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Does United Healthcare cover Wegovy for weight loss?

United Healthcare has specific criteria for Wegovy coverage, which varies by plan
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By | Updated on Mar. 21, 2025 Medically reviewed by Jesse P. Houghton, MD, FACG
Semaglutide pens and a scale: Does United Healthcare cover Wegovy for weight loss?

Key takeaways

  • United Healthcare coverage may cover Wegovy for approved uses, although the exact coverage can vary by plan.

  • Wegovy typically costs close to $1,850 for a one-month supply without insurance, but the retail cost can vary depending on the quantity prescribed and the pharmacy location.

  • Patients need a BMI of 30 or greater (obesity) or a BMI of 27 to 30 (overweight) alongside a weight-related health condition to be eligible for Wegovy coverage.

  • Wegovy may also be covered by insurance to reduce the risk of heart disease-related events like stroke and heart attack in people who are obese or overweight and have heart disease.

In this article:

Wegovy is an injectable prescription medication approved to treat obesity in adults and children ages 12 and older. It is also approved for adults who are overweight with at least one weight-related health condition, such as diabetes or high blood pressure. Additionally, healthcare providers may prescribe Wegovy to reduce the risk of heart attacks, strokes, and death in individuals with heart disease and excess weight.

Semaglutide, the active ingredient in Wegovy, is a GLP-1 agonist that regulates appetite and blood sugar. Wegovy is intended to be taken weekly alongside a balanced diet and increased physical activity. Coverage for Wegovy under United Healthcare (UHC) plans varies, with some plans covering it for weight loss.

Wegovy insurance coverage

Insurance coverage can vary greatly from plan to plan. Coverage for Wegovy may also depend on whether you have private insurance, Medicare, or Medicaid. Therefore, it’s important to check your policy to verify prescription drug coverage and get an exact idea of how much you’ll be expected to pay. 

If your employer-sponsored insurance doesn’t cover obesity medication, that may not be the end of the line. Novo Nordisk, Wegovy’s manufacturer, offers tips for gaining Wegovy insurance coverage, including a sample coverage request letter you can provide to your benefits or human resources manager, who can use it to request coverage from your insurance provider on your behalf.

Novo Nordisk recommends asking these questions to an insurance company that does not cover Wegovy:

  • Are there any other options to get Wegovy covered by insurance? If so, what steps are required?
  • Are exceptions or appeals accepted? If so, what steps are required?

Wegovy Medicare coverage

UHC Medicare plans aren’t likely to cover Wegovy because Medicare doesn’t cover obesity medications. Novo Nordisk says that some select Medigap and Medicare Advantage plans may cover Wegovy, but you should check with the plan’s administrator to verify coverage.

Although Medicare doesn’t cover Wegovy for weight loss as of March 2025, legislators are trying to change that with the Treat and Reduce Obesity Act of 2023. If the bill is passed, Medicare Part D would be able to cover weight loss drugs like Wegovy.

Wegovy Medicaid coverage

If you have a UHC Medicaid plan, you may have coverage for Wegovy. However, each state decides which prescription drugs it will cover through Medicaid, so you’ll need to contact your state’s Medicaid office to see whether it covers GLP-1 drugs to treat obesity. 

RELATED: Does Medicaid cover Wegovy?

Does United Healthcare cover Wegovy for weight loss?

UHC members who are 12 years and older may qualify for a four-month Wegovy prescription if they meet UHC’s criteria for Wegovy coverage:

  • The patient is requesting treatment for appetite suppression or weight loss treatment.
  • The patient will use Wegovy alongside lifestyle modification (e.g., dietary or caloric restriction, exercise, behavioral support, and community-based programs).
  • The patient has a body mass index (BMI) at or above 30 kg/m² for adults or in the 95th percentile for pediatric patients. 

OR

  • The patient has a BMI at or above 27 kg/m² with a weight-related medical condition such as high blood pressure, sleep apnea, or Type 2 diabetes.

UHC Wegovy reauthorization

After four months, UHC members can request coverage for an additional 12 months of a Wegovy prescription if:

  • The person taking Wegovy has lost at least 5% of their baseline body weight, and
  • They are continuing to make lifestyle modifications.

State mandates and federal regulatory requirements may also impact coverage criteria.

