{"id":627509,"date":"2024-03-21T11:53:24","date_gmt":"2024-03-21T15:53:24","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=627509"},"modified":"2025-10-22T19:15:18","modified_gmt":"2025-10-22T23:15:18","slug":"how-to-get-wegovy-covered-by-insurance","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/how-to-get-wegovy-covered-by-insurance\/","title":{"rendered":"How to get Wegovy covered by insurance"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">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. <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/wegovy\"><span style=\"font-weight: 400;\">Wegovy<\/span><\/a><span style=\"font-weight: 400;\"> is an injectable weight loss medication that could help, but that doesn\u2019t mean insurance will always cover it.\u00a0<\/span><\/p>\n<p><span data-sheets-root=\"1\" data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;&quot;}\" data-sheets-userformat=\"{&quot;2&quot;:6849,&quot;3&quot;:{&quot;1&quot;:0},&quot;9&quot;:1,&quot;10&quot;:2,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:0},&quot;15&quot;:&quot;Arial&quot;}\" data-sheets-formula=\"=CONCATENATE(R[0]C[-2],R[0]C[-3],R[0]C[-1])\"><\/span><\/p>\n<h2 id=\"does-insurance-cover-wegovy\"><span style=\"font-weight: 400;\">Does insurance cover Wegovy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">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\u2019re offered by the same insurance company, so it is important to verify coverage for Wegovy. This is especially important because the drug\u2019s high cost has some employers ending or limiting coverage of weight loss medications, including Wegovy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Not all plans will cover Wegovy for weight loss. If they do, they may have eligibility requirements, and they may also require <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/prior-authorization\/\"><span style=\"font-weight: 400;\">prior authorization<\/span><\/a><span style=\"font-weight: 400;\">. Insurance plans that cover Wegovy typically require that patients meet the following criteria:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Adults must have an initial body mass index (BMI) of 30 or higher; or<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">An initial BMI of 27 or higher (overweight) with at least one weight-related medical condition, such as:<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Heart disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">High cholesterol\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Type 2 diabetes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">High blood pressure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Sleep apnea<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pediatric patients ages 12 years and older must have an initial BMI at the 95th percentile or higher for age and sex.<\/span><\/li>\n<\/ul>\n<p><b>RELATED:<\/b> <a href=\"https:\/\/www.singlecare.com\/blog\/wegovy-prior-authorization-criteria-blue-cross-blue-shield\/\"><span style=\"font-weight: 400;\">Wegovy prior authorization criteria<\/span><\/a><\/p>\n<h2 id=\"how-to-get-wegovy-covered-by-insurance\"><span style=\"font-weight: 400;\">How to get Wegovy covered by insurance<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">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\u2019ll 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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.\u00a0 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\u2014or you can check the manufacturer&#8217;s website for self-pay options.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you are turned down, ask why. It could be because you didn\u2019t 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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cIf you are having trouble getting medication covered, find a provider with experience with these medications who will be an advocate,\u201d says <\/span><a href=\"https:\/\/www.primeinstitute.us\/michelle-pearlman-md\/\"><span style=\"font-weight: 400;\">Michelle Pearlman, MD<\/span><\/a><span style=\"font-weight: 400;\">, CEO and co-founder of Prime Institute and ByteMD, who is board-certified in internal medicine, gastroenterology, and obesity medicine.\u00a0\u00a0<\/span><\/p>\n\t\t<div id=\"coupon-cta\" class=\"coupon-cta master-template\">\n\t\t\t<p id=\"headline\">Save up to 80% on Wegovy with SingleCare<\/p>\n\t\t\t<p id=\"subheadline\">Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t<div class=\"details-wrap\">\n\t\t\t\t<div class=\"details\">\n\t\t\t\t\tWegovy 2.4 mg\/0.75 mL (4 Pens)\t\t\t\t<\/div>\n\t\t\t\t<div class=\"address\">\n\t\t\t\t\t23666 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"api-response\">\n\t\t\t\t\t\t<div class=\"coupon\">\n\t\t\t<div class=\"logo\">\n\t\t\t<img decoding=\"async\" src=\"https:\/\/images.singlecare.com\/content\/images\/pharmacy\/logo-color-kroger.svg\" alt=\"Kroger Pharmacy\" \/>\t\t\t<\/div>\n\t\t\t<div class=\"price\">\n\t\t\t\t<div class=\"price-number\">\n\t\t\t\t\t$1170.27<br\/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"price-signup\">\n\t\t\t\t\t<span