{"id":632841,"date":"2025-07-11T20:03:08","date_gmt":"2025-07-12T00:03:08","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=632841"},"modified":"2025-10-23T17:01:04","modified_gmt":"2025-10-23T21:01:04","slug":"how-to-qualify-for-wegovy-a-guide-to-getting-a-prescription","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/how-to-qualify-for-wegovy-a-guide-to-getting-a-prescription\/","title":{"rendered":"How to qualify for Wegovy: A guide to getting a prescription"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/wegovy\"><span style=\"font-weight: 400;\">Wegovy<\/span><\/a><span style=\"font-weight: 400;\"> (semaglutide) is an injectable GLP-1 (glucagon-like peptide-1) medication that was initially approved by the Food and Drug Administration (FDA) for weight loss along with lifestyle changes like diet and exercise. Since its initial FDA approval, it has also been approved to <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/wegovy-heart-disease-fda-approval\/\"><span style=\"font-weight: 400;\">reduce cardiovascular risk<\/span><\/a><span style=\"font-weight: 400;\"> in adults with obesity or adults who are overweight with a weight-related health condition. The active ingredient is semaglutide, the same active ingredient used in <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ozempic\"><span style=\"font-weight: 400;\">Ozempic<\/span><\/a><span style=\"font-weight: 400;\">; however, Ozempic was FDA approved to treat Type 2 diabetes. <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/wegovy-vs-ozempic\/\"><span style=\"font-weight: 400;\">Like Ozempic<\/span><\/a><span style=\"font-weight: 400;\">, Wegovy has quickly risen in demand. As such, many people are wondering how to qualify for Wegovy and, if so, how to get Wegovy prescribed.\u00a0\u00a0<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/how-much-does-wegovy-cost\/\"><b>How much does Wegovy cost?<\/b><\/a><\/p>\n<h2 id=\"how-to-qualify-for-wegovy\"><span style=\"font-weight: 400;\">How to qualify for Wegovy<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Wegovy must be prescribed by a licensed physician, but you can\u2019t just go to your doctor and ask for it, expecting to get it. You must meet specific requirements in order to get a Wegovy prescription. You\u2019re more likely to get prescribed Wegovy if your healthcare provider believes it\u2019s the right option for you and if you plan on taking it for the indications it was FDA approved to treat:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight loss in adults with obesity or who are overweight with a weight-related health condition<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight loss in adolescents ages 12 and older who have obesity<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">To reduce the risk of cardiovascular events in adults with known heart disease who are either overweight or have obesity\u00a0\u00a0<\/span><\/li>\n<\/ul>\n<h3 id=\"bmi-requirements\"><span style=\"font-weight: 400;\">BMI requirements<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In order to qualify for Wegovy, you need to meet certain body mass index (BMI) requirements. The drug\u2019s <\/span><a href=\"https:\/\/www.novo-pi.com\/wegovy.pdf\"><span style=\"font-weight: 400;\">prescribing information<\/span><\/a><span style=\"font-weight: 400;\"> states that adults with a body mass index (BMI) of 30 or higher have obesity, while adults with a BMI of 27 or higher are considered overweight. If you are overweight, you must also have at least one weight-related health condition in order to qualify for Wegovy. If your BMI is 30 or higher, that alone is enough to qualify for Wegovy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For adolescents 12 and older, obesity is considered having a BMI equal to or greater than the 95th percentile for their age and gender.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Still, some healthcare providers will only use these bodyweight recommendations as general guidelines. \u201cIt\u2019s important to understand that even though the BMI criteria are there, they are mostly there to guide us,\u201d explains Asad Niazi, MD, lead physician at<\/span> <span style=\"font-weight: 400;\">Shed<\/span><span style=\"font-weight: 400;\">, a virtual wellness clinic. \u201cThese BMI cutoffs aren\u2019t based on actual studies but just general recommendations, and as a healthcare provider, it\u2019s extremely important to provide a case-by-case treatment for patients.