How much does Wegovy cost?

Without health insurance, the typical cash price of Wegovy is approximately $1,847 for a 30-day supply (four injector pens), although that cost varies by pharmacy and doesn’t include any discounts. Since the cost varies by pharmacy, one pharmacy may charge more than another.

Even with insurance, Wegovy’s cost and coverage vary by insurance plan—contact your insurance provider for details. If your United Healthcare plan doesn’t cover Wegovy in its formulary, consider using a SingleCare coupon card to make it more affordable. You can compare Wegovy pharmacy costs here.

RELATED: Save money on weight loss meds

How to check whether your United Healthcare plan covers Wegovy for weight loss

Find your UHC coverage details by logging in to your UHC health plan account online. Under your pharmacy and prescription coverage information, you’ll find your plan’s prescription drug list (PDL), where you can search for Wegovy. 

Another way to verify coverage is by using the Novo Nordisk costs and coverage tool.

You can also call the UHC member services number on the back of your insurance card to verify your specific insurance policy coverage. Novo Nordisk shares questions to ask your insurance company, such as:

  • What will my copay be?
  • Once I meet my deductible and out-of-pocket expenses, how much will my Wegovy copay be?
  • Are there other ways to save? For example, would a 90-day prescription cost less?
  • Are there any steps my healthcare provider or I should take, such as prior authorization?

Wegovy prior authorization criteria

Prior authorization is an important topic to discuss with your insurance company. “Insurance plans have different requirements for weight loss medications,” explains Christie Kunde, Pharm.D., owner of InformedRx. “Some may cover Wegovy with no restrictions, while others may need prior authorization. Prior authorization criteria can vary, from having the right diagnosis to trying other medications first.”

For those looking to streamline prior authorization for Wegovy, Suneye Koohsari, MD, owner of Manhattan Medical Weight Loss, recommends assembling a history of your chronic weight management efforts and sharing them with your healthcare provider. You can include efforts such as:

  • Prior diets, medications, or weight loss programs
  • Start and end dates for each program or medication
  • Effectiveness, side effects, and reasons for discontinuation of previous treatments

“This information will be invaluable for your medical team in expediting the prior authorization process,” Dr. Koohsari says. 

How to save on Wegovy

There are other ways to save on Wegovy if your UHC plan doesn’t cover it. 

Free Wegovy coupons

A SingleCare Wegovy coupon card offers sizable savings. Depending on the pharmacy, you can save nearly $600 per month on out-of-pocket costs. All you need to qualify for the coupon is a valid Wegovy prescription and citizenship in the United States or Puerto Rico.

Find your free SingleCare Wegovy coupon card here, then:

  1. Type in your zip code.
  2. Customize dosage and quantity.
  3. Choose your preferred pharmacy.
  4. Click “Get free coupon.” 
  5. Click “Save coupon” or enter your email or phone number. 
  6. Show your pharmacist the coupon during checkout. 

Wegovy manufacturer savings card

Novo Nordisk has a program called NovoCare that offers support for people using Wegovy. This program might help lower the cost of a 28-day supply, depending on your insurance. It’s a good idea to look into this offer to see how it could help you save money. Check out the details on the NovoCare website for more information that fits your needs. 

Wegovy alternatives

If your UHC plan doesn’t cover Wegovy, there are other options for weight loss, such as Saxenda (liraglutide) and Adipex-P (phentermine). Some medications are approved for other conditions but also help manage weight. For example, Mounjaro is approved to treat Type 2 diabetes, but it also reduces appetite. Without a weight-related condition, you might not be eligible for insurance coverage, but your healthcare provider may be able to prescribe it off-label. You’ll most likely need prior authorization, depending on the medication prescribed. Talk to your healthcare provider about your options.

RELATED: Wegovy vs. phentermine: Differences, similarities & side effects

For added support, UHC offers Real Appeal, a healthy lifestyle and weight management program. Real Appeal is free through participating UHC insurance plans and provides online coaching, on-demand workouts, and science-backed health resources. Call the number on the back of your UHC membership card to see if your plan is eligible for Real Appeal benefits. Additionally, it’s a good idea to check with your healthcare provider for tips or referrals to dietitians who can help you on your journey.