updates: the new job insurance problem, the awful second-in-commands, and more

by Alison Green on October 12, 2023

Here are three updates from past letter-writers.

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

I am the person who wrote in about the company not covering Wegovy when it was on the formulary list they gave me during the interview process and I would not have taken the job if I had known they would not cover it. After much back end discussion, they told me that they were not able to cover it for a variety of reasons which I understood. However, they understood that it is important to me and we negotiated an almost 25% of my salary bonus to commit to staying for two years. Taking into account the other perks of working there, I agreed.

2. How to tell my boss his second-in-commands are making it impossible for me to do my job (#5 at the link)

There’s a wee bit of drama, but the overall outcome is a positive one.

When the director got back from paternity leave, I was initially going to leave it for a while before addressing the situation delicately with him (as he and the Goons are personal friends).
Unfortunately, however, Caligula (thank you to the reader who suggested that one!) got to him first.

The director and I were catching up one day when he started to ask me about when I start work, when I finish work and what my productivity was looking like at the moment. I knew that this had come from Caligula, because he was seemingly out to get everyone in Director’s absence. I had anticipated this though so had a response ready. I reminded Director that at my job interview, I made him aware that I have ADHD and have about six hours per day of super productivity before my meds wear off and I crash really quickly, and he had said that was fine.
This is probably where I put my foot in it, though, and word-vomited my grievances about Caligula.

Director listened intently to me and then went on his way, until a few hours later where I was called into a meeting with Director and Caligula, and Director told us basically that we needed to sort our differences out. The way that man was acting like a confused puppy in front of Director was nauseating. But I stuck to my guns, and told him that he needs to stop getting involved in my work, stop trying to micromanage me, especially since we’re technically on the same level of hierarchy, and to start contributing where his input is requested. He agreed that he would and that was that.

And I’m happy to report that he has noticeably wound back the BS. Not completely, but enough that I can toe the line between pacifying him and keeping my own peace.

Goon 2 is still an absolute bozo, but I fortunately don’t have much to do with him anymore now that Director is back.

I also recently had my probation/performance review where Director told me that I’m his “best hire in about 18 months,” which is saying a lot for a place with relative turnover, and he also assured me that he’s aware of some of the other managers not taking me seriously and he’s been addressing this with them in their own performance reviews (one guess for my gender and that of the other managers). I’ve also heard from two lower-level managers that every time something is said against me or my work, Director shuts it down pretty quickly.

So it’s still not perfect here, far from, but knowing that Director has my back definitely makes things easier.

3. I’m scared to tell my boss how behind on work I am (first update here)

First, an update on my husband. He finished his chemotherapy treatment in the fall of 2019. He started a new job in March 2020. He is still employed there today and it has been wonderful. Each follow-up scan for cancer has been clear and after one more clear scan, he won’t have to visit the oncologist again!

Back to me: At some point in 2019, my department divided the hierarchy so that Toxic Boss was over the other half of our department, and I reported to a new boss. She was a lovely boss, who actively solved problems and advocated for us that our workload was too much (and we were growing, so it was constantly increasing). She really pushed back on the work on which I was months behind, so when we were relieved of doing it at all, my stress level dropped immensely. Honestly, if my role hadn’t switched to reporting to her, I would have quit solely because of Toxic Boss. I felt sorry for the department half that reported to Toxic Boss.

Side note: I later discovered that a lot of my colleagues were also behind as much as I was, but didn’t have the guts (or realization of how far behind they were) to own up to it in the meetings.

My role evolved into payroll accounting. I loved doing it, but I was still working with Toxic Boss. Eventually the tasks that brought me into contact with Toxic Boss were moved over to Lovely Boss, so my job became even more enjoyable. With the shelter-in-place order in 2020, I started working remotely and I’ve been remote since then. In the fall of 2020, I started working with payroll, which really got me away from Toxic Boss, as she had no authority over payroll. I only saw or heard from her if I went into the office and even then, it was merely social conversation. To boot, Lovely Boss was promoted over Toxic Boss and became Toxic Boss’ boss, so I really had no work reason to contact Toxic Boss anymore.

My job title changed again in 2022, as did my boss, and I view him as a mentor. My workload can fluctuate, but I’m not stressed or overloaded. I really enjoy my work. I have reached the light at the end of the tunnel!

Final Piece: In September 2022, Toxic Boss RESIGNED. I keep an eye on her so I can avoid working with her ever again.

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  2. jane's nemesis*

    LW3: I LOVE THIS UPDATE!! I’m so happy things improved for you and that your spouse has had such a wonderful outcome!

    1. goddessoftransitory*

      Me too! Especially after reading the first update. Magical Thinking can be so toxic in workplaces, and that’s what the first boss was doing.

