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Does the member have a BMI greater than 95% of children their age

In studies with non-placebo control groups, the results were inconclusive

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If not, who decides our formulary?" Make the business case: Obesity treatment reduces long-term healthcare costs (diabetes, heart disease, joint problems) Gather support: If coworkers also want coverage, a group request carries more weight Time it right: Benefits are often reviewed in Q3-Q4 for the following year Be patient: Formulary changes typically take effect at the next plan year WHAT AETNA REQUIRES Prior Authorization Requirements Prior Authorization Requirements Wegovy Is Covered PA Is Required Since Wegovy is the preferred GLP-1 on most Aetna plans, the main hurdle is meeting the prior authorization requirements

(Ongoing coaching visits are available for an additional fee.) Program Costs Provider and Wellness Coaching visits may be billed through insurance or with discounted self-pay rates