What Insurance Covers Wegovy

Wegovy is a prescription medication used for weight management in adults with obesity. The medication is only available with a doctor’s prescription and is injected once a week. While this medication has been shown to be effective in aiding weight loss, many patients wonder if their insurance will cover the cost of the medication.

What is Wegovy?

Wegovy is a medication that contains semaglutide, a GLP-1 receptor agonist that has been shown to aid weight loss in clinical trials. Semaglutide works by mimicking the effects of a hormone called glucagon-like peptide-1 (GLP-1), which is naturally produced by the body in response to food intake.

In clinical trials, patients taking Wegovy lost an average of 15-20% of their body weight, compared to patients taking a placebo.

How is Wegovy Administered?

Wegovy is administered by subcutaneous injection once a week. The medication is available in pre-filled pens, which patients can use to inject themselves at home.

Who is Eligible for Wegovy?

Wegovy is indicated for use in adults with a body mass index (BMI) of 30 or greater or in adults with a BMI of 27 or greater who have at least one weight-related medical condition, such as high blood pressure or type 2 diabetes.

Does Insurance Cover Wegovy?

The cost of Wegovy can vary depending on a number of factors, such as insurance coverage and pharmacy location. However, many insurance plans do cover the cost of Wegovy under certain circumstances.

What Insurance Plans Cover Wegovy?

Many insurance plans cover Wegovy under their prescription drug benefit. However, coverage may vary depending on the specific plan and the patient’s individual circumstances.

Patients should check with their insurance company to see if Wegovy is covered under their plan. Some insurance plans may require prior authorization before covering the cost of the medication.

How Much Does Wegovy Cost Without Insurance?

Without insurance coverage, the cost of Wegovy can be quite expensive. The medication typically costs around $1,300 per month, which can be prohibitive for many patients.

However, patients can save money on the cost of Wegovy by using coupons or discount programs offered by the medication’s manufacturer or by shopping around for the best price at different pharmacies.

What Should Patients Know About Wegovy and Insurance?

Patients who are considering taking Wegovy should be aware of a few things when it comes to insurance coverage.

Prior Authorization

Some insurance plans may require prior authorization before covering the cost of Wegovy. This means that patients will need to get approval from their insurance company before the medication will be covered.

Formulary

Wegovy may not be included on all insurance formularies, which is a list of medications that are covered by a particular insurance plan. Patients should review their insurance formulary to see if Wegovy is covered and to check if there are any restrictions or requirements for coverage.

Out-of-Pocket Costs

Even if a patient’s insurance plan covers the cost of Wegovy, there may still be out-of-pocket costs, such as deductibles, copays, or coinsurance. Patients should review their insurance plan’s details to see what their out-of-pocket costs for Wegovy will be.

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