{"id":633289,"date":"2025-08-22T15:16:39","date_gmt":"2025-08-22T19:16:39","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=633289"},"modified":"2025-10-22T19:23:52","modified_gmt":"2025-10-22T23:23:52","slug":"does-blue-cross-blue-shield-cover-saxenda","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-blue-cross-blue-shield-cover-saxenda\/","title":{"rendered":"Does Blue Cross Blue Shield cover Saxenda?"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/saxenda\"><span style=\"font-weight: 400;\">Saxenda<\/span><\/a><span style=\"font-weight: 400;\"> (liraglutide) is a brand-name prescription drug that\u2019s approved by the Food and Drug Administration (FDA) to help people 12 and older lose weight and maintain their weight loss. Like most <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/glp-1-agonists\"><span style=\"font-weight: 400;\">glucagon-like peptide-1 (GLP-1) receptor agonists<\/span><\/a><span style=\"font-weight: 400;\">, Saxenda is injected under the skin, once daily in this case, and works best when used alongside a low-calorie diet and routine physical activity. Some insurance companies cover weight loss medications like Saxenda, but others don\u2019t.\u00a0<\/span><\/p>\n<h2 id=\"does-blue-cross-blue-shield-cover-saxenda\"><span style=\"font-weight: 400;\">Does Blue Cross Blue Shield cover Saxenda?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Blue Cross Blue Shield (BCBS) drug coverage varies based on a couple of factors:<\/span><\/p>\n<ul>\n<li><b>BCBS affiliate: <\/b><span style=\"font-weight: 400;\">There are more than 30 independently owned and operated BCBS affiliates around the country, and some don\u2019t cover <\/span><a href=\"https:\/\/www.novo-pi.com\/saxenda.pdf\"><span style=\"font-weight: 400;\">Saxenda<\/span><\/a><span style=\"font-weight: 400;\"> in any of their health plans.<\/span><\/li>\n<li><b>Plan: <\/b><span style=\"font-weight: 400;\">When a BCBS affiliate does offer Saxenda coverage, it\u2019s usually only available in specific insurance plans.\u00a0<\/span><\/li>\n<\/ul>\n<p>For example, most <a href=\"https:\/\/fm.formularynavigator.com\/FBO\/143\/Essential_4_Tier_ABCBSVa.pdf\">Anthem BCBS formularies<\/a> list Saxenda with a \u201cBE\u201d caveat. This stands for \u201cbenefits exclusion\u201d and means specific plans might not cover Saxenda.\u00a0<b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">In addition, federal law prevents Medicare plans from covering weight loss drugs like Saxenda. An alternative, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/wegovy\"><span style=\"font-weight: 400;\">Wegovy <\/span><\/a><span style=\"font-weight: 400;\">(semaglutide), may be covered when used for heart disease indications. Insurance coverage for Saxenda under Medicaid varies by state.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When Saxenda is covered, it\u2019s usually as a non-preferred drug that requires <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/prior-authorization\/\"><span style=\"font-weight: 400;\">prior authorization<\/span><\/a><span style=\"font-weight: 400;\">. This means the insurance company wants to know why you need to take Saxenda instead of a lower-cost alternative. Your healthcare provider will handle that on your behalf. There\u2019s a chance the insurance company will deny your claim, so coverage isn\u2019t guaranteed.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI have had a few patients with BCBS plans who were able to get Saxenda approved after submitting a prior authorization,\u201d says <\/span><a href=\"https:\/\/www.linkedin.com\/in\/jenbrownmd\/\"><span style=\"font-weight: 400;\">Jennifer Brown<\/span><\/a><span style=\"font-weight: 400;\">, MD, a board-certified obesity medicine doctor at Maxwelton Health Center in Maxwelton, West Virginia. She says once your initial prior authorization is approved, the insurance company will request updates on a regular basis.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If Saxenda isn\u2019t included in your BCBS plan\u2019s <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-a-formulary\/\"><span style=\"font-weight: 400;\">formulary<\/span><\/a><span style=\"font-weight: 400;\">, you can ask your healthcare provider to submit an exception request, or you could <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/insurance-appeal-letter\/\"><span style=\"font-weight: 400;\">appeal<\/span><\/a><span style=\"font-weight: 400;\"> the denial. Under certain circumstances, health insurance companies may cover the cost of a prescription drug that they normally don\u2019t cover. You or your healthcare provider will need to explain why Saxenda is medically necessary and why you can\u2019t take an alternative medication.<\/span><\/p>\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;\">BCBS Wegovy prior authorization criteria<\/span><\/a><\/p>\n<h2 id=\"how-much-is-saxenda-without-insurance\"><span style=\"font-weight: 400;\">How much is Saxenda without insurance?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Without insurance, a one-month supply of Saxenda retails for about $1,810 for 5, 3 mL of 18 mg\/3 mL pens. This is about the same price as 4, 0.75 mL of 2.4 mg\/0.75 mL pens of Wegovy, but around $300 more expensive than 4, 0.5 mL of 5 mg\/0.5 mL pens of <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zepbound\"><span style=\"font-weight: 400;\">Zepbound<\/span><\/a><span style=\"font-weight: 400;\"> (tirzepatide).