Does Optum Rx cover Wegovy for weight loss?

Covered, prior authorization. Tier 2 on the 2026 Select Standard formulary, with prior authorization, a quantity limit, and the benefit-design marker.

Does Optum Rx cover Zepbound for weight loss?

Covered, prior authorization. Tier 2 on the same formulary, with prior authorization and a quantity limit.

Does Optum Rx cover Saxenda for weight loss?

Covered, prior authorization. Tier 2, with prior authorization, a quantity limit, and the benefit-design marker.

Pharmacy benefit manager

Does Optum Rx cover GLP-1s for weight loss?

Optum Rx marks all three weight-loss GLP-1s "++" on the formulary itself, which its legend defines as "Benefit design options. Coverage is determined by your prescription medication benefit plan." The drug is listed and the plan still decides.

By John Weeks Checked against the primary source August 25, 2026

Your employer decides, not Optum Rx. On most commercial plans, whether weight-loss medication is covered at all is chosen by whoever buys the plan. The criteria below apply only once that choice has been made, so the first document to read is your own plan's benefit summary.

What Optum Rx covers for weight loss, and the criteria that apply.
Medication	Position	What it asks for
Wegovy	Prior authorization	Tier 2 on the 2026 Select Standard formulary, with prior authorization, a quantity limit, and the benefit-design marker.
Zepbound	Prior authorization	Tier 2 on the same formulary, with prior authorization and a quantity limit.
Saxenda	Prior authorization	Tier 2, with prior authorization, a quantity limit, and the benefit-design marker.

Wegovy Prior authorization

Tier 2 on the 2026 Select Standard formulary, with prior authorization, a quantity limit, and the benefit-design marker.
Zepbound Prior authorization

Tier 2 on the same formulary, with prior authorization and a quantity limit.
Saxenda Prior authorization

Tier 2, with prior authorization, a quantity limit, and the benefit-design marker.

Worth knowing

Optum Rx publishes several formularies and this is the Select Standard one. A plan sponsor may use a different list, so being here is the starting point rather than the answer.

Asking about one medicine instead

If the answer is no. Around 45% of initial prior authorizations for these drugs are refused, and 35 to 45% of first-level appeals are overturned. A refusal is not the end of the process, and the cash-pay routes are priced on this site alongside it.

Sources

Every claim above is checked against the primary text, and the date is the day we last opened it.

1 cited records

1
2026 Select Standard Formulary
Optum Rx, UnitedHealth Group Primary text read and checked Checked August 25, 2026