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Does Blue Cross Blue Shield cover Contrave?

Explore coverage rules, prior authorization, costs, and savings options for Contrave
Spilled bottle of white tablets: Does Blue Cross Blue Shield cover Contrave?

Key takeaways

  • Contrave (naltrexone/bupropion) is a prescription medication that can help people with obesity (or overweight with a weight-related health condition) lose weight.

  • Some Blue Cross Blue Shield plans may cover Contrave, while others won’t. Plus, some plans might have prior authorization requirements.

  • Contrave can cost over $800 when paid completely out of pocket. However, several ways (including health insurance) can reduce that price.

In 2025, 52% of Americans said they would like to lose weight, according to a Gallup survey. In recent years, many people have been turning to weight-loss medications like Contrave (naltrexone/bupropion) to help. Contrave works by helping reduce cravings and decrease appetite, leading to weight loss for many people. But those benefits come at a cost, which might leave you wondering if insurance will cover it. If you have Blue Cross Blue Shield (BCBS) health insurance, it might cover Contrave, but it all depends on the plan and your specific medical condition. Read on for details.

Does Blue Cross Blue Shield cover Contrave?

Sometimes, yes. Sometimes, no. Here’s why: The Blue Cross and Blue Shield Association is actually a collection of 33 independent companies and licensees, each providing service to different states. Each of these companies has its own health plans and policies, which means there are many different BCBS plans out there, and the prescription drug coverage criteria can vary.

Some plans may cover weight management medications like Contrave, but others might not. Here are a few of the factors that may determine your plan’s coverage.

Medical Condition

Some BCBS plans might have requirements you need to meet before receiving coverage for Contrave. For example, Contrave is FDA-approved for adults with a body mass index (BMI) of 30+, or a BMI of 27+ with at least one weight-related health condition like high blood pressure (hypertension), Type 2 diabetes, or high cholesterol. Often, insurance plans will only issue coverage for people who meet these requirements.

Formulary

This is an insurance plan’s drug list that shows how the plan classifies and covers different drugs. Most plans will sort medications into various tiers, with generics occupying the lowest tier, then preferred brands, then non-preferred brands, and specialty drugs on the higher tiers. Typically, the lower tiers receive better coverage, and the highest tiers receive much less, or none at all.

Some plans will list Contrave as a non-preferred brand, while others might prefer it to expensive GLP-1 drugs like Wegovy or Saxenda. The only way to know for sure is to check your plan’s formulary. Even then, some copays, deductibles, or co-insurance might apply.

Even when a plan doesn’t cover brand-name Contrave, it might cover generic naltrexone and bupropion individually. Neither of these is a suitable substitute for Contrave by itself, but some healthcare providers may prescribe them together. You just have to be careful to follow their dosage instructions and follow up with your healthcare provider. 

Note: Medicare generally does not cover Contrave, so you may not receive coverage if you have a BCBS Medicare plan. However, plans vary, so it’s best to check with your specific BCBS Medicare plan for more information. Medicaid plans vary by state, so if you have a BCBS Medicaid plan, you’ll need to check your specific plan. 

Prior Authorization

For certain brand-name drugs (particularly expensive ones), insurance companies will want to confirm that they are medically necessary before providing coverage. This is called prior authorization. Not every plan requires prior authorization, but if so, it will be listed on the formulary. 

How to get approved for Contrave

The first step in getting approved for Contrave is visiting your healthcare provider. They will likely perform a physical exam, ask you some questions about your lifestyle habits, and record your height and weight to determine your BMI. Tell your healthcare provider you are interested in trying Contrave, and they will let you know whether they think it’s a good option for you.

If your BCBS plan requires prior authorization, the healthcare provider may also need to submit additional paperwork, such as documentation of specific symptoms, conditions, side effects to other drugs, or even notes on prior weight management programs.

Sometimes, BCBS requires a process called step therapy. This is when you need to attempt a diet and exercise plan for a certain amount of time first, or other, less expensive drugs, before moving on to Contrave. 

“That said, it’s crucial to recognize who should not take this medication,” says Logan G. Galbraith, MD, a physician at Invigor Medical. “Contrave should not be used by individuals who are currently taking opioids or have a history of opioid dependence, as it can trigger withdrawal symptoms, which can be severe and may require hospitalization.”

Additionally, Contrave may interact with monoamine oxidase inhibitors (MAOIs), opioids, other weight loss drugs, drugs that lower the seizure threshold, and certain other medicines. That’s why “if someone is considering Contrave, it’s essential they consult with their healthcare provider to review their current medications and medical history, since the biggest risk would be a bad interaction,” Dr. Galbraith says.

How much does Contrave cost?

Like many prescription drugs, Contrave can be pricey for people paying entirely out of pocket. It may cost around $843 for 120 8-90 mg extended-release tablets, which is about a 30-day supply. Over an entire year, that can add up to more than $10,000. Fortunately, many people receive assistance from insurance or other sources to help pay for it.

According to Contrave’s website, the lowest people might pay for the drug with insurance coverage is around a $20 copay per month. That is, if you have insurance that covers Contrave, and you also use the manufacturer’s savings card. But again, this depends on the plan. If your plan classifies Contrave as a non-preferred drug, you might have to pay more. People who have insurance that does not cover Contrave, or those who are uninsured, can also use the savings card, but will pay a maximum of $199 per month. You can check the Contrave manufacturer’s website (Currax Pharmaceuticals) for more information on savings programs and eligibility.

Related: Weight loss coupons & resources

How to check whether your Blue Cross Blue Shield plan covers Contrave 

It’s all about finding your formulary, which is typically available online. Go to the website for your specific independent licensee of BCBS, and you will likely find a “Resources” tab where you can view or download the formularies for each plan. Some websites even have a medication lookup feature where you can select your plan and search for Contrave, and it will give you the coverage details.

You can also find information about your drug list by logging into your member portal. There is also a toll-free number on your member ID card to reach a member support representative who can provide details about your coverage.

What to do if insurance won’t cover Contrave 

If your BCBS plan does not cover Contrave initially, you can ask your healthcare provider if they can submit a prior authorization or coverage exception request. However, not all plans provide coverage for weight loss drugs. If, despite submitting additional documentation, your plan does not cover Contrave, there are other options. You can look into savings and other financial assistance options through the manufacturer (more on paying for Contrave without insurance below). If Contrave is still expensive even after applying savings options, you can ask your healthcare provider about Contrave alternatives that might be appropriate for you. 

How to get Contrave without insurance

If you don’t have health insurance, or your plan doesn’t cover Contrave, don’t panic. There are other ways to save on Contrave and avoid paying the full out-of-pocket cost. For example, SingleCare offers free coupons that can reduce the cost of Contrave from $843 to as low as $614. Annually, those savings can add up to over $2,700. All you have to do is sign up, then present your SingleCare card at a participating pharmacy.

Additionally, Contrave’s manufacturer offers a savings card and a patient assistance program (CurAccess) that can help decrease costs, with or without insurance. And you can always ask your healthcare provider if they know of any other savings or financial resources.

Lifestyle changes can also help you lose weight more effectively while taking Contrave, so you might not need to take it as long. “We know that behavior modification remains one of the most effective approaches to weight loss, especially since there’s no ‘magic’ fat burner currently on the market,” Dr. Galbraith says.

Either way, talk to your healthcare provider. They can help you find savings and develop a personalized weight loss plan.

The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Jun. 12, 2026. Prices vary by pharmacy. Visit our coupon page for updated drug prices at pharmacies near you.

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