<\/span><\/p>\n<h2 id=\"how-much-does-saxenda-cost-with-bcbs\"><span style=\"font-weight: 400;\">How much does Saxenda cost with BCBS?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The cost of Saxenda with BCBS varies by plan. Some BCBS plans have a $0 copay and 0% coinsurance for prescription drugs as long as you get them from a participating pharmacy.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Others have a coinsurance of 40% or higher for Tier 3 drugs like Saxenda, which means you\u2019d pay about $724 in out-of-pocket costs each month until you reach your plan\u2019s out-of-pocket maximum.\u00a0<\/span><\/p>\n<h2 id=\"how-to-check-whether-your-bcbs-plan-covers-saxenda\"><span style=\"font-weight: 400;\">How to check whether your BCBS plan covers Saxenda\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are several ways to check whether your BCBS plan covers Saxenda:\u00a0<\/span><\/p>\n<ul>\n<li><b>Check for coverage through the manufacturer\u2019s website. <\/b><span style=\"font-weight: 400;\">Fill out a <\/span><a href=\"https:\/\/www.novocare.com\/obesity\/products\/saxenda\/check-coverage.html\"><span style=\"font-weight: 400;\">short form<\/span><\/a><span style=\"font-weight: 400;\"> on the NovoCare website to find out if your plan covers Saxenda. You\u2019ll need to share your first and last name, date of birth, gender, ZIP code, and healthcare provider\u2019s last name and state.<\/span><\/li>\n<li><b>Call the customer care number on the back of your insurance card. <\/b><span style=\"font-weight: 400;\">A representative can look up your plan information and verify whether Saxenda is covered.<\/span><\/li>\n<li><b>Log in to your BCBS account. <\/b><span style=\"font-weight: 400;\">Look for Saxenda on the latest drug formulary (also called a drug list).<\/span><\/li>\n<\/ul>\n<h2 id=\"how-to-save-on-saxenda\"><span style=\"font-weight: 400;\">How to save on Saxenda<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If your BCBS plan doesn\u2019t cover Saxenda, consider using a <\/span><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\"><span style=\"font-weight: 400;\">SingleCare prescription discount card<\/span><\/a><span style=\"font-weight: 400;\"> to avoid paying the full retail price. SingleCare coupon cards are free to download and are accepted at most major pharmacies nationwide.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">With a SingleCare card, the total cost of 5, 3 mL of 18 mg\/3 mL Saxenda pens is as low as $1,215. That\u2019s about 30% off, or about $600 in savings.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">But that\u2019s still pretty pricey. To save even more, Dr. Brown recommends talking to your healthcare provider about liraglutide, the generic version of Saxenda and Victoza, which is FDA approved to treat Type 2 diabetes. \u201cI have used it off-label for weight loss treatment, and it\u2019s significantly less expensive than the other GLP-1 medications,\u201d she says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Liraglutide costs about $211 for 1, 3 mL of 18 mg\/3 mL pen with a SingleCare <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/liraglutide\"><span style=\"font-weight: 400;\">liraglutide coupon<\/span><\/a><span style=\"font-weight: 400;\">\u2014a savings of about $150 per 3 mL pen compared to the cost of brand-name Saxenda.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To get a SingleCare coupon, search for Saxenda (or liraglutide, if applicable) on the SingleCare website. Then enter your ZIP code and browse the list of pharmacies that accept SingleCare coupons. Prices vary by pharmacy, so choose the one that works best for you. Click the \u201cGet Free Coupon\u201d button to view your unique discount code. You can print it, email it, text it, or access it later via your SingleCare account.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tell your healthcare provider to send your Saxenda prescription to the pharmacy you chose when selecting your coupon. When it\u2019s ready for pickup, show the pharmacy staff your SingleCare discount code and enjoy your savings.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To save the most money, you may want to consider a different weight loss medication altogether. Your healthcare provider can help you weigh the pros and cons of Saxenda alternatives and help you explore covered options.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Learn more about <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/how-to-save-on-saxenda\"><span style=\"font-weight: 400;\">how to save on Saxenda<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Saxenda (liraglutide) is a brand-name prescription drug that\u2019s approved by the Food and Drug Administration (FDA) to help people 12 and older lose weight and maintain their weight loss. Like most glucagon-like peptide-1 (GLP-1) receptor agonists, Saxenda is injected under the skin, once daily in this case, and works best when used alongside a low-calorie [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":633290,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[21067,608,9825],"coauthors":[21074],"class_list":["post-633289","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 v27.0 (Yoast SEO v27.0) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does Blue Cross Blue Shield cover Saxenda?<\/title>\n<meta name=\"description\" content=\"Saxenda coverage is rare, since it\u2019s a weight loss drug, but some 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