Zealthy is a scam!! Avoid at all costs!! This is the actual threat of cancellation sent me me from Zealthy on February 23, 2024; 5:40 pm: “ Your PA approval will be cancelled and your provider will not be able to send your GLP-1 prescription to your pharmacy if you do not sign up for additional months of care. Once the PA is cancelled, it will take up to 14 days to receive a response from your insurance Get GLP-1 sent to local pharmacy.” This is my actual response to Zealthy’s threat to cancel my PA (pre-authorized) prescription from being sent to my local pharmacy for pick up. “Please refrain from contacting me again in regards to sending my PA prescription to my pharmacy for local pick up. It is not now nor ever, has been approved/preauthorized/PA. It is a “covered” medication under my plan but ONLY for TYPE 2 DIABETES. As the Zealthy “Cover My Meds” database states and per (redacted doctor’s name) supposedly, my provider at Zealthy, my primary diagnosis is OVERWEIGHT. “ “I have contacted Express Scripts on multiple occasions in regards to this matter. Express Scripts, my pharmacy benefit provider since 2013, has none, zero, ANY record Zealthy or any of its representatives submitted a prescribed medication on my behalf for preauthorization/PA.” “Express Scripts has provided their protocol for submission of medications for preauthorization, which is: the claimant/insured will be notified in writing of any decision for approval or denial, from whom it was submitted, with diagnoses and associated ICD10 codes, and the reason for approval or denial. If approved, the claimant/insured will be informed of the amount of any copay, if any, is the responsibility of the insured. If denied, instructions for an appeal will be provided.” (Express Scripts also stated my copay, if preauthorized/PA, would have been $25. Since it is not approved for OVERWEIGHT and only for TYPE 2 Diabetes, the out of pocket cost is $1549.53 per month from my local pharmacy.) “Express Scripts has not issued to me any such letter because no submission for preauthorization has ever been completed by Zealthy, its representatives or any other company. (The only record Express Scripts has for medications submitted on my behalf requiring preauthorization was in 2021 for home infused chemotherapy medication.)” “Further, Express Scripts went above and beyond to see if the diagnosis of OVERWEIGHT would have been approved. The answer is no; only for TYPE 2 DIABETES.” Express Scripts also stated the criteria for an appeal to be considered. “Occasionally on appeal, the diagnosis of prediabetes, an AIC greater than 6.0, and having failed Metformin therapy or other oral antihyperglycemic medications AND with comorbidities of obesity, hypertension, hyperlipidemia, copd, or heart disease would be considered for approval on appeal to the medical director of Express Scripts.” “I understand Zealthy uses “Cover My Meds” as a database to check for covered medications under an insured’s plan (not for approved diagnoses), I actually have a copy of mine (see attached) from Zealthy which states this form is for records only “do not send to plan” and “does NOT represent preauthorization.” It also provides the provider, (name, address and NPI) the diagnosis of OVERWEIGHT, and the ICD10 code E66.3.” “Your continued effort to collect membership fees, ($600 for 3 months), BEFORE Zealthy will forward the “PA” prescription to the pharmacy for local pick up constitutes fraud.” “I am posting this to information all social media, medical boards, BBB, and any/all legitimate review databases I can find to prevent anyone from being scammed by Zealthy and its attempts to collect membership fees before “PA” prescriptions can be sent to their local pharmacies for local pickup.” I have removed, for the purposes of this review, any personal information and the attachment as it contains sensitive/protected health information. I would have been out any membership fees prepaid to Zealthy and have to pay $1539.53 to pick up my prescription!! Advice to all: check with your insurance company yourself before prepaying any membership fees to Zealthy! DO NOT TRUST Zealthy when you are informed your prescription has been PA/preauthorized. Total scam!!! Avoid at all costs! Date of experience: February 23,