Insurance coverage for Wegovy varies by plan; private insurers often cover it with prior authorization, while government plans typically do not. Steps include obtaining a prescription, prior authorization, and appealing denials.
Medically reviewed by the Klarity Editorial Team, this guide explains how to navigate insurance policies to cover Wegovy, a popular weight loss medication. Coverage depends on your insurer and plan specifics.
Coverage depends on your insurance provider. Most private plans like Aetna, BCBS, United Healthcare, and Cigna may offer coverage if you meet certain criteria. Government plans such as Medicare and Medicaid usually do not, with some exceptions like Medicare Part D or specific cases for Tricare.
To qualify, you need a prescription from a licensed healthcare provider. The FDA approves Wegovy for adults and children aged 12+ with obesity or overweight with health conditions. Prior authorization is often required before coverage begins.
Common reasons include incomplete medical documentation, policy exclusions deeming weight-loss drugs as non-essential, or not meeting prior authorization criteria such as BMI thresholds or unsuccessful prior weight-loss attempts.
The cost depends on your insurance formulary and tier placement. Some plans list copays as low as $25–$40/month, while others may require higher payments or prior authorization. Wegovy may be fully covered or require a copay.
Without insurance, Wegovy can cost approximately $1,418 for a 2 mL supply, but programs like NovoNordisk’s NovoCare® Pharmacy offer reduced prices around $499/month for cash-paying patients.
If you're ready to lose weight, a provider on Klarity Health can assess your needs, prescribe Wegovy if appropriate, and help you navigate insurance or payment options. Appointments are often available within 24 hours.
Visit helloklarity.com to find a licensed healthcare provider online. Get prescriptions, including Wegovy, prescribed safely and conveniently from home.
The information provided is for educational purposes only and does not substitute professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment. Providers on Klarity Health operate independently and autonomously.
Medical Disclaimer: This content is for informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your healthcare provider.
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