{"id":634540,"date":"2025-12-05T17:48:41","date_gmt":"2025-12-05T22:48:41","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=634540"},"modified":"2025-12-05T17:48:41","modified_gmt":"2025-12-05T22:48:41","slug":"does-the-va-cover-wegovy","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-the-va-cover-wegovy\/","title":{"rendered":"Does the VA cover Wegovy?"},"content":{"rendered":"

According to a 2024 Gallup poll, 55% of Americans reported wanting to lose weight. And for some of those people, weight loss medications like<\/span> Wegovy<\/span><\/a> (semaglutide) might be the answer. A GLP-1 drug that\u2019s FDA-approved for weight management, clinical trials have proven its effectiveness in reducing body weight, waist circumference, and waist-to-height ratio. However, Wegovy can be expensive when paying out of pocket, and if you have U.S. Department of Veterans Affairs (VA) benefits, you may wonder if they can be use. Possibly, but it depends on several factors. We\u2019ve outlined them all here.\u00a0<\/span><\/p>\n\t\t

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Save up to 80% on Wegovy with SingleCare<\/p>\n\t\t\t

Different pharmacies offer different prices for the same medication. SingleCare helps find the best price for you.<\/p>\n\t\t\t

\n\t\t\t\t
\n\t\t\t\t\tWegovy 2.4 mg\/0.75 mL (4 Pens)\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\t23666 - Hampton, VA\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t\t\t
\n\t\t\t
\n\t\t\t\"Kroger\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$1220.27\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
\n\t\t\t
\n\t\t\t\"Harris\t\t\t<\/div>\n\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t$1220.27\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t\ti<\/span>\n\t\t\t\t\tPrice with signup<\/a>\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t
\n\t\t\t\tGet free coupon<\/a>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\tSee Wegovy prices at all pharmacies<\/a>\n\t\t<\/div>\n\n\t\t\n

Does the VA cover Wegovy?<\/span><\/h2>\n

The VA does not typically cover Wegovy; however, it may do so under specific circumstances and after prior authorization is approved. Patients who receive coverage must meet several criteria, including body mass index (BMI) requirements, lifestyle modifications, and, in some cases, the presence of coexisting medical conditions.\u00a0<\/span><\/p>\n

The VA\u2019s national formulary<\/span><\/h2>\n

Every health insurance plan has a list of drugs that shows how they\u2019re classified and covered, along with any special requirements. This is a formulary, and while private insurance companies have different formularies for each plan, the VA has a single overarching list called the national formulary. This formulary lists Ozempic, but not Wegovy.<\/span><\/p>\n

\u201cThe VA formulary is created through the careful evaluation and selection of available drugs by committees of medical and pharmacy experts, including pharmacists, physicians, and nurses,\u201d says<\/span> Shannon Fitzgerald, Pharm.D<\/span><\/a>, pharmacist, toxicologist, and contributor at Drugwatch.com. \u201cThese Pharmacy and Therapeutics Committees focus on clinical evidence, cost-effectiveness, and safety through a formal review process that can include voting on changes to the existing formulary.\u201d<\/span><\/p>\n

The U.S. Department of Veteran Affairs updates this list every month and posts every update\u2014along with a new version of the list\u2014on<\/span> this page<\/span><\/a>. The most recent formulary shows that Ozempic is covered, but it requires prior authorization. Name-brand Wegovy, however, is not. That said, individuals who meet specific criteria (see below) may have it approved.\u00a0<\/span><\/p>\n

How to request coverage for a non-formulary drug<\/span><\/h3>\n

Wegovy isn\u2019t listed on the national formulary, but that doesn\u2019t mean coverage is out of the question. However, you and the prescribing healthcare provider will need to follow a few steps, and the first is<\/span> submitting a non-formulary request<\/span><\/a> explaining why Wegovy is medically necessary.\u00a0<\/span><\/p>\n

\u201cThis request is sent to the VA Pharmacy, and reviews must be completed within 96 hours, resulting in approval or denial,\u201d Fitzgerald says. \u201cIf the medication is not approved, information necessary to support a future request will be provided by a VA Pharmacist, and an appeal may be made to the VA care team.\u201d<\/span><\/p>\n

VA requirements for Wegovy coverage<\/span><\/h2>\n

Even in cases where the VA agrees to cover Wegovy for weight loss, that coverage comes with several contingencies. Here are<\/span> the criteria<\/span><\/a>.<\/span><\/p>\n

Body mass index<\/span><\/h3>\n

Typically, the VA does not cover Wegovy for individuals with a body mass index (BMI) of 25-29.99 who simply want to lose a few pounds. In fact, they will only cover it for people with obesity, defined as a body mass index (BMI) of 30 kg\/m2 or higher. People who have a BMI of 27 kg\/m2 or higher can get coverage too, but only if they have a weight-related comorbidity like cardiovascular disease, metabolic disorder, or Type 2 diabetes.<\/span><\/p>\n

Lifestyle changes<\/span><\/h3>\n

Weight loss medications work best when paired with a diet and exercise program, and the VA requires patients to have an existing program that includes both before they\u2019ll cover Wegovy.<\/span><\/p>\n

The VA will only cover Wegovy \u201cfor those patients who have verifiable participation in a comprehensive lifestyle intervention (CLI) that targets all three aspects of weight management: diet, physical activity, and behavioral changes,\u201d Fitzgerald says. The Veterans Health Administration (VHA) offers its own weight loss program, MOVE!, available to all veterans.<\/span><\/p>\n

Additional medical conditions<\/span><\/h3>\n

The BMI and lifestyle requirements are both non-negotiable for Wegovy coverage, but on top of that, patients must meet one of the following requirements:<\/span><\/p>\n