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Drug Info

Does Kaiser cover Contrave?

Insurance coverage for weight loss drugs is rare but possible
A health insurance card, stethoscope, and medicine: Does Kaiser cover Contrave?

Key takeaways

  • Although Contrave coverage varies by plan, most Kaiser Permanente plans don’t cover this weight loss drug.

  • Some Kaiser Permanente plans cover other weight loss medications besides Contrave.

  • A SingleCare discount card can save you money on Contrave if your insurance doesn’t cover it.

Contrave (naltrexone/bupropion) is a brand-name prescription drug that’s approved by the Food and Drug Administration (FDA) for long-term weight management in adults with a body mass index (BMI) of 30 or more and adults with a BMI of 27–29 who have at least one weight-related condition, such as high cholesterol, high blood pressure, or Type 2 diabetes. Its two active ingredients reduce hunger and cravings, which can make it easier for some people to lose weight with lifestyle changes like a low-calorie diet and physical activity. Like other weight loss medications, Contrave isn’t always covered by health insurance

Does Kaiser cover Contrave?

Prescription drug coverage varies by plan. Most Kaiser plans don’t cover Contrave, but we found a few exceptions: 

When Kaiser covers Contrave, it usually requires prior authorization. This means your healthcare provider will answer a few questions from the insurance company, and Kaiser will use that information to approve or deny your claim. When it comes to prescription weight loss drugs like Contrave, insurance companies sometimes want to confirm that patients have tried a strict diet and exercise program first.

According to federal law, Medicare plans can’t cover weight loss medications. Therefore, Kaiser Permanente Medicare plans don’t cover Contrave. 

Medicaid coverage is determined at the state level. Kaiser Permanente offers Medicaid plans in Colorado, Hawaii, Maryland, Oregon, Virginia, and Washington. Unfortunately, Contrave isn’t covered by Medicaid in these states.

How much is Contrave without insurance?

Without insurance, Contrave costs an average of $837 per 120, 8 mg/90 mg tablets. Drug prices fluctuate and vary by pharmacy and location. You’ll start taking just one Contrave tablet once per day and slowly increase the dose to two tablets twice per day. So, 120 tablets is about a 30-day supply. 

How much does Contrave cost with Kaiser?

The cost of Contrave with Kaiser Permanente depends on the cost-sharing structure of your plan.

For example, with a Kaiser Permanente of Georgia 2 Tier plan, you’d pay up to a $30 copay or 40% coinsurance for Contrave. With a Kaiser Foundation Health Plan of Washington Federal FEHB plan, your copay would be $40–$100.

How to check whether your Kaiser plan covers Contrave 

To check whether your Kaiser plan covers Contrave, call the customer service number on your Kaiser Permanente insurance card. A representative can look up your plan information and help you understand your insurance coverage and copays.

Or, log in to your Kaiser Permanente customer portal and look for the drug list. This document contains all the prescription medications that Kaiser covers. If Contrave is on the list, note its tier number. Then navigate to your Summary of Benefits document to see how much you owe out of pocket for that drug tier. Sometimes insurance cards have this information on them as well.

Drug formularies (also called preferred drug lists) may change at any time. If you have a printed or saved copy of the formulary, it could be out of date. Following the steps above ensures you’re looking at an accurate drug list. 

Note that even if Contrave isn’t covered by your health insurance plan, your healthcare provider can submit an exception request if they believe Contrave is medically necessary. There’s no guarantee that Kaiser Permanente will allow the exception, but it’s worth a try.

How to save on Contrave

You don’t have to pay full price for Contrave if your Kaiser plan doesn’t cover it. “As someone who’s been on both sides of the exam room and the pharmacy counter, I know firsthand how tough it can be to afford medications like Contrave. The good news is, there are ways to cut costs if you know where to look,” says Thomas George, Jr., DNP, a family nurse practitioner, doctor of nursing practice, and clinic director at Wellspring Weight and Wellness in Shelley, Idaho. 

Here are three ways to save on Contrave.

1. SingleCare prescription discount card

Save more than $200 on a one-month supply of Contrave with a SingleCare prescription discount card. It’s completely free and is accepted at pharmacies across the country. 

To find a SingleCare coupon, type Contrave into the search box at the top of the SingleCare website or app. Then, enter your ZIP code to see how much you’ll pay at nearby pharmacies. Click the “Get Free Coupon” button next to your preferred pharmacy to get your unique coupon code. You can create a free SingleCare account to save the coupon digitally, or you can print, email, or text it. 

When you pick up your Contrave prescription, show the pharmacy staff your SingleCare code and enjoy the savings. 

Dr. George recommends that his patients check discount sites like SingleCare because it allows them to compare prices. “I often see the same medication is half the price just down the street. Don’t be afraid to speak up and shop around. You deserve care that works and fits your budget,” he says.

2. Manufacturer’s savings card

Currax Pharmaceuticals, the manufacturer of Contrave, has a savings program that can limit your out-of-pocket expenses if your Kaiser Permanente Plan doesn’t cover Contrave. The program has eligibility requirements, and maximum savings limits apply. 

3. Alternatives to Contrave

Your Kaiser Permanente plan may cover other weight loss drugs besides Contrave.

For example, Colorado commercial HMO plans don’t cover Contrave but do cover the following:

Although they’ve risen in popularity, glucagon-like peptide-1 (GLP-1) receptor agonists like Saxenda (liraglutide), Wegovy (semaglutide), and Zepbound (tirzepatide) tend to be more expensive than Contrave. Insurance companies often don’t cover GLP-1 receptor agonists unless they’re used to treat Type 2 diabetes. In that case, the medications are sold under different brand names (Victoza, Ozempic, and Mounjaro, respectively). 

If your plan doesn’t cover any weight loss medications or your healthcare provider doesn’t believe the covered options are right for you, they can help you select the safest and most effective option that fits your budget. SingleCare discount cards reduce your out-of-pocket expenses so you never have to pay the full retail price.

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