How to get Wegovy covered by insurance

In this article:

• Does insurance cover Wegovy?
• How to get Wegovy covered by insurance
• What insurance covers Wegovy?
• Does Medicare cover Wegovy?
• Does Medicaid cover Wegovy?
• Does the VA cover Wegovy?
• Wegovy cost with insurance
• Wegovy cost without insurance

In this article

• Does insurance cover Wegovy?
• How to get Wegovy covered by insurance
• What insurance covers Wegovy?
• Does Medicare cover Wegovy?
• Does Medicaid cover Wegovy?
• Does the VA cover Wegovy?
• Wegovy cost with insurance
• Wegovy cost without insurance

We have finally entered an age where physicians, public health advocates, and insurers recognize that obesity is a condition that requires medical treatment. Obesity is a serious health issue associated with many leading causes of death, including heart disease, stroke, diabetes, and certain types of cancer. Wegovy is an injectable weight loss medication that could help, but that doesn’t mean insurance will always cover it. 

Does insurance cover Wegovy?

It depends. Major health insurance plans tend to offer several different types of plans, whether employer-sponsored or individually obtained. Coverage can vary greatly between plans, even if they’re offered by the same insurance company, so it is important to verify coverage for Wegovy. This is especially important because the drug’s high cost has some employers ending or limiting coverage of weight loss medications, including Wegovy.

Wegovy is well-known for weight loss and chronic weight management, but it is also approved by the Food and Drug Administration (FDA) to lower the risk of cardiovascular events in adults with heart disease and who either have obesity or are overweight. Many plans may cover Wegovy for cardiovascular risk, but coverage varies by plan, so you will need to check with your specific plan. 

Not all plans will cover Wegovy for weight loss. If they do, they may have eligibility requirements, and they may also require prior authorization. Insurance plans that cover Wegovy typically require that patients meet the following criteria:

• Adults must have an initial body mass index (BMI) of 30 or higher; or
• An initial BMI of 27 or higher (overweight) with at least one weight-related medical condition, such as:
  • Heart disease
  • High cholesterol 
  • Type 2 diabetes
  • High blood pressure
  • Sleep apnea
• Pediatric patients ages 12 years and older must have an initial BMI at the 95th percentile or higher for age and sex.

How to get Wegovy covered by insurance

Getting Wegovy covered by insurance starts with a visit to your healthcare provider, who will determine whether you qualify for Wegovy. If you do, they’ll write you a prescription. You can either have your healthcare provider send the prescription to the pharmacy or take it there yourself, where your pharmacist can check your coverage.

Alternatively, you can call your insurance company to find out if your plan covers the cost of Wegovy before having the prescription sent to your pharmacy.  The phone number is listed on the back of most insurance cards and prescription drug cards. You may want to also ask whether you need prior authorization. If so, your healthcare provider will have to contact your health insurance provider for approval before your prescription can be filled under your insurance plan. If you are turned down, ask what you need to do to appeal—or you can check the manufacturer’s website for self-pay options. 

If you are turned down, ask why. It could be because you didn’t meet the criteria, but it could also be because your employer has opted out of weight loss benefits. If so, your healthcare provider can submit a request to the employer asking them to reconsider benefits or send an appeal to the insurance company to show that you meet the FDA requirements for the medication.

“If you are having trouble getting medication covered, find a provider with experience with these medications who will be an advocate,” says Michelle Pearlman, MD, CEO and co-founder of Prime Institute and ByteMD, who is board-certified in internal medicine, gastroenterology, and obesity medicine.  

What insurance covers Wegovy?

Several insurance companies, including Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare, typically cover Wegovy in some form or another. However, coverage varies by plan. Benefits offered by employer plans also vary, and coverage is often based on what employers are willing to cover. And some plans will cover Wegovy for cardiovascular risk reduction, but may not cover it for weight loss.