class=\"info-icon\">i<\/span>\n\t\t\t\t\tPrice with <a href=\"https:\/\/www.singlecare.com\/prescription\/wegovy#blog-cta\">signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"couponbtn\">\n\t\t\t\t<a target=\"_blank\" href=\"https:\/\/www.singlecare.com\/prescription\/wegovy#blog-cta\">Get free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"coupon\">\n\t\t\t<div class=\"logo\">\n\t\t\t<img decoding=\"async\" src=\"https:\/\/images.singlecare.com\/content\/images\/pharmacy\/logo-color-harristeeter.svg\" alt=\"Harris Teeter Pharmacy\" \/>\t\t\t<\/div>\n\t\t\t<div class=\"price\">\n\t\t\t\t<div class=\"price-number\">\n\t\t\t\t\t$1170.27<br\/>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"price-signup\">\n\t\t\t\t\t<span class=\"info-icon\">i<\/span>\n\t\t\t\t\tPrice with <a href=\"https:\/\/www.singlecare.com\/prescription\/wegovy#blog-cta\">signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"couponbtn\">\n\t\t\t\t<a target=\"_blank\" href=\"https:\/\/www.singlecare.com\/prescription\/wegovy#blog-cta\">Get free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t<a target=\"_blank\" href=\"https:\/\/www.singlecare.com\/prescription\/wegovy#blog-cta\" class=\"coupon-see-all-btn\">See Wegovy prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t\n<h2 id=\"what-insurance-covers-wegovy\"><span style=\"font-weight: 400;\">What insurance covers Wegovy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Several insurance companies, including <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/is-wegovy-covered-by-blue-cross-blue-shield\/\"><span style=\"font-weight: 400;\">Blue Cross Blue Shield<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/does-aetna-cover-wegovy\/\"><span style=\"font-weight: 400;\">Aetna<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/cigna-weight-loss-coverage\/\"><span style=\"font-weight: 400;\">Cigna<\/span><\/a><span style=\"font-weight: 400;\">, and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/does-united-healthcare-cover-wegovy-for-weight-loss\/\"><span style=\"font-weight: 400;\">United Healthcare<\/span><\/a><span style=\"font-weight: 400;\">, 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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Novo Nordisk, the manufacturer of Wegovy, sponsors NovoCare, a website with resources that help people <\/span><a href=\"https:\/\/www.novocare.com\/obesity\/products\/wegovy\/cost-navigator.html\"><span style=\"font-weight: 400;\">check insurance coverage<\/span><\/a><span style=\"font-weight: 400;\">, manage the cost of medication, explore savings and assistance options, and more.\u00a0<\/span><\/p>\n<h2 id=\"does-medicare-cover-wegovy\"><span style=\"font-weight: 400;\">Does Medicare cover Wegovy?<\/span><\/h2>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/does-medicare-cover-wegovy\/\"><span style=\"font-weight: 400;\">Medicare<\/span><\/a><span style=\"font-weight: 400;\"> does not cover weight loss medications and does not let people use manufacturer\u2019s 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.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In July 2023, a bipartisan group in Congress reintroduced the <\/span><a href=\"https:\/\/www.obesityaction.org\/troa\/\"><span style=\"font-weight: 400;\">Treat and Reduce Obesity Act (TROA)<\/span><\/a><span style=\"font-weight: 400;\">, 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 \u201cmultiplier effect\u201d because private insurers often follow Medicare\u2019s lead. This is only introduced legislation and is not yet a law.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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\u2019s best to check with your plan.<\/span><\/p>\n<h2 id=\"does-medicaid-cover-wegovy\"><span style=\"font-weight: 400;\">Does Medicaid cover Wegovy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">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, <\/span><a href=\"https:\/\/stateline.org\/2025\/01\/06\/as-demand-for-weight-loss-drugs-rises-states-grapple-with-medicaid-coverage\/\"><span style=\"font-weight: 400;\">14 states<\/span><\/a><span style=\"font-weight: 400;\">\u2014<\/span><span style=\"font-weight: 400;\">California, Delaware, Kansas, Massachusetts, Michigan, Minnesota, Mississippi, New Hampshire, North Carolina, Pennsylvania, Rhode Island, South Carolina, Virginia, and Wisconsin<\/span><span style=\"font-weight: 400;\">\u2014cover GLP-1 receptor agonists (such as Wegovy) for weight loss.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many Medicaid plans will provide Wegovy coverage for cardiovascular risk reduction, but it\u2019s best to check with your specific plan to confirm coverage details.\u00a0\u00a0<\/span><\/p>\n<h2 id=\"does-the-va-cover-wegovy\"><span style=\"font-weight: 400;\">Does the VA cover Wegovy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The Veterans Administration (VA) covers obesity management for eligible veterans, but whether it will cover the cost of Wegovy varies. Wegovy is <\/span><a href=\"https:\/\/www.va.gov\/formularyadvisor\/drugs\/4040576-SEMAGLUTIDE-INJ-SOLN\"><span style=\"font-weight: 400;\">not on the VA national formulary<\/span><\/a><span style=\"font-weight: 400;\"> and requires a non-formulary drug request and prior approval. See your local VA office to discuss your options.