    2. ferrina*

      YES! The first update from the LW was so heartbreaking- she was in an impossible situation. I’m so glad she got moved under Lovely Boss!

      AND YAY FOR HER HUSBAND!

    3. Blakely*

      Coming here to say this as well — LW3 I love this for you!!! I especially hope you feel relieved (and maybe a bit proud) for knowing your coworkers were also just as behind and just didn’t own it in that moment. You were and are doing great and I wish you all the best things!

      1. Where’s the Orchestra?*

        I’m betting the other coworkers were probably a combination of in denial about how far behind they were and scared of what Toxic Boss was going to do to them if they found out.

    4. English Rose*

      Me too. I’m really happy for all the updates but yours in particular, so pleased for you and for your husband, this is really cheering news.

    6. RemoteisBest*

      I came to say this exact thing. I am SO happy that your husband is doing well and that you have lovely new boss. That’s just great!

  5. bassclefchick*

    Re: #1. My doctor just prescribed Wegovy for me. It’s not covered by my insurance. The out of pocket is $1,000 per month. Seriously. That is not even close to being affordable for me. My doctor explained this med is the last step before bariatric surgery. I don’t get it. The health care industry berates me for being overweight, then keeps all the tools need to get to where I need to be out of reach. Because for some of us, it’s not about “will power” or “just eat healthy and exercise”. Glad you got your employer to negotiate with you, OP!

    1. Washi*

      You’ve probably already tried this, but I believe Novo Norodisk offers some financial help for Wegovy, although from my skimming, it’s still very expensive. Not all practices have this, but some have prescription assistance programs that help people connect to cost saving resources. My local hospital has a diabetes education clinic and if someone is referred to that, they can then get help from the hospital’s prescription assistance program.

      (I am a medical social worker though not a doctor)

      1. Berin*

        Seconding this; google Wegovy Savings Card, and it’ll take you to their website; I believe you can save up to $500 per month using it (I know that’s still a huge chunk of out of pocket change though, so I understand if this isn’t a feasible solution).

        I’d also suggest seeing if Ozempic is covered by your insurance; for a while Wegovy wasn’t covered under my insurance, so I used Ozempic until my insurance started covering Wegovy. I know there are a lot of feelings out there about using Ozempic right now, but this was the solution I found that would allow me to get the medicine I needed without absolutely decimating my bank account.

        1. OP #1*

          OP#1 here. I did try the Ozempic route as requested by my employer but the insurance company denied me because my blood sugar is not high enough. Also those savings cards make the drug about $1000 per month per person (both my husband and I were on it).

    2. The Unspeakable Queen Lisa*

      I think you should shop around for another doctor. One that believes in Health at Every Size and will not berate you for being overweight. That’s just how your body is – you don’t have anything to fix because you’re not broken.

      I also highly recommend Maintenance Phase (podcast) and Burnt Toast (newsletter). I heard about them here and they have fundamentally shifted the way I think about my (and everyone else’s) body.

      1. BP*

        YES to Maintenance Phase and Burnt Toast. I can also recommend the Weight and Health Care newsletter by Ragen Chastain. Please find a new doctor, one who will care for your body as it is rather than requiring you to undertake expensive and potentially dangerous treatments to alter it.

      2. NotRealAnonForThis*

        Mentioning Maintenance Phase episode specifically titled “Ozempic” as it details a LOT on exactly what you’ve mentioned about “d@mned if you do, d@mned if you don’t”, the discourse in popular culture, the science, and well, the fact that some people see little to no weight loss.

        No skin in the game here, its just exactly what was queued up at lunchtime for me.

        1. Simon (he/him)*

          Yesss that episode was so interesting, I learned so much about Ozempic! I love Maintenance Phase, it’s helped me unpack so much societal BS around body size.

    3. Sindy*

      The last step?? I recommend getting a second opinion, that’s just an odd thing to say. Bariatric surgery has a lot of downsides, it’s generally the last resort. You don’t need to go that far, I’m positive there are lots of options that will work with your needs.

      1. New Jack Karyn*

        I think that we, as internet commenters, have little to no idea what OP’s needs are, or what options will work with them.

    4. Michelle Smith*

      I really encourage you to consider another doctor. I am considered “morbidly obese” by medical standards like BMI and I refuse to go to doctors now that berate me for my weight. I still encounter casual fatphobia now and then, but anyone who recommends bariatric surgery for me despite all the very serious and debilitating complications is not someone I’m willing to put in charge of my healthcare.

