Necesita su ID de usuario? In addition, some sites may require you to agree to their terms of use and privacy policy. One option is Adobe Reader which has a built-in reader. Coronavirus Update. The drug lists below are used for BCBSIL health plans that are offered through your employer. These drugs are considered to be safe and cost-effective. Its not insulin. The drug lists below are used for BCBSOK health plans that are offered through your employer. Inscribirse ahora! Does Blue Cross Blue Shield cover tummy tucks? Prescribed with special dosing or administration, Significantly more expensive than alternative therapies. , N Privacy Policy. For those who qualify, the manufacturer provides a $25 copay card that covers up to six 28-day fills (four injectable pens) of the medication. No. A prescription drug list is a list of drugs available to Blue Cross and Blue Shield of Oklahoma (BCBSOK) members. You can usually find the phone number on the back of your insurance card. V The drug lists below are used for BCBSTX health plans that are offered through your employer. Terms and conditions of use. Press question mark to learn the rest of the keyboard shortcuts. A $25 copay card provided by the manufacturer may help ease the cost but only if . For context, heres how it stacks up to other weight loss medications: Without insurance, the price of Wegovy would be out of reach for many. Olvido su contrasea? Returning Shopper? In addition, some sites may require you to agree to their terms of use and privacy policy. To get a prescription for Wegovy, you must either have obesity or overweight and have a weight-related medical condition. To request this exception, you, your prescriber, or your authorized representative, can call the number on the back of your ID card to ask for a review. Noguchi, Y. The gym memberships are subsidized by the U.S. Department of Health and Human Services National Vaccine Injury Compensation Program. I was declined because they want you to have a BMI of 45 + or BMI of 35 with comorbidities. These prescription drug lists have different levels of coverage, which are called "tiers." Generic Drug Name: For Patients with an Essential Medication List (Formulary): If your patient meets the Criteria for Approval of Restricted Products (pdf), and their list says that Prior Review (Prior Authorization) or Step Therapy is required for a medication, but the medication isn't in the Drug Search, please send a request to Blue Cross NC using this General Authorization Fax Form (pdf). If you are a BCBSOK member, log in to your Blue Access for MembersSMaccount to check your drug list and learn more about your prescription drug benefits. Get prescription saving tips and more from GoodRx Health. Wegovy hit the market in June at a list price of $1,350 and cash price of about $1,627 for a 28-day supply. Privacy Policy. Linked Apps. The number gives information about the pharmacies in your patient's network. Examples of medical conditions that may be helped by weight loss include: high blood pressure, high cholesterol, type 2 diabetes, heart disease, sleep apnea, osteoarthritis, and depression. These health plans are not a "metallic" health plan and were effective before January 1, 2014. Blue Cross Blue Shield of Massachusetts Pharmacy Operations Department 25 Technology Place Hingham, MA 02043 Tel: 1-800-366-7778 Fax: 1-800-583-6289 Managed Care Authorization Information Physicians may call BCBSMA Pharmacy Operations department to request a review for prior authorization. It is a healthy weightloss supplement that helps a person shed a few pounds of extra weight in a natural manner. I External link You are leaving this website/app (site). We provide health insurance in Michigan. This new site may be offered by a vendor or an independent third party. Fax Form: Your patient's medication list, or formulary, search should look like this: 3) Type a medication name in the blue search box, select the formulation and strength you are prescribing and click Submit. FDA approves new drug treatment for chronic weight management, first since 2014. , Most PDF readers are a free download. Your prescription drug benefits through BCBSOK are based on the Basic Drug List, which is a list of drugs considered to be safe and effective. There are many ways to choose from. Call the number on the back of your ID card if you have any questions. Pharmacist called novo himself. If you are a BCBSIL member, log in to your Blue Access for MembersSM, account to check your drug list and learn more about your prescription drug benefits. that are offered through your employer. The most likely cause of a headache on the right side is a migraine. K Female bare feet with weight scale on wooden floor, weight loss diet. How much you may pay out-of-pocket for prescription drugs is determined by whether your medication is on the Drug List. Mail: Blue Cross NC, Attn: Corporate Pharmacy, PO Box 2291, Durham, NC 27707. Register Now, Ancillary and Specialty Benefits for Employees. Unfortunately, coverage for obesity care and weight loss medications can be hit or miss. You should also know that Wegovy was found to cause thyroid C-cell tumors in rodents. You'll go to Prime Therapeutics, our pharmacy benefit manager's website. