Anthem Blue Cross (HMO, PPO, EPO)
Wegovy (semaglutide (weight loss))
Drugs for Eating Disorders : Drugs for Eating Disorders
  • Quantity Limit: 1 pen per 1 week(s).
  • Obesity:
    Duration: 24 week(s)
    Documented Diagnosis: Yes
    Medical Test Required: No
    Reauthorization Required: Yes
    Duration of Reauthorization: = 6 month(s)

  • Prior Authorization: Obesity:
    Documented Diagnosis: Yes
    Duration: 24 week(s)
    Reauthorization Required: Yes

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