If your usual copay is more than $25, you’d be saving money by using the copay card at a participating retail pharmacy. Are there any options available to help cover the price of Wegovy? Use a manufacturer copay cardįor those who qualify, the manufacturer provides a $25 copay card that covers up to six 28-day fills (four injectable pens) of the medication. Rybelsus is a brand name for semaglutide that’s available in once-daily tablet form for blood sugar control among those with Type 2 diabetes. Another Novo Nordisk drug, Ozempic, a Type 2 diabetes medication approved to help control blood sugar, also contains semaglutide but at a lower dose than Wegovy. Other prescription medications contain semaglutide but aren’t FDA-approved for weight loss. And, based on the law that sets patent terms at 20 years, there probably won’t be one for quite a while. Because Wegovy is a new drug, and under an active patent, a generic version isn’t available. Is a generic version of Wegovy available? It’s important to understand that your insurer may require prior authorization or have you try less expensive treatments before you can get coverage for Wegovy. Here are the state Medicaid programs that don’t cover Wegovy: But the good news is that about 78% of state Medicaid programs cover it so far, according to.
Insurance coverage policies for Wegovy are evolving. If you have Medicaid, coverage will depend on where you live. ACA marketplace plans aren’t required to have obesity medication coverage, but some plans may offer it. Individual/family coverage via (the Affordable Care Act) Tricare Prime and Tricare Select plans can offer coverage if it’s determined to be a medically necessary treatment of obesity. Those participating in the MOVE! program may qualify for coverage. If no coverage is available, you may be able to work with your healthcare provider to write a letter requesting coverage. For context, here’s how it stacks up to other weight loss medications:Įxpected coverage for weight loss medications Wegovy’s retail cost for a one-month supply is around $1,627. How does Wegovy’s cost compare to other weight loss drugs? But it isn’t known if Wegovy can cause those tumors in humans. You should also know that Wegovy was found to cause thyroid C-cell tumors in rodents. Wegovy should not be used if you have a personal or family history of medullary thyroid carcinoma (MTC), or if you have Multiple Endocrine Neoplasia syndrome type 2. The most common side effects of Wegovy are digestion-related, including: Samples of the drug are available from healthcare practitioners. Wegovy launched in late June and is available in pharmacies throughout the U.S. As an example, someone whose starting weight was 220 pounds would have lost an average of 27 pounds while taking Wegovy. In the 68-week clinical trial, participants lost an average of 12.4% of their initial body weight, compared to those who had a placebo (sugar pill). To get a prescription for Wegovy, you must either have obesity or overweight and have a weight-related medical condition. It’s in a drug class called glucagon-like peptide 1 (GLP-1) agonists and is used along with a reduced-calorie diet and increased exercise. If you were to inject it, you might feel less hungry throughout the day and subsequently eat less than usual. Wegovy is a weekly injection that targets areas of the brain that regulate appetite and food intake. To find out which services are covered under your policy at any facility, please call the customer service phone number on the back of your Blue Cross and Blue Shield of Texas member ID card.Living With Extra Weight: A Mission to Get Rid of Obesity Stigma Written by Natalie Pompilio What is Wegovy?
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