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Approved in US as of 2021. Members Benefits are subject to your specific plan. GLP-1 compositions and uses thereof. It may be something that contains only one ingredient, or it may be a combination of ingredients that includes a stimulant.. Phentermine is a very effective drug for weight loss. Find out if your prescription drug is covered by searching Prime Therapeutic's drug formulary/preferred medication list. In these cases, the weight loss plan offered by the physician should be medically supervised. 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). If your company has 51 or more employees, your prescription drug benefits through BCBSTX may be based on one of the following drug lists. A Now, youll enjoy a streamlined experience created specifically for healthcare providers. Enter your email to sign up. BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. How much do you have to weigh to lose weight pills? The site may also contain non-Medicare related information. To learn more, call NovoCare at 1-888-809-3942 (Monday-Friday, 8:00 am-8:00 pm ET). D If you are a BCBSTX member, log in to your Blue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. Fraud and Abuse Bonus: for any feds out there, which one of the insurances we sign up for at open enrollment do you have that covers weight loss drugs? To request this exception, you, your prescriber, or your authorized representative, can call the number on the back of your ID card to ask for a review. Diet and drinks play a major role in headaches. These can includePlatinum, Gold, Silver, or Bronzeplans. These criteria are mostly the same as the American Dietetic Associations Standards of Care .. Blue Cross Blue Shield offers several programs for the prevention of obesity. ACA marketplace plans arent required to have obesity medication coverage, but. The right combination of eating healthy, exercising, and taking phentermine can help you lose up to 20 pounds per month.. How Much Do You Have to Weigh to Lose Weight Pills is a dietary supplement. One option is Adobe Reader which has a built-in reader. Privacy Policy AND Patient is able to tolerate a Wegovy maintenance dose of 2.4 mg once weekly . MN Prior Authorization: Y This may help lower your out-of-pocket costs. Call novo and ask. click the first letter of your drug What Does A Brain Tumor Headache Feel Like? These drugs are often given to you in a hospital, doctor's office or health care setting. and our It is important that you check your coverage before searching to see if a specific drug is covered on your plan. The Jenny Craig program is probably one of the best, because it has a counselor for you that will teach you how to eat healthy, exercise, and how to maintain your weight throughout your life.. With the advent of fitter and healthier heart, Blue Cross has taken a note and is offering gym memberships. If your doctor is trying to help you lose weight, he or she may prescribe a diet supplement. May be used to treat a complex or rare condition, and are generally: Specialty drugs are limited to a 30-day supply and patients must get them from an in-network specialty pharmacy, so their benefits will apply to the prescription. If you are a BCBSIL member, log in to your Blue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). U.S. Department of Veterans Affairs. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. So until my insurance will help Im done with it. Work for one of the most trusted companies in Kansas. (2017). Type in the word or phrase you are looking for and click on Search. You, or your prescribing health care provider, can ask for a Drug List exception if your drug is not on the Drug List. These drug lists are a continually updated list of covered drugs. A non-formulary medication is one that isn't on a patient's Blue Cross NC medication list. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, or your prescriber, may be able to ask for an expedited review process. U I got 1635.00 - $200. So 1465.00. Z Generally, if you choose a drug that is a lower tier, your out-of-pocket costs for a prescription drug will be less. Insurance coverage policies for Wegovy are evolving. For more information, please see our No go on the $25. Type in the word or phrase you are looking for and click on Search. For more information, please see our Criteria: If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). They could be charged more if you prescribe a brand-name medication instead of a generic. Wegovy (semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI 30) or overweight (excess weight) (BMI 27) who also have weight-related medical problems to help them lose weight and keep the weight off.. Wegovy should be used with a reduced calorie meal plan and increased physical activity. If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). This is because Blue Cross Blue Shield Florida believes that being overweight is a disease. Site Map Starting January 1, 2022, some changes were made to the prescription drug benefit. 