Reference Desk — Coverage

Who pays. For what.

Coverage matrix for the eight major U.S. payers. Drug details sourced live from FDA OpenFDA. Pricing via GoodRx verified averages.

Avg. Wegovy / month, retail
16
Medicaid states covering GLP-1
78%
Plans requiring prior auth
6mo
Typical lifestyle prereq.
Notes

Wegovy now covered for cardiovascular indication only (Mar 2024). Bariatric surgery covered with comorbidity.

Glossary

Prior Auth. Carrier approval required before dispensing.

Step Therapy. Cheaper drug must fail before GLP-1 is approved.

Comorbidity. Diabetes, hypertension, sleep apnea, dyslipidemia.

Drug data: FDA OpenFDA API. Pricing: GoodRx verified averages. Coverage: demo / illustrative.