\u201d<\/span><\/p>\n<h3 id=\"weight-related-conditions\"><span style=\"font-weight: 400;\">Weight-related conditions<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If you\u2019re an adult whose BMI is in the 27 to 29 range, you need to have at least one weight-related health condition to qualify for Wegovy. Examples include high blood pressure, elevated cholesterol, Type 2 diabetes, or sleep apnea, according to Dr. Niazi.<\/span><\/p>\n<h3 id=\"medical-evaluation\"><span style=\"font-weight: 400;\">Medical evaluation<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Most importantly, if you want to qualify for a Wegovy prescription, you need to be evaluated by a licensed healthcare provider. \u201cYou will always need a full medical evaluation to be prescribed Wegovy, as your BMI needs to be documented, you need to have your vitals checked, you need to be placed on a concurrent diet and exercise regimen, and you need to be clear of major contraindications,\u201d says Austin Shuxiao, MD, internal medicine physician and founder of <\/span><span style=\"font-weight: 400;\">PeachIV<\/span><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"how-to-get-a-wegovy-prescription\"><span style=\"font-weight: 400;\">How to get a Wegovy prescription<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most people will go to their primary care doctor first to get a Wegovy prescription. But there are many different options when it comes to healthcare providers who write Wegovy prescriptions.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThe most likely person you will be asking is your primary care doctor, who can be a doctor trained in either family medicine, internal medicine, or OB-GYN,\u201d Dr. Shuxiao explains. \u201cFrom there, if they cannot prescribe it to you for whatever reason, or if insurance does not approve, they may be able to send you to an endocrinologist or obesity medicine specialist.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Additionally, he says, sometimes nurse practitioners (NP) or physician assistants (PAs) can prescribe Wegovy, depending on state regulations.<\/span><\/p>\n<h3 id=\"undergo-a-full-medical-evaluation\"><span style=\"font-weight: 400;\">Undergo a full medical evaluation<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">At your appointment, you will likely need to undergo a full medical evaluation. According to Dr. Shuxiao, this will likely include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A BMI evaluation or documentation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Having your vitals checked<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Discussing your medical history<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Discussing any medications you are currently taking<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Evaluating any recent blood test results<\/span><\/li>\n<\/ul>\n<h3 id=\"discuss-weight-loss-goals-and-treatment-options\"><span style=\"font-weight: 400;\">Discuss weight loss goals and treatment options<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If losing weight is your goal while taking Wegovy, you\u2019ll need to develop a plan of care with your healthcare provider. \u201cWegovy works best when combined with healthy lifestyle changes,\u201d explains Andrew Shapiro, MD, surgeon at<\/span> <a href=\"https:\/\/www.toplinemd.com\/advanced-surgical-physicians\/\"><span style=\"font-weight: 400;\">Advanced Surgical Physicians<\/span><\/a><span style=\"font-weight: 400;\"> and the medical director of the<\/span> <a href=\"https:\/\/wellingtonregional.com\/services\/breast-care-services\/\"><span style=\"font-weight: 400;\">Comprehensive Breast Center at Wellington Regional Medical Center<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Shapiro, who has prescribed Wegovy for his breast cancer patients, says that the best way to lose weight while taking Wegovy is to eat a balanced diet, increase physical activity, get enough sleep, and manage stress levels.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cGLP-1s are not magic fixes; they support your body\u2019s ability to feel full and control appetite, but long-term success depends on building sustainable habits,\u201d Dr. Shapiro shares. \u201cI tell patients to think of it as a partner to help you reach your goals and not a replacement for the basics of good health.\u201d\u00a0<\/span><\/p>\n<p><strong>RELATED: <a href=\"https:\/\/www.singlecare.com\/blog\/can-i-start-wegovy-at-1-7-mg\/\">Can I start Wegovy at 1.7 mg?<\/a><\/strong><\/p>\n<h2 id=\"how-to-get-insurance-to-cover-wegovy\"><span style=\"font-weight: 400;\">How to get insurance to cover Wegovy\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If you are hoping to <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-to-get-wegovy-covered-by-insurance\/\"><span style=\"font-weight: 400;\">have your insurance cover Wegovy<\/span><\/a><span style=\"font-weight: 400;\">, you should be aware that coverage may be limited. While some plans cover Wegovy, other plans are more restrictive. For example, some health insurance plans will only cover Wegovy as a cardiovascular risk treatment, not as a weight loss drug. If insurance companies cover Wegovy for weight loss, they may require prior authorization.