What Insurance Covers Wegovy - Factors that Affect the Cost of Wegovy

What insurance covers wegovy? Are you thinking about using wegovy to lose weight but unsure if your insurance will pay for it? There is nowhere else to look! It is a prescription drug with FDA approval that helps people lose weight. It is a stronger form of semaglutide, a drug that was first prescribed to treat type 2 diabetes.

Wegovy helps people sustainably lose weight by decreasing hunger and raising feelings of fullness. We will examine the insurance plans that cover wegovy, the ground-breaking weight-loss drug, in this extensive guide.

What is Wegovy?

Wegovy is a weekly injection that works on the parts of the brain responsible for controlling cravings, fullness, and appetite. It also lessens the speed at which food exits your stomach.

You may feel less hungry during the day and eat less than normal if you inject it once a week. It belongs to the class of medications known as glucagon-like peptide 1 (GLP-1) agonists and is taken in conjunction with a balanced diet and regular exercise.

Those with a prescription can obtain the drug at pharmacies around the United States. Healthcare practitioners can obtain Wegovy samples.

You must have been informed that you are overweight or obese and that you suffer from at least one weight-related medical condition to be eligible for a prescription for wegovy.

How Much Does Wegovy Cost with Insurance

Wegovy will cost you approximately $405 monthly if you have insurance coverage. Even if your insurer covers it, you might still be responsible for a percentage of the cost, like a copay or coinsurance.

Depending on your health insurance plan, wegovy’s cost varies when combined with insurance. Certain providers might pay the whole cost of the prescription drug. On the other hand, some can demand a deductible or copay.

It also depends on the dosage and the quantity of doses needed.

How Much Does Wegovy Cost Without Insurance

Wegovy costs $1,349 per month if you pay the entire price. Usually, a one-month supply comes out to be about $1,300. To help qualified patients save money, the manufacturer, Novo Nordisk, offers a savings program.

A maximum of $600 savings can be obtained per prescription under the program. Wegovy is a costly medication, but it works well to help people lose weight and achieve better health outcomes.

Furthermore, specific clinics and pharmacies could provide uninsured individuals with payment plans or discounts.

Companies That Cover the Cost of Wegovy

Here are some insurance providers that cover wegovy:

Blue Cross Blue Shield.
Aetna.
Cigna.
UnitedHealthcare.
Kaiser Permanente.

It is crucial to note that coverage may differ with each insurance plan.

Factors that Affect the Cost of Wegovy

The amount you pay out of pocket for Wegovy may vary depending on some circumstances, such as:

The pharmacy of your choice.
The status of your insurance coverage.
Your location.
The dosage that you were prescribed.
Your qualification for manufacturer discount cards or patient assistance programs

Wegovy is usually given for extended periods, so your pharmacy bills could increase quickly.

Eligibility Criteria for Wegovy

Several elements are taken into consideration to assess if you are eligible for Wegovy:

Body Mass Index (BMI): You may qualify if your BMI is greater than 30 or 27 and you have a medical problem related to your weight, such as high blood pressure or high cholesterol.
Previous weight loss attempts: You may be eligible if you have tried to lose weight for at least three months by making lifestyle changes like exercising and eating a low-calorie diet, but you have been unable to keep the weight off.

Other factors, including your insurance coverage, existing medications, and medical history, must be considered.

Frequently Asked Questions

Below are frequently asked questions.

How can I get Wegovy Covered by Insurance?

To get your wegovy covered by insurance:

File an appeal to urge the insurance company to reconsider its choice.
Request that the insurance plans at your job begin to pay for prescription medications used for weight loss.
Modify your health insurance policy.

What is Wegovy?

Wegovy is a prescription medicine used to regulate weight in adults who are obese or overweight and have at least one weight-related medical problem, such as high blood pressure, type 2 diabetes, or high cholesterol.

Does Insurance cover Wegovy?

Yes, most insurance policies, both commercial and Medicare, cover Wegovy. However, coverage could vary based on the particular plan and each person’s situation.

How Much Weight do you Lose per Month on Wegovy?

Wegovy’s weight loss goals depend on some factors, including your initial weight, nutritional status, and activity routine. According to clinical trials, Wegovy users dropped 12–14% of their body weight on average over a year. This corresponds to a 15–17 pounds monthly weight decrease on average.

Conclusion

With diet and exercise, wegovy (semaglutide) may be a valuable weight-loss aid. But many people may find the expensive sticker price off-putting, particularly those without Wegovy-covering insurance.

Nevertheless, with the assistance of your healthcare provider, you might be able to lobby for coverage and benefit from savings plans.