      If you want to be on this medication, I understand it and I hope it helps you. (Seriously, no judgement: I’m on Ozempic. I am diabetic and haven’t seen weight loss from it, but I know other people take it for that purpose). I would encourage you to consider contacting the company to see if they can help with payments. Even if they won’t, at a minimum, download GoodRx to your phone and give that information to your pharmacy. I used GoodRx for many years when I didn’t have prescription coverage at all. TO BE CLEAR the GoodRx coupons are NOT going to make Wegovy affordable, but it still may be better than full price. Consider whether there is a way to get samples for your medication. My primary care doctor used to give me samples of Rybelsus when I was prediabetic and couldn’t afford a $1k medication with no coverage. And finally, big chain pharmacies like CVS and Walgreens often have their own prescription discounts for people who don’t have coverage – ask at the counter for an application.

      1. Jackalope*

        There are also some states that have their own prescription assistance, if you’re in the US; some are income-related but some are not. Don’t know if this will help you with this specific situation but I’m sharing it in case it’s helpful more broadly.

      2. DJ Abbott*

        Good Rx May be worth looking at, but it didn’t help when I was unemployed and trying to get my $400+ asthma medicine. I would look online and it would show I could get my medicine for $36 at a specific pharmacy. Then I would have my prescription transferred and when I went to pick it up, it was hundreds of dollars. This happened two or three times before I gave up on Good Rx.
        In the early 2010s I used it and it was good then, but not so much now.
        Worth trying, but don’t get your hopes up too much.

    5. Someone Online*

      Y’all, maybe trust that bassclefchick and their doctor know more about their personal health than you, an internet commenter?

      2. Sorrischian*

        Normally I would agree, but doctors have such a nightmarishly bad track record of giving substandard care to fat people and recommending invasive, unproven, and/or actively dangerous interventions to people with the claim that they have to lose weight before they can be treated for any other health issues (which just isn’t true most of the time!) that I can’t blame anyone for airing their concerns.

    6. Two Fish*

      No advice, just sharing a story.

      A few years ago the London Guardian reported on Britons who received bariatric surgery, covered by the NHS. However, the NHS didn’t also cover the cosmetic surgery needed to remove the large flaps of excess abdominal skin these people had post-weight loss.
      I don’t know if the cosmetic surgery policy has since changed.

      1. londonedit*

        Technically, it’s the Manchester Guardian. But just the Guardian these days. The NHS doesn’t cover any elective cosmetic procedures, never has. It’s not specifically about weight loss surgery. However the NHS will cover procedures that could be deemed cosmetic, where the patient is suffering undue hardship either physically or psychologically. So if you could convince your GP that your mental or physical health was being unduly affected by the excess skin, then you could get a referral for surgery on the NHS. Same sort of thing with things like breast reductions – again, not generally available on the NHS because it’s deemed cosmetic, but if you can prove that your breasts are causing physical or psychological pain then you might be able to get the NHS to do the surgery.

        At any rate I’d rather the NHS than a system that makes people pay £1000 out of pocket for medication. Our NHS is under serious threat in the UK from a government that seems determined to underfund and mismanage everything to do with it so that they can eventually sell it off to their mates in private healthcare, and we should be doing everything we can to fight for it. We really are not going to appreciate what we have until they take it away from us.

    7. Hot Flash Gordon*

      Sorry to say, but many insurers are going to follow suit and not cover semi-glutides for weight loss because of the cost. They are trying to reign in the claims cost of these types of drugs being prescribed off label. It’s sucky, but as with anything in our health insurance industry in the US, that cost will eventually trickle down to consumers.

    8. Daisy*

      I was on prescription semaglutide (the active ingredient in Wegovy/ozempic) last summer to get my A1C down during an incredibly stressful period (my blood sugar shoots up with stress). I got it from the compounding pharmacy for $125 a month, no insurance involvement at all (mine would not have paid because I was pre-diabetic, not diabetic, which seems wrong as I was doing it to NOT become diabetic). So that might be an option if your doctor is open to it. Good luck! It made me horribly nauseous but did bring my A1C down. I didn’t lose a pound, though.

      1. Zweisatz*

        Definitely not an expert on this, but the Maintenance Phase podcast mentioned that compounding pharmacies are not required to create a product that’s equal to the actual prescription content-wise. In this case the relevant active ingredient is patented so they cannot produce the same product (best to listen to their Ozempic episode to ascertain I summed that up correctly), which can be risk or at least unhelpful.

        Glad it helped you though!

    9. Miss Curmudgeonly*

      The coupon that people are referring to seems to be most accepted at Walmart, and it brings the price down to generally around $550 or so per month. Still a lot. There are also compounding pharmacies and other methods. If you’re on reddit, there are semaglutide and tirzepatide subreddits for more info. All the caveats about doing your own research apply of course.

  6. Casey*

    As a non-male manager in a male-dominated environment who also struggles with ADHD… I am blown away that LW1 has the level of trust to disclose that to their boss! Thanks for challenging my assumptions about how that kind of conversation would go.