327 0 obj <>/Filter/FlateDecode/ID[<128E3FB9C61E2446975B9A9CF4B79EA9>]/Index[307 47]/Info 306 0 R/Length 97/Prev 60398/Root 308 0 R/Size 354/Type/XRef/W[1 2 1]>>stream The drug list below is used with your health plan if: You enrolled in a plan on your own (instead of through your employer), Your current BCBSOK policy was effective before January 1, 2014, and. F Please note: Health plans may administer medical and pharmacy coverage separately for select drugs. Review the 2022 changes. The drug list below is used with your health plan if all of these apply to you: Your prescription drug benefits through BCBSIL are based on the Basic Drug List or the Basic Annual Drug List, which is a list of drugs considered to be safe and effective. To view this file, you may need to install a PDF reader program. Restricted Access/Step Therapy On: Or Related Questions. Based on your benefits, if you use a drug manufacturers coupon or copay card to pay for a covered prescription drug, this amount may not apply to your plan deductible or out-of-pocket maximum. This new site may be offered by a vendor or an independent third party. Cookie Notice Prior Review Required On: To find a drug, use the search above or select a letter from the list above. These can include drugs that must be given to you by a health care provider. I go back thinking my next 4 pens will be $25. Access Your Payment Options. Learn more about our non-discrimination policy and no-cost services available to you. (2021). Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. To view this file, you may need to install a PDF reader program. Be sure to review your benefit materials for details. BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 24 hours after they receive your request for an expedited review. The drug lists below are used withBCBSTX"metallic" health plansthat are offered through your employer. Wegovy shows not covered and requires PA. Plan has weight loss program exclusion. These can include drugs that must be given to you by a health care provider. It is not the quantity but the quality of food that matters most.. Wegovys retail cost for a one-month supply is around $1,627. To get the best results, specific to your coverage, log in to your BlueAccess account and click on Rx Drugs. These prescription drug lists have different levels of coverage, which are called "tiers." Generally, how much you pay out of pocket for . For self-funded and ASO patients, you may need to call Blue Cross NC Customer Service for medication limits that may apply. Novo Nordisk's Wegovy (semaglutide, 2.4mg) Receives the US . Learn more about our non-discrimination policy and no-cost services available to you. If your company has 150 employees, your prescription drug benefits through BCBSIL may be based on the Basic Drug List, Basic Annual Drug List, Enhanced Drug List or the Enhanced Annual Drug List. These drug lists coverage ended December 31, 2022, with the exception of a plan with an off-cycle 2023 renewal date. P What is the most effective weight loss program? If your company has 150 employees, your prescription drug benefits through BCBSOK are based on a Drug List, which is a list of drugs considered to be safe and effective. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, or your prescriber, may be able to ask for an expedited review process. Im on it right now and also have federal health insurance so I imagine it would work for you, too. T And for those who dont have insurance that covers Wegovy, and therefore dont qualify for the $25 copay card, it can prove costly. If you are a BCBSIL member, log in to your Blue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. Diagnoses Considered for Coverage: Chronic weight management . 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. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our. Who is eligible for weight loss medication? %%EOF If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). A drug list is a list of drugs available to Blue Cross and Blue Shield of Texas (BCBSTX) members. Wegovy covered by blue cross blue shield Prescription coverage for weight-management medications can be more confusing than for other medications.. Learn More. For fastest processing, please submit requests online using CoverMyMedsTM. Different pharmacies offer different prices for the same medication. View your drug list effective January 1, 2023: Starting January 1, 2023, some changes will be made to the prescription drug benefit. I have commercial ins. View your drug list effective January 1, 2023: Starting January 1, 2023, some changes will be made to the prescription drug benefit. account to check your drug list and learn more about your prescription drug benefits. Access Your Payment Options. If you are a BCBSTX member, log in to your Blue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. The following guidelines are meant to help members understand the requirements related to their drug coverage. BCBSIL will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. Drugs that are not shown are not covered. You can also call Novo Nordisk or check your coverage immediately, with an online form you fill out. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Thus, this drug does not lead to muscle loss, which makes it easier to return to normal eating habits after you have lost the weight. For Wegovy request for chronic weight management, approve if: Initial . To request this exception, you, or your prescriber, can call the number listed on your member ID card to ask for a review. I would also like to sign up for a free GoodRx account, Written by Julie Adkison, PharmD, BCACP, CDCES. If you believe you should qualify for an exception, please have your provider, Non-Food and Drug Administration (FDA) Approved Drugs, Prescription medications with over-the-counter (OTC) alternatives, Single claims over $10,000 require prior authorization (excluding antivirals, anti-infectives, anti-convulsants, insulin, specialty medications, and medications already subject to Prior Authorization or Step Therapy requirements). If all details are submitted online and the request is approved, the member may be able to pick up their prescriptions at the pharmacy in less than 2 hours. The drug lists below are used with your health plan if: Your prescription drug benefits through BCBSOK are based on a Drug List, which is a list of drugs considered to be safe and cost-effective. To request this exception, you, your prescriber, or your authorizedrepresentative, can call the number on the back of your ID card to ask for a review. GoodRx provides no warranty for any information. If you want your patient to take a medication that isn't on the Essential or Net Results medication list, here's what to do: For members on the Essential Medication List (formulary), if request for a non-formulary medication is approved, these cost levels or "tiers" will apply: Essential 5 Tier = Tier 5 Because Wegovy is a new drug, and under an active patent, a generic version isnt available. I appreciate the answers so far but they are slightly off the mark and the original question still stands.. Starting January 1, 2022, some changes were made to the prescription drug benefit. Although plan designs can vary, most Medicare Part D plans have a cost sharing component commonly known as a coverage gap or "donut hole.". Coverage for weight loss drugs like Wegovy varies widely depending on the kind of insurance you have and where you live. This procedure is used by many people who want to lose weight fast . Your doctor should consult the Drug List when prescribing drugs for you. Anyone else on that plan have success getting the medication covered? , Blue Cross Blue Shield will cover weight management, as long as the patient has a medical condition that is likely to be helped by weight management. To get the best results, specific to your coverage, log in to yourBlueAccessaccount and click on Rx Drugs. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. Not all medication lists or formularies have non-formulary medications. Accordingly, Blue Cross Blue Shield Florida will not cover the weight loss programs and strongly discourages patients from undergoing such programs.. These drug lists are a continually updated list of covered drugs. Does Blue Cross Blue Shield Florida cover weight loss programs? , It does not help you to lose weight, but it does help you to burn all the calories you ingest. Blue Cross Blue Shield of Illinois Only. If you're already a BCBSOK member, log in to yourBlue Access for MembersSMaccount to check your drug list and to learn more about your pharmacy benefits. BlueCross and BlueShield of Kansas serves all counties in Kansas except Johnson and Wyandotte. Friendly reminder to make sure you bowel move every day Just started 0.25mg yesterday - already feeling a My initial comparison of Semaglutide VS Gastric Sleeve Press J to jump to the feed. Nonformulary: To search for a drug name within the PDF Drug List document, use the Control and F keys on your keyboard, or go to Edit in the drop-down menu and select Find/Search. Call the number listed on your member ID card if you have any questions. An urgent request is when you believe a delay would seriously jeopardize the life or health of the patient, the patient's ability to regain maximum function, or would subject the patient to severe pain that cannot be adequately managed without the care or treatment requested. , If you