Does aetna cover wegovy. With just a few clicks, you can.

Does aetna cover wegovy. Policy: FDA-approved Wegovy is indicated as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of: • 30 kg/m 2 or greater (obesity), or • 27 kg/m 2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e. Talk to your doctor about how these changes might impact you. , hypertension, type 2 diabetes mellitus, or Jul 31, 2025 · While Aetna prescription plans cover thousands of medications, the inclusion of Zepbound may change, and coverage for weight loss medications like Wegovy and Zepbound is limited, with many employer plans not covering these options. Aug 7, 2024 · Some Aetna plans may cover Wegovy for weight loss, but it will depend on your plan’s prescription coverage and your specific diagnosis. For many people, Aetna is their health insurance provider, and a common question is, "Does Aetna cover weight loss injections?" The short answer is that it really depends. See if you can save on Wegovy®. Apr 5, 2024 · Aetna, Elevance Health and Kaiser Permanente will cover Wegovy to reduce heart attack risk in Medicare patients with heart conditions, following the FDA's approval of the drug to reduce stroke or There are upcoming changes to your plan’s drug coverage — and we want to be sure you’re ready Starting April 1, 2024 you’ll see changes to the drugs your Advanced Control Plan-Aetna covers. You can call Aetna and share your Member ID to ask about their prior authorization criteria for Wegovy. Duration of Approval (DOA): • 4774-C: Initial therapy DOA: 7 months; Continuation of therapy DOA: 12 months RATIONALE The intent of the criteria is to provide coverage consistent with product labeling, FDA guidance, standards of medical practice, evidence-based drug information, and/or published guidelines. • to reduce excess body weight and . Find out if Wegovy ® is covered by your insurance plan and discover what your estimated cost could be. g. Conversely, some plans exclude coverage of programs and supplies for obesity, diet, and weight control—including weight-reduction medications such as Wegovy. Some plans may exclude coverage of programs and supplies for obesity, diet, and weight control. Find a list of covered prescription drugs under your Aetna plan - or for the plan you're considering if not yet a member - as well as medication cost estimates. Some employer-sponsored plans offer enhanced prescription benefits that include weight-loss medications, even if standard policies exclude them. This makes staying up to date with formularies especially important. Check your insurance coverage for Wegovy®. Intent: The intent of this policy/guideline is to provide information to the prescribing practitioner outlining the coverage criteria for Wegovy under the patient’s prescription drug benefit. Policy: FDA-APPROVED INDICATIONS Wegovy is indicated in combination with a reduced calorie diet and increased physical activity: • to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight. Aetna does have policies that can lead to coverage for certain weight management treatments, but it's not a simple yes or no. Aetna, like other insurance providers, requires prior authorization for Wegovy coverage. Feb 27, 2025 · While Aetna maintains strict criteria for covering Wegovy, exceptions may apply in certain cases. May 14, 2025 · Aetna prescription plans cover thousands of drugs, including NSAIDs, semaglutide, and Naltrexone/Bupropion (Contrave). Visit Aetna’s website or speak with customer service to confirm plan-specific coverage for Wegovy. Access resources that may help you take the next step with Wegovy®. Mar 31, 2025 · Does Aetna cover Wegovy? Yes, Aetna may cover Wegovy, but coverage depends on your specific Aetna plan, eligibility criteria, prior authorization requirements, and whether the medication is a medical necessity. Mar 6, 2025 · Yes, some Aetna health insurance plans cover Wegovy. Wegovy is indicated in combination with a reduced calorie diet and increased physical The intent of this policy/guideline is to provide information to the prescribing practitioner outlining the coverage criteria for Wegovy under the patient’s prescription drug benefit. As of 2025, Aetna continues to cover Wegovy for eligible patients but has removed Zepbound from its weight management drug list. Dec 15, 2024 · Understanding Aetna Prior Authorization To get your Aetna prior authorization for Wegovy approved, it's essential to understand the requirements in advance. Aetna, Elevance Health, and Kaiser Permanente will cover Wegovy to reduce heart attack risk in Medicare patients with heart conditions. Mar 24, 2025 · Does insurance cover Wegovy? Learn about insurance coverage, copays, and deductibles for Wegovy, including Medicare, Medicaid, and commercial plans. Pharmacy Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. It’s important that you review the changes in the chart enclosed. With just a few clicks, you can. xkwwa4j eqn eato44pj imh0n gxttvvb gqua wf24w9 uf2im w0 pm8mk