<\/span><\/p>\n<h2 id=\"wegovy-cost-with-insurance\"><span style=\"font-weight: 400;\">Wegovy cost with insurance<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">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 <\/span><a href=\"https:\/\/www.reuters.com\/business\/healthcare-pharmaceuticals\/novo-nordisk-80-us-wegovy-patients-with-insurance-paying-less-than-25month-2023-11-02\/\"><span style=\"font-weight: 400;\">80% of insured patients pay less than $25 a month for Wegovy<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\t\t<div class=\"singlecare-dynamic-newsletter-wrapper sin-newsletter-wrapper\">\n\t\t\t<span class=\"heading\">Get our weight management newsletter<\/span>\n\t\t\t<form class=\"form-wrapper\" data-newsletter-form=\"1\" data-subsource=\"Weight Management Newsletter\">\n\t\t\t\t<div class=\"input-wrapper\">\n\t\t\t\t\t<label for=\"dynamic-email\">Email<\/label>\n\t\t\t\t\t<input type=\"email\" id=\"dynamic-email\" class=\"email\" required>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"input-wrapper\">\n\t\t\t\t\t<input class=\"submit-form-btn\" type=\"submit\" value=\"Click to sign up\">\n\t\t\t\t<\/div>\n\t\t\t<\/form>\n\t\t\t<p class=\"success-message\" aria-live=\"polite\"><\/p>\n\t\t<\/div>\n\t<\/span><\/p>\n<h2 id=\"wegovy-cost-without-insurance\"><span style=\"font-weight: 400;\">Wegovy cost without insurance<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The typical cash price of a 28-day supply (one month) of Wegovy is $1,8479, but that cost varies by pharmacy. Although it\u2019s expensive, there are <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/save-on-wegovy\/\"><span style=\"font-weight: 400;\">ways to save on Wegovy<\/span><\/a><span style=\"font-weight: 400;\">. With a <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/wegovy\"><span style=\"font-weight: 400;\">SingleCare prescription discount card<\/span><\/a><span style=\"font-weight: 400;\">, you\u2019ll pay an average of $1,225 for a month\u2019s supply of Wegovy at CVS, depending on your preferred pharmacy.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You can also check the Wegovy website for more information about the NovoCare <\/span><a href=\"https:\/\/www.novocare.com\/obesity\/products\/wegovy\/savings-offer.html\"><span style=\"font-weight: 400;\">savings card<\/span><\/a><span style=\"font-weight: 400;\">. 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.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.\u00a0<\/span><\/p>\n<p><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/wegovy\"><span style=\"font-weight: 400;\">Wegovy coupons<\/span><\/a><\/p>\n<h2 id=\"bottom-line\"><span style=\"font-weight: 400;\">Bottom line<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">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\u2019s not a quick fix for obesity. Wegovy is typically recommended along with lifestyle changes like a reduced-calorie diet and increased physical activity.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWhen we speak about obesity, we\u2019re looking at a multi-disciplinary approach that includes behavioral interventions, lifestyle modifications, and pharmacology, \u201c says <\/span><a href=\"https:\/\/www.sleepadvisor.org\/dr-rajkumar\/\"><span style=\"font-weight: 400;\">Raj Dasgupta, MD<\/span><\/a><span style=\"font-weight: 400;\">, a board-certified physician and associate professor of clinical medicine at the University of Southern California in Los Angeles. \u201cIt 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.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Always consult your healthcare provider for more information and medical advice about Wegovy, including information about side effects and other important warnings.\u00a0<\/span><\/p>\n<p><small><small>The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of October 22, 2025. Prices vary by pharmacy. Visit our Wegovy coupon page for updated prices near you.<\/small><\/small><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/es\/recursos\/como-conseguir-que-el-seguro-cubra-wegovy\"><span style=\"font-weight: 400;\">Lea este art\u00edculo en espa\u00f1ol aqu\u00ed.<\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>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 [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":627510,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[21067,608,9825],"coauthors":[21008],"class_list":["post-627509","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-glp-1-drugs","tag-health-insurance","tag-weight-loss","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>How to get Wegovy covered by insurance<\/title>\n<meta name=\"description\" content=\"Learn how to get Wegovy covered by insurance, even if your plan administrator says it\u2019s not covered.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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