Cost

What insurance covers Wegovy

Whether your insurance covers Wegovy for weight loss is usually decided by your employer rather than by the insurance company on your card. UnitedHealthcare describes its own weight-loss program as "an optional program that is put in place for clients or businesses that have elected to cover weight loss products".

What that is based on

CVS Caremark says plan sponsors "retain discretion to customize coverage" for their members. Where a plan does cover Wegovy for weight loss it usually asks for a prior authorization first, and then asks you to have lost at least 5% of your starting weight before it will keep paying. Wegovy is also approved for two other things, and that matters: a plan that excludes weight-loss medication can still cover Wegovy for cardiovascular risk reduction or for MASH, under different criteria.

By John Weeks Updated September 11, 2026

The door most people are never told about

Wegovy for weight loss: Excluded on many plans Chosen by the employer, before any clinical criteria apply
Wegovy for other approved uses: A separate decision Cardiovascular risk reduction and MASH are judged on their own criteria

Wegovy is approved for more than weight loss, and a plan that excludes weight-loss medication has not necessarily excluded Wegovy. UnitedHealthcare directs its own reviewers to separate criteria for plans that do not cover weight-loss drugs. Whether either applies to any individual is a question for a prescriber.

What we found when we read them

What we found when we read the payers and the state programs ourselves. Anything nobody here has opened is counted as unchecked rather than guessed.

Commercial payers we have read

Of the 8 payers read from their own published policy, 4 cover Wegovy only after a prior authorization and 2 cover it outright. 2 have not been checked for this medicine. On 6 of them the employer decides whether it is covered at all.

Blue Cross Blue Shield is not counted here, because each of its member companies decides for itself.

See each payer

Medicaid, by state

Across 51 jurisdictions, 13 cover Wegovy for weight loss subject to prior authorization and 0 cover it outright. 22 cover it only for another indication, which is not coverage for weight loss, and 12 refuse it. 4 are honestly marked not checked.

Check your state

The short version

Who decides on a plan through work: Your employer, not the insurer
To keep covering it: At least 5% of starting weight lost by the first review
If weight loss is excluded: The cardiovascular and MASH criteria are separate

Where you can actually get it

Three things to do next, in the order that costs least. None of them is a recommendation.

Check what your own plan says

Free

Your plan’s benefit summary is the document that decides, and it is not the insurer’s clinical policy.
What that includes
- The only answer that is actually about your plan
- What each payer published, read and dated
What it does not include
- A decision. Only your plan administrator can say what your employer elected
See what each insurer published
If you are on Medicaid, check your state

Free

Medicaid is a state decision, and the answers are not close to each other.
What that includes
- Every state read from its own document, and dated
- The states that cover it for another indication only
What it does not include
- Commercial plans, which are a different decision entirely
Check your state
Sesame, if you need a prescriber first

$99 a month for the care

From $59 a month on annual prepay. The medication is a separate bill on top of this.
What that includes
- A prescriber, labs and ongoing review
- A route in if you have no prescription and no plan that will pay
What it does not include
- The medication, which is charged separately
- Any effect on what your insurance decides
- Controlled weight loss medications, which providers there do not prescribe
Referral fee. It never changes what you pay, or the order of these routes. How we make money
See Sesame pricing (opens in a new tab, we are paid a referral fee)

Referral fee from some of these. It never changes what you pay. How we make money

Questions people ask

How do I find out if my plan covers Wegovy?

Read your own plan’s benefit summary rather than the insurer’s clinical policy, and look for whether weight-loss medication is excluded as a category. On a plan bought through an employer that exclusion is the employer’s choice, so two people holding the same insurance card can get different answers about Wegovy.

Is Wegovy covered if my plan excludes weight-loss drugs?

Possibly, and this is the part most pages leave out. Wegovy is approved for cardiovascular risk reduction and for MASH as well as for weight loss, and UnitedHealthcare’s own program document tells reviewers to "refer to Nonformulary Wegovy criteria for plans that do not cover weight loss medications". Those criteria are different and are judged separately. Whether either indication applies to any individual is a matter for a prescriber.

What does a Wegovy prior authorization ask for?

Across the payers audited on this site, a Wegovy prior authorization typically asks for a BMI of 30 or over, or 27 or over with a weight-related condition, alongside lifestyle measures. Aetna adds the hardest requirement found here: taking part in a weight management program with follow-up for at least six months before starting the drug.

Why would insurance stop covering Wegovy?

Most plans reauthorize rather than renew. UnitedHealthcare’s own program sets an initial authorization of five months for Wegovy and then requires at least 5% of baseline body weight lost, plus continued lifestyle modification, before it runs for another twelve. Almost nobody is told this before they start.

Does Medicaid cover Wegovy?

Medicaid is a state decision, so there are 51 separate answers and they are not close to each other. This site reads each state from its own preferred drug list, administrative rule or provider letter, and the commonest answer is coverage for another indication only, which is not coverage for weight loss.

Providers offering this medication

LifeMD
Medication $199/mo Wegovy pen Care $149/mo
Mochi Health
Care $79/mo Medication charged separately, not published
Pallas Health
Medication $199/mo Compounded, billed every 12 weeks after the first month
Sesame
Care $99/mo Medication charged separately, not published
Hims & Hers
Medication $199/mo Wegovy pen, medication only Care $149/mo
Ro
Medication $199/mo Wegovy pen, against a $1,349 list price Care $74/mo
SkinnyRx
First month $99 Compounded injectable, first month. No monthly rate published
MEDVi not checked
TrimRx
Compounded $179 to $259 /mo
Noom
Medication $149 /mo
Found
All in $99 to $169 /mo
PlushCare
Care $19.99/mo Care $129/visit Medication charged separately, not published
Alloy
Medication $70 /mo Care $99/mo
Midi Health
Care $250/visit Medication charged separately, not published
Maven Clinic not checked
Brello Health
Compounded $79 to $247 /mo
Zealthy
Medication $151 /mo
Sprout Health
Compounded $199 /mo
Direct Meds
Compounded $249 to $297 /mo