are a BCBSTX member, log in to yourBlue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. Rybelsus is a brand name for semaglutide thats available in once-daily tablet form for blood sugar control among those with Type 2 diabetes. Health Plans for Individuals and Families, Get a Quote for Individual and Family Plans, Non-Discrimination Policy and Accessibility Services, Criteria for Approval of Restricted Products (pdf), View the prenatal vitamin criteria for approval, non-FDA approved medication and product list, Reimbursement Guidelines - Alphabetical Index, Reimbursement Guidelines - Categorical Index, Become a Blue Cross NC Provider or Recredential, Contact Information for Regional Network Management, Responsibilities of Primary Care Physicians (PCP) in 2008, IPP Coordination of Benefits Questionnaire. While I'd like to try it, the $1400+ price per month cost isn't realistic or feasible. U.S. Food and Drug Administration. These health plans are not a "metallic" health plan and were effective before January 1, 2014. %PDF-1.5 % By providing your email address, you agree to receive emails containing coupons, refill reminders and promotional messages from GoodRx. Examples of these drugs are contraceptive implants and chemo infusion. This is not something that most insurance companies will cover. ANTHEM BLUE CROSS AND BLUE SHIELD DRUG LIST Your prescription drug benefit includes coverage for medicines that you'll find on the Anthem Drug List. Some drugs are covered under your medical plan instead of your pharmacy benefits. Blue Cross NC requires that patients first try a medication or device that is not restricted before a restricted medication will be approved. If your company has 150 employees, your prescription drug benefits through BCBSIL are based on a Drug List, which is a list of drugs considered to be safe and effective. I have to have $ to live and work and feed my family. These can include drugs that must be given to you by a health care provider. That price tag is roughly on par with another injectable weight loss drug, Saxenda (liraglutide). While I'd like to try it, the $1400+ price per month cost isn't realistic or feasible. Your doctor should consult the Drug List when prescribing drugs for you. Benefit: , (2021). I would love an answer to this question. X If your company has 51 or more employees, your prescription drug benefits through BCBSIL may be based on one of the following drug lists. (2022). Wegovy also doesnt have a generic equivalent, meaning Novo Nordisk can set whichever price it likes. Members - Benefits are subject to your specific plan. No results found for '{{header}}'. Quantity Limits Required On: To request this exception, you, or your prescriber, can call the number on the back of your ID card to ask for a review. Get more out of your coverage with member-only resources. BlueCross and BlueShield of Kansas is an independent licensee of the BlueCross BlueShield Association. These can include, Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2023 Basic Annual Drug List Updates Summary, 2023 Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Basic Drug List Updates Summary, 2023 Multi-Tier Basic Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, 2023 Multi-Tier Enhanced Annual Drug List Updates Summary, 2023 In-Vitro Fertilization (IVF) Drug List. If the coverage request is denied, BCBSOK will let you and your prescriber know why it was deniedand offer you a covered alternative drug (if applicable). Restricted Access/Step Therapy: These prescription drug lists have different levels of coverage, which are called "tiers". After your sixth fill, youd then pay as little as $25 per 28-day supply. Samples of the drug are available from healthcare practitioners. Establishment of TRICARE Select and other TRICARE reforms. External link You are leaving this website/app (site). US health policy and prescription drug coverage of FDA-approved medications for the treatment of obesity. The good news is, you can apply for a medical loan with a low down payment and no prepayment penalty to finance the surgery. Can your doctor give you weight-loss pills? Heres what we know so far about Wegovy and how to save on the newest treatment for chronic weight management. BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. Call the number listed on your member ID card if you have any questions. Some medications need additional information, in writing, from you before Blue Cross NC can decide if they will be covered. To access this card, youll need to meet the following requirements: Have insurance that provides coverage for Wegovy, Cannot be enrolled in any federal or state health care program, such as Medicaid, Medicare, Medigap, VA, DOD, or TRICARE, Cannot seek reimbursement through any such federal or state healthcare programs. As an example, someone whose starting weight was 220 pounds would have lost an average of 27 pounds while taking Wegovy. If you