Obesity Medication Coverage

With the growing advancements in medical science, it's an exciting time for those seeking to manage obesity. There are now a variety of FDA-approved medications that can support long-term weight loss and overall health. These treatments offer new hope for individuals struggling to achieve their weight goals through traditional methods alone. However, it's important to verify coverage with your insurance company to ensure that your chosen treatment is supported and affordable. Taking this step can help you access the right medications and begin your journey toward better health.

Guide to Calling Your Insurance about Obesity Medications

TIPS:

• Record all information provided for future reference.

• Consider requesting a written summary of coverage details.

• Confirm the coverage details for each specific medication you are interested in, as they may vary.

GLP-1 Medications

GLP-1 Medication options for treating Obesity are Zepbound, Saxenda or Wegovy.

• Make sure you are asking about the brand name of the medication and you are getting benefits for obesity coverage, NOT diabetes coverage.

• Ask if the medication will apply to your deductible. If yes, how much is your deductible.

• Ask if you have a copay or coinsurance for that medication

• Ask if a prior authorization is required. If yes, ask for the listed coverage criteria.

• When checking for coverage on Wegovy, ask if it is covered to treat obesity or for secondary prevention of “MACE” - Major Adverse Cardia Events or BOTH

Non GLP-1 Medications

Other medications for treating obesity are Phentermine, Lomaira, Contrave, and Qsymia.

• Ask about each medication you are interested in, some may be excluded from your plan.

• Ask if the medication will apply to your deductible. If yes, how much is your deductible.

• Ask if you have a copay or coinsurance for that medication

• Ask if a prior authorization is required. If yes, ask for the listed coverage criteria.