Any experience with SesameCare.com? (Costco-partnered online telemedicine for cheap prescription fills)

In My Humble Opinion
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(Heh, this post is gonna sound like some sort of AI-generated ad, but I promise I’m a real person writing this.)

At the Costco pharmacy recently, I saw an ad there for $29 virtual/online doctor visits through a company called Sesame that they’ve partnered with. Has anyone tried this service, or similar online “budget” out-of-pocket healthcare providers?

I’ve recently been struggling with the cost of Wegovy prescriptions. The drug itself is expensive enough — the Costco discount brings it from like $1500/mo down to $150-$300/mo, but that’s still a lot of money for a single drug. Then, to gradually ramp up the dosages per the manufacturer’s recommendations, I had to keep booking appointments with my primary care doctor. Because I made the dumb decision to switch to a high-deductible health plan last year (stupid me), each office visit can cost upward of $300. One hour-long nutritionist consult costs $600 by itself. I had to cancel most of my pending appointments once I got the bill, and was concerned I would not be able to get more dosages.

So I decided to give Sesame a try instead. The ad wasn’t completely accurate. Turns out the $29 visit was a bit misleading… that only applies to certain types of drugs, and weight loss ones are excluded. To get or change a Wegovy script, you need their separate weight loss subscription, at $50/mo paid annually or $70/mo paid quarterly.

But since even the quarterly option was cheaper than a single visit at my PCP, I decided to give it a chance.

The tech worked surprisingly well (their software is one of the better telemedicine options I’ve tried, definitely much nicer than the Cigna or MyChart ones, for example). One thing that surprised me, though, is that none of the providers seemed to be M.D.s, but various advanced nurse practitioners of different sorts/certifications, licensed to practice in several states. I had a meeting with one of them to discuss the Wegovy, and it actually went super well… she was informative, patient, and genuinely helpful in a way that I did not expect budget telehealth to be. It was better than many of the healthcare experiences I’ve had locally, actually.

I’ll need to check in again in a few more weeks to adjust the dosage again, but all the visits are already included in the prepaid subscription, so there shouldn’t be any further costs.

So far, so good, right? I guess what I’m worried about is that it seems a little too good to be true, like what’s the catch? How can it be so much cheaper? Even if I had a better health plan (and not a HDHP), even the copay at $50/visit would be higher than a subscription cost.

Is it just that the providers are nurse practitioners and not MDs? Or is there some hidden downside to this sort of online prescription service I should be aware of?

Otherwise, it seems like a no-brainer to use this sort of thing for routine prescription management (but still going in-person to my PCP for check-ups and bigger issues, of course).

What am I missing?

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Oh, i misread and thought you were looking for cheap online pharmacies. In case that’s also of interest, I’m a big fan of costplusdrugs.

I haven’t worked with a service like that because my physician has been willing to manage prescriptions for me via messaging, without generally requiring an office visit. (So, free in most cases.) And when a visit is required (like a suspected infection that needs to be cultured) i usually see either one of his nurse practitioners or a nurse practitioner at CVS, either of which is much less than $300. But when i first went on estrogen for menopause symptoms, there was a long period of determining the right dose, and my doctor changed my prescription several times until we were comfortable i had the right level. That was all zero appointments, as he’d suggested it at my prior annual physical, and I’d initially said “no”, but changed my mind a couple months later.

Legally, i think a doctor needs to have seen you (or had a telehealth meeting with you) within the past year to write most scripts. Charging $300 for every adjustment to your meds is a choice many doctors make to increase revenue, not anything they need to do.

(My doctor is a salaried employee of a not-for-profit hospital, and isn’t under much pressure to optimize revenue.)

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Never used that company. My insurance offers a whole range of things you can do online. I avail myself of many of them.

My doctor has a dedicated nurse line. She often wants to face time but I never do. My stuff is usually straight forward. Just refills or should I come in type of questions.

I’ve never had a problem with the costs. My co-pays end after a certain amount of money. I usually meet that with one visit to dialysis or the diabetes clinic.

I think you may have found a great work around for the Wegovy. Enjoy it til it changes. Cause it will. It always does.

Good luck.

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When I first started in Zepbound, I went through Sesame. I don’t recall at that time that they required a subscription, but they did require semi regular check-ins, which is only sensible when you consider it. It’s actual medical treatment.

The doctor I met with was an interesting character. I I came prepared with my medical and weight, loss history, my questions and concerns, and why I thought I would be a good candidate for the drug. About 1 minute into the call he cut me off and said, “Dude, do you want Zepbound? Cause dude, you should totally be on it. I just sent the prescription to your pharmacy. Follow up with me in about a month, dude. Thanks for the call!”

It was… weird. But I got the rx. And about a month later, I was finally able to get in to see the endocrinologist that eventually took over my care. Dude.

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That sounds like the doctor was being paid by the number of patients that he sees.