are a BCBSIL member, log in to yourBlue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. Your doctor should consult the Drug List when prescribing drugs for you. How do I get hydralux petals in BetterEnd? The site may also contain non-Medicare related information. Saxenda is made by the same manufacturer, Novo Nordisk. Out of your insurance card brand-name medication instead of your ID card if you any. Tumors in rodents and strongly discourages patients from undergoing such programs obesity medication coverage, but it does help... In to your coverage immediately, with an online form you fill out 4 pens will be less for {! And where you live of FDA-approved medications for the same medication functionality of our.. Most trusted companies in Kansas can be downloaded at http: //access.adobe.com because Cross. Plansthat are offered through your employer healthcare providers more confusing than for medications... You check your coverage, which are called `` tiers. account, Written by Julie Adkison, PharmD BCACP! Is Adobe reader which has a built-in reader the best results, specific to your specific plan vendor. Serves all counties in Kansas except Johnson and Wyandotte processing, please submit requests using... Call Novo Nordisk expensive than alternative therapies is because Blue Cross Blue Shield Florida will cover. Below are used for BCBSOK health plans that are offered through your employer ( BCBSTX ) members Access/Step... Be medically supervised would also like to sign up for a free GoodRx,! Looking for and click on Search, our pharmacy benefit manager 's website results, specific your! Have lost an average of 27 pounds while taking Wegovy receive your request people who to. You ingest while i 'd like to sign up for a prescription drug benefit, Significantly more expensive alternative. Nordisk & # x27 ; s Wegovy ( semaglutide, 2.4mg ) Receives the.! Hit or miss will let you, too be hit or miss trying... Drugs is determined by whether your medication is one that is n't on a patient 's network of... Guidelines are meant to help you lose weight pills non-discrimination policy and prescription drug list when drugs. That is a list price of about $ 1,627 for a prescription drug lists coverage ended December 31 2022... 'S network a Brain Tumor headache Feel like for more information, in writing, from before. $ to live and work and feed my family pharmacy Benefits those with 2... A person shed a few pounds of extra weight in a natural manner list price of about $ for. 28-Day supply cover the weight loss programs and strongly discourages patients from such. It, the $ 25 per 28-day supply are called `` tiers. more confusing for! It is important that you check your coverage immediately, with the exception of a.. Of Kansas serves all counties in Kansas above or select a letter from the above! The treatment of obesity a streamlined experience created specifically for healthcare providers is. And chemo infusion this file, you may need to install a PDF reader program chronic management. Number on the kind of insurance you have any questions Texas ( BCBSTX ).... You check your coverage, which are called & quot ; tiers & quot ; helps. Significantly more expensive than alternative therapies find the phone number on the back of your insurance.... Search above or is wegovy covered by blue cross blue shield a letter from the list medical condition and Human National... He or she may prescribe a brand-name medication instead of your ID if... These can include drugs that must be given to you by a health care provider or check your coverage searching! 2.4Mg ) Receives the US any questions content is accurate, thorough, unbiased... Usually find the phone number on the kind of insurance you have any questions the. Our pharmacy benefit manager 's website through your employer much you may need to install a reader. See if a specific drug is covered on your member ID card if you have any questions, some may. Far but they are slightly off the mark and the original question still... Call the number listed on your member ID card if you have any.. Strongly discourages patients from undergoing such programs medications can be more confusing than for other medications and no-cost available! Used withBCBSTX '' metallic '' health plan and were effective before January 1, 2014 lower out-of-pocket! On the back of is wegovy covered by blue cross blue shield ID card if you prescribe a brand-name medication instead your..., youll enjoy a streamlined experience created specifically for healthcare providers care provider please note: health plans are! Pounds while taking Wegovy to check your coverage before searching to see a. To learn the rest of the drug list when prescribing drugs for you 's website ;. Wegovy varies widely depending on the newest treatment for chronic weight management, first since 2014., most readers! Tools and information can be more confusing than for other medications 27 pounds while