    1. ferrina*

      Right?! My boss is great, but I want to make sure I’m untouchably good before I disclose. I’m sure Boss would be great, but I’m worried about my wider reputation. When I go through one of my streaks of only answering half my emails, will people assume it’s because ADHD/lazy or heavy workload? Currently it’s the latter, but will that change? I do juggle a lot- ADHD allows me to juggle a lot more than most people, but it can also make me drop some of those balls (I always pick them back up, just not always as fast as folks want).

  7. Boof*

    LW3 – so glad things got better for you. Boo for toxic boss who just seemed to insist some kind of 1984 “what I say is reality, regardless of actual reality”. I am glad you had the guts to speak truth to power even if your instincts were correct that power would not listen, at least it didn’t hurt you to do so, and fortunately someone else came along who would listen and adjust appropriately!

  8. Hills to Die on*

    OP 3- I honestly wanted to cry re-reading all of this, so I am *thrilled* that things are going well on all fronts. It is an amazing world going from a toxic boss to a good boss!

  9. Not Tom, Just Petty*

    Side note: I later discovered that a lot of my colleagues were also behind as much as I was, but didn’t have the guts (or realization of how far behind they were) to own up to it in the meetings.
    Front and center note: the hell you say. I was surprised reading your letters that you didn’t mention the possibility that everyone else was fibbing.
    Toxic Boss got everyone so afraid to say “I cannot do this,” so that she would not have to deal with “WE cannot do this.”

  10. Coverage Associate*

    The medical expenses tax deduction is tricky. You have to pay a certain percentage of your income in medical expenses, and there may be a limit to the percentage you can deduct. To get the deduction, you have to itemize.

    But if you know you will have high medical expenses, keep good records and budget for improved tax preparation assistance, and get the deduction! (The basic tax preparation software is less than $100. It’s not Free File, but it’s worth it if you haven’t itemized in the past.)

    1. The Unspeakable Queen Lisa*

      It is *not* tricky to take a deduction. It is quite straightforward. However, as with most non-rich people, it’s probably not worth it to itemize because your standard deduction will be more.

      Also, your options are not $100 or Free File. There are reasonably priced-to-free options such as FreeTaxUSA. I dropped TurboTax and switched to them a few years back.

      Basically, please stop reinforcing the idea that doing your own taxes is scary and impossible.

      1. Reluctant Mezzo*

        I usually pick up H&R at Home pretty cheap (Staples on Black Friday has offered the Deluxe with one state CD with the download code as cheap as $15, though I suspect those days are over). Last year I paid $40, and even though I had to paperfile both (special circumstances never to occur again, please God), I received my refund much more quickly than I imagined possible.

  11. A person in the legal field*

    For LW 3: please talk to a bankruptcy lawyer before you tap into your retirement accounts. Sometimes, depending on your state, bankruptcy is the best way forward and can give you a clean slate and leave your retirement accounts protected. Don’t be afraid of the B word, especially when it comes to outrageous medical debt. At least explore your options.

    1. A person in the legal field*

      Apologies, I think I was reading the prior update and didn’t see the latest one—I’m so glad things are so much better!!

  12. Roy G. Biv*

    OP 2 —
    That is infuriating: “Acted like a confused puppy.” I have worked with malicious snakes who turned into puppies (kind of adorable, a little rambunctious and in need of some guidance) when someone with authority over their jobs showed up. But as soon as that person was gone, the puppy turned back into a snake and showed his fangs again.

    Makes me wonder if the snakes ever did get their justly deserved comeuppance. Maybe that only happens in movies.

    1. 2 Cents*

      Yeah, and though I want to hope OP’s director “has her back,” this whole place still sounds like a beehive and the head bee is only temporarily tamed. I’d be looking elsewhere.

  14. StiffChangesConstantly*

    OP1, I am impressed. It is very common for formularies to change in the middle of a plan year with no notice and, for the most part, you’re out of luck when that happens. Kudos too for getting formulary information out of the company ahead of time too – it’s really difficult to get that level of detailed info out of a company before you start/sign up for their insurance.

    1. ScruffyInternHerder*

      Similarly impressed.

      Not the same class of drugs, but the cost difference between two different GENERIC forms of epinephrine autoinjector on my plan is about $230 out of pocket (that’s the difference, y’all, not the cost). One brand of generic is $110. The other is $340. Did I mention its ALL out of pocket til I hit my deductible? And neither of them is an actual Epi-Pen.

      One of many reasons I look at the “who cares, just eat it and use your Epi-Pen if you need it” crowd with a lot of side-eye. I’m not asking y’all to make special food. I’m just asking what’s in it so I can determine whether I can eat or not.

  15. Dek*

    “Director told us basically that we needed to sort our differences out.”

    Ugh, I always hate this. I feel like if issues have gotten to the level that a higher-up is looped in, maybe it’s a problem that needs a third party to step in? Especially if one person is bullying the other.

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