Novo Nordisk, the manufacturer of Wegovy, sponsors NovoCare, a website with resources that help people check insurance coverage, manage the cost of medication, explore savings and assistance options, and more. 

Does Medicare cover Wegovy?

Medicare does not cover weight loss medications and does not let people use manufacturer’s coupons in combination with their Part D plan. The ban on coverage for weight-loss treatments was instituted in 2003, partly due to concerns over the safety of fen-phen (the combination of fenfluramine and phentermine), the popular weight loss medication at the time. Fen-phen was associated with life-threatening hypertension and heart valve issues. 

In July 2023, a bipartisan group in Congress reintroduced the Treat and Reduce Obesity Act (TROA), which would work to prevent diseases associated with obesity, including heart disease, stroke, Type 2 diabetes, and certain cancers that are leading causes of preventable death. The expansion of Medicare coverage for weight-loss medications would increase their availability for many older adults who cannot afford them and have a “multiplier effect” because private insurers often follow Medicare’s lead. This is only introduced legislation and is not yet a law.

Because Wegovy has an FDA approval for cardiovascular risk reduction, many Medicare prescription plans that may not have covered Wegovy for weight loss may now cover it for this use. However, coverage varies by plan, and prior authorization may be required, so it’s best to check with your plan.

Does Medicaid cover Wegovy?

Every state decides what prescription medications to cover through Medicaid, so coverage for Wegovy depends on the reason for use and the state you live in. As of January 2025, 14 states—California, Delaware, Kansas, Massachusetts, Michigan, Minnesota, Mississippi, New Hampshire, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, and Wisconsin—cover GLP-1 receptor agonists (such as Wegovy) for weight loss. 

Many Medicaid plans will provide Wegovy coverage for cardiovascular risk reduction, but it’s best to check with your specific plan to confirm coverage details.  

Does the VA cover Wegovy?

The Veterans Administration (VA) covers obesity management for eligible veterans, but whether it will cover the cost of Wegovy varies. Wegovy is not on the VA national formulary and requires a non-formulary drug request and prior approval. See your local VA office to discuss your options.

Wegovy cost with insurance

The cost of Wegovy with insurance depends on many factors, including the specifics of the plan, prescription drug copays, and limits on coverage. In November 2023, Novo Nordisk told Reuters that 80% of insured patients pay less than $25 a month for Wegovy. 

Wegovy cost without insurance

The typical cash price of a 28-day supply (one month) of Wegovy is $1,847, but that cost varies by pharmacy. Although it’s expensive, there are ways to save on Wegovy. With a SingleCare prescription discount card, you’ll pay an average of $1,218 for a month’s supply of Wegovy, depending on your preferred pharmacy. 

You can also check the Wegovy website for more information about the NovoCare savings card. People with insurance coverage for Wegovy and an out-of-pocket expense of $849 or less per month can pay as little as $0 per month, subject to a maximum of $225 savings per month. 

For individuals without insurance or those whose insurance does not cover Wegovy (or if your out-of-pocket cost exceeds $849 per month), NovoCare offers a savings program that can reduce the cost to $650 per month. 

Wegovy coupons

Bottom line

Many insurance plans cover Wegovy for patients who fit the criteria once someone has met their deductible, but this can vary by policy. Although weight loss medication can help, it’s not a quick fix for obesity. Wegovy is typically recommended along with lifestyle changes like a reduced-calorie diet and increased physical activity.

“When we speak about obesity, we’re looking at a multi-disciplinary approach that includes behavioral interventions, lifestyle modifications, and pharmacology, “ says Raj Dasgupta, MD, a board-certified physician and associate professor of clinical medicine at the University of Southern California in Los Angeles. “It is especially important to realize that even when you are on medications, you need to continue with lifestyle modifications that include diet and exercise because when people stop these medications, they gain the weight back.” 

Always consult your healthcare provider for more information and medical advice about Wegovy, including information about side effects and other important warnings. 

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