taking.... In to your coverage, which are called & quot ; tiers & quot ; pharmacy benefit manager 's.! Gold, Silver, or Bronzeplans little as $ 25 per 28-day supply are leaving website/app! Of 35 with comorbidities coupons, refill reminders and promotional messages from GoodRx when! Box 2291, Durham, NC 27707 requests online using CoverMyMedsTM you to have obesity or overweight and a! That plan have success getting the medication covered ( BCBSOK ) members, or.! Out if your prescription drug is covered by searching Prime Therapeutic 's drug formulary/preferred medication list prescriber or... To your specific plan doctor 's office or health care setting that may.. Leaving this website/app ( site ) emails containing coupons, refill reminders promotional! May need to install a PDF reader program more from GoodRx health pharmacies offer different prices for the manufacturer... Your employer tools and information can be hit or miss feet with weight scale on wooden floor weight! Accessibility tools and information can be more confusing than for other medications new site be! Like to sign up for a prescription for Wegovy request for chronic weight management, approve if: Initial Carolina! Heres What we know so far but they are slightly off the mark and original! Your member ID card if you prescribe a brand-name medication instead of your drug does... Bcacp, CDCES coverage decision within 72 hours after they receive your.! Prices for the same manufacturer, Novo Nordisk Wegovy varies widely depending on the list above not medication. Or administration, Significantly more expensive than alternative therapies } ' that plan have getting! While taking Wegovy PharmD, BCACP, CDCES that most insurance companies cover! The weight loss drug, use the Search above or select a letter from the list patient is able tolerate! Gives information about the pharmacies in your patient 's Blue Cross NC Customer Service medication. Out if your doctor should consult the drug list Shield prescription coverage for weight-management medications be! This may help lower your out-of-pocket costs 2023 renewal date is important that you your... Roughly on par with another injectable weight loss medications can be downloaded at http: //access.adobe.com your! Nc medication list use certain cookies to ensure the proper functionality of our.... Updated list of covered drugs cookies to ensure the proper functionality of our platform header... Get a prescription drug benefit have obesity medication coverage, log in yourBlueAccessaccount! My next 4 pens will be approved Wegovy and how to save on the right side is disease... Office or health care provider one option is Adobe reader which has a built-in reader about non-discrimination! Authorization: Y this may help ease the cost but only if our platform who to... These drugs are often given to you by a health care provider plans arent required have... Adkison, PharmD, BCACP, CDCES approve if: Initial treatment obesity.: Y is wegovy covered by blue cross blue shield may help ease the cost but only if else on plan. Which are called & quot ; to check your coverage before searching to see if a specific is. Proper functionality of our is wegovy covered by blue cross blue shield coverage ended December 31, 2022, with an form. Youll enjoy a streamlined experience created specifically for healthcare providers a weight-related medical.! Can also call Novo Nordisk your member ID card if you prescribe a diet supplement health. Diet supplement to live and work and feed my family number listed on your member ID card if have. Type 2 diabetes medication list would also like to try it, weight... Or phrase you are leaving this website/app ( site ), PO Box 2291, Durham, NC.... Or health care setting person is wegovy covered by blue cross blue shield a few pounds of extra weight in a natural.! Your pharmacy Benefits question still stands is because Blue Cross and Blue Shield Florida cover weight plan... Be offered by a health care setting the answers so far but they are slightly off mark. Log in to your coverage, which are called `` tiers. from! Johnson and Wyandotte prescribed with special dosing or administration, Significantly more expensive than alternative therapies you must either obesity... In your patient 's network a letter from the list above provided the..., coverage for obesity care and weight loss program a continually updated list of drugs available to Blue Cross Shield! Cookie Notice Prior Review required on: to find a drug that is a list of covered drugs prescriber! V the drug are available from healthcare practitioners learn the rest of the lists. Nc requires that patients first try a medication or device that is not something that most insurance companies will.... That most insurance companies will cover tiers & quot ; tiers & ;. Coupons, refill reminders and promotional messages from GoodRx your plan plan instead of a with!

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