yes, leave it off. I had personal experience with this. Twice, as a matter of fact. And none of those two jobs are on my resume or on LinkedIn. It has never been an issue. At most, any prospective employer would just look at it as a short gap. And 2.5 months isn’t even a big deal. You have nothing to worry about.

  41. thisiska*

    I’m in a similar situation to LW4, but I wasn’t laid off from the original job. I left my previous position (of 3.5 years) by choice at the end of April and started a new job in May. I’ve found that it’s just not a good fit and I am going to accept a new job offer by the end of the week and will start in September. This will look like a 4 month gap on my resume if I leave it off – and possibly look like I was let go from the first job. I feel like I should leave it on for now to not have a gap, but pull it after a year at my new position? Any thoughts?

  42. bunniferous*

    re letter one, let me encourage you that the appeal may very well work. I have a husband on a lot of medications and more than once insurance companies try to act like they know better than our docs do what meds he should be on-we have had good results with appeals. But if I were in your shoes I would be VERY ticked off. If I were you I might start looking for another position while going through your appeal process just in case.

  43. Mary PopTarts*

    For #5 – I wanted to point out that in California, this would not be legal. This is due to a successful lawsuit years ago by salaried IT employees about their unpaid overtime. As a result, many IT employees in California must submit timesheets (and limit their hours) even if they are salaried.

    My husband worked for many years for a big tech company and had to submit timesheets, plus was limited to 40 hours a week.

    I would also agree with the other posters’ comments: 1) weekend work is to be expected in this type of job and 2) absolutely use the comp time offered to you – you earned it!

  45. PlainJane*

    The problem with LW1 going the route of telling her new boss that it was a condition of her taking the job is that she’s moved out of that range of choice, which is why it’s absolutely infuriating that the company is putting her through this. She doesn’t have the option of saying, “Well, I can’t work here anymore,” because that door is closed, and they know it. If she can’t afford the pill when she has insurance for everything else, what if she lost THAT insurance by leaving the job and had to pay the rest of her medical expenses out of pocket? (Health care options need a serious reform and to be divorced from where you’re working. This is not a feasible situation we have here.)

    Of course, the other issue is that Wegovy is somewhat controversial and insurance companies are dropping it all over the place. Is there a chance of your doctor prescribing something else that would help with insulin resistance?

  46. Jeanius*

    LW#1-another option is checking if the mfg offers assistance when their medication isn’t covered. I was able to be approved for a different, also very expensive and not covered, drug at no cost through the mfg “safety net foundation”. Had to jump through some hoops but ultimately was approved. Good luck!

  47. NP08*

    I feel for you, writer going through divorce. I’m in a similar situation and torn about telling my boss because I don’t want to seem distracted or like my life is always on fire (I’m in a new job), but it’s also really hard to get through a meeting without crying when my husband just texted me right before saying he’s moving out next weekend and when should we tell the kids. Balancing life and work is really hard sometimes.

  48. Veryanon*

    Scheduling a training session at 6AM is not reasonable under the best of circumstances. Scheduling it with very little notice is even less reasonable. Maybe your team as a group could push back on your manager and just let her know this is not going to work for you.

  49. Anon in Canada*

    #1 – Yes, insurance plans can change, and if say her medication was delisted from the formulary a few weeks after she started the job… that would still be awful, but I think the company would be within their rights to ask for the signing bonus back.

    But it doesn’t seem to be what happened – it appears that the company provided her a formulary that contained wrong information at the time it was provided. If this is the case, the company is in the wrong and should either honor their word and compensate the cost of the medication, or let her out of repaying the signing bonus if she leaves.

  50. FormulariesChangeConstantly*

    OP1, this type of thing happens all the time. While it’s most common at rollover time, plans typically reserve the right to change their formulary at any time. If you have a formal insulin resistance diagnosis from an endocrinologist they should be able to get you coverage if this is the drug that successfully treats it. Typically, this will require using the prior authorization process and showing a medical need for the drug (weight loss will not qualify; insulin control – what someone with a formal insulin resistance diagnosis needs – should).

    Without the medical support from your treating endocrinologist appeals to the insurance company are unlikely to do anything.

    If you do choose to leave, be aware this may be an ongoing issue at future employers unless you have that authorization from your doctor showing medical need, especially for a drug that so many people are trying to take strictly for weight loss rather than for underlying medical conditions it was designed to treat.

    Good luck!

  51. Tute83*

    LW1– as long as healthcare is tied to employment, this will be an issue pretty much anywhere you might go. Reason number 3,246, 310 for universal healthcare.

  52. Letter 2 update*

    hi all, Letter Writer 2 here! I have an update, and some clarification. I was trying to keep it short, and I left out some things. thank you all that have offered advice and sympathy! I can’t possibly respond to everyone, so have a blanket virtual hug of gratitude!

    first of all, some clarifications: 1. I work at a tiny nonprofit. we have 5 staff total. so there is no HR or corporate. the only “manager” I could go to above my boss is the board of directors, which is all volunteers who are buddies with my boss. 2. I do not have to reschedule vacation this time, but I would have to move work meetings. 3. I do not know why we didn’t use a local trainer to begin with, but my boss chose this out of town group and flew them in for the June training. I guess what happened that lead to this virtual 6am session is that they offered to let us join in on the next one they did at no additional cost because so many people missed the June session.

    The calendar invite did not look like something I could decline. She said “We are very fortunate that the trainers are willing to let us sit in on this virtual training after so many people missed the last one. This work is crucial to building a common language around antiracism. thank you in advance for your flexibility with the early start time.”

    The update is that my boss went on vacation right after sending us these calendar invites, and won’t be back until the first day of the training. My coworker just sent me a message that she spoke with a board member who is also invited to the training, and they said it’s Tuesday/Wednesday, not Monday/Tuesday. so now I don’t even know which day I’m meant to be working at 6am.

    Those of your guessing that this is an ongoing pattern for my boss are correct. I am looking for a new job, but I’m just trying to survive this right now.

    1. Letter 2 update*

      I am grateful for the specific wording from Allison, and I’m glad to have my instincts affirmed that continuing to be matter of fact and not upset is the right way to handle it. I think that’s the best way to stay sane. I don’t see it ever working for a long term solution though, because I have talks like that with my boss every day. the resolution only lasts about an hour, and then she completely forgets whatever we have agreed upon. getting things in writing and showing her what she previously said frustrates her, and she calls me inflexible.

    2. Hlao-roo*

      Thanks for this update, LW2! Sadly, based on this information, I agree that job-searching is the best long-term resolution to this problem. Best of luck with the search!

  53. CocoB*

    OP1 – I hope you have a successful outcome to your appeal. You researched and planned accordingly. However, please keep in mind that you could face this same dilemma in a future plan year whether at your old company or a new company. Each plan year could bring a change in insurance providers, formularies, etc. Unfortunately, this is an issue that you may have to fight several times in the future. Any time a drug is new, expensive or possibly has “off label” uses, it can be many years of dealing with insurance carriers.

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