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you are unable to get insurance coverage for Wegovy, there are multiple<\/span> <a href=\"https:\/\/www.singlecare.com\/blog\/save-on-wegovy\/\"><span style=\"font-weight: 400;\">ways to save<\/span><\/a><span style=\"font-weight: 400;\"> on your Wegovy prescription if you\u2019re paying out of pocket.<\/span><\/p>\n<p><strong>RELATED: <a href=\"https:\/\/www.singlecare.com\/blog\/does-kaiser-cover-wegovy\/\">Does Kaiser cover Wegovy?<\/a><b>\u2502<\/b><a href=\"https:\/\/www.singlecare.com\/blog\/does-aetna-cover-wegovy\/\"><b>Does Aetna cover Wegovy?| <\/b><\/a><b><a href=\"https:\/\/www.singlecare.com\/blog\/wegovy-prior-authorization-criteria-blue-cross-blue-shield\/\">BCBS Wegovy prior authorization criteria<\/a><\/b><\/strong><\/p>\n<h2 id=\"who-should-not-take-wegovy\"><span style=\"font-weight: 400;\">Who should not take Wegovy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are certain <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/who-should-not-take-wegovy\/\"><span style=\"font-weight: 400;\">people who shouldn\u2019t take Wegovy<\/span><\/a><span style=\"font-weight: 400;\">. \u201cThere are exclusion criteria with Wegovy, including a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/black-box-warning\/\"><span style=\"font-weight: 400;\">black box warning<\/span><\/a><span style=\"font-weight: 400;\"> regarding an increased risk of thyroid C-cell tumors,\u201d Dr. Shuxiao says. \u201cAnyone with a family history of multiple endocrine neoplasia syndrome 2 (MEN 2) and medullary thyroid carcinoma (MTC) should not take Wegovy.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You should also not take Wegovy if you\u2019re pregnant. \u201cIf you\u2019ve been taking Wegovy and have become pregnant while on it, you should stop taking it immediately,\u201d Dr. Shuxiao advises. If you are taking Wegovy and plan to become pregnant, Dr. Shuxiao recommends stopping Wegovy at least two months beforehand.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Lastly, anyone with an allergy to Wegovy or semaglutide should not take it.<\/span><\/p>\n<h2 id=\"bottom-line\"><span style=\"font-weight: 400;\">Bottom line<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Wegovy is an effective weight loss medication, but it shouldn\u2019t be used alone. The best way to use Wegovy is to combine it with lifestyle adjustments, such as healthy eating and exercise. If you want a prescription for Wegovy, you will need to visit a licensed healthcare provider. They will evaluate your health and decide if Wegovy is the best choice for you. If you are not a good candidate for Wegovy, your healthcare provider can discuss<\/span> <a href=\"https:\/\/www.singlecare.com\/blog\/wegovy-alternatives\/\"><span style=\"font-weight: 400;\">alternative Wegovy medications<\/span><\/a><span style=\"font-weight: 400;\"> with you, which may include<\/span> <a href=\"https:\/\/www.singlecare.com\/prescription\/alli\"><span style=\"font-weight: 400;\">Alli<\/span><\/a><span style=\"font-weight: 400;\"> (orlistat OTC),<\/span> <a href=\"https:\/\/www.singlecare.com\/prescription\/phendimetrazine-tartrate-er\"><span style=\"font-weight: 400;\">Phendimetrazine<\/span><\/a><span style=\"font-weight: 400;\">, or<\/span> <a href=\"https:\/\/www.singlecare.com\/blog\/phentermine-without-insurance\/\"><span style=\"font-weight: 400;\">Lomaira<\/span><\/a><span style=\"font-weight: 400;\"> (phentermine).<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Wegovy (semaglutide) is an injectable GLP-1 (glucagon-like peptide-1) medication that was initially approved by the Food and Drug Administration (FDA) for weight loss along with lifestyle changes like diet and exercise. Since its initial FDA approval, it has also been approved to reduce cardiovascular risk in adults with obesity or adults who are overweight with [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":632849,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[21067,608,9825],"coauthors":[20899],"class_list":["post-632841","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 qualify for Wegovy: A guide to getting a prescription<\/title>\n<meta name=\"description\" content=\"There are age and BMI guidelines regarding how to qualify for Wegovy. 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