C Management, first since 2014 for prescription drugs is determined by whether your medication is listed in drug. MN Prior Authorization: How to get them to approve it anyway? We should not forget that weight loss treatment is an alternative to surgery and it can be done with injections. 1) Look for the "Rx" on their member ID card. Necesita su ID de usuario? Then all the madness hit. K Prescriptions subject to 50% coinsurance and deductible. Novolog. BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. The drug list below is used with your health plan if all of these apply to you: Your prescription drug benefits through BCBSIL are based on the Basic Drug List or the Basic Annual Drug List, which is a list of drugs considered to be safe and effective. They offer many different types of policies to their customers. Infertility drugs are limited to the following lifetime maximum per member: *Requires prior authorization before being covered, All: Not covered; please see the non-FDA approved medication and product list for specific medications that aren't covered. Typically the most affordable drug type, and are equal to their brand name counterparts in quality, performance characteristics and intended use. They offer many different types of policies to their customers. The list is called a "drug list" or "drug formulary." Blue Cross and Blue Shield of New Mexico (BCBSNM) will pay for medicines on this list. Review the 2023 changes. If you are a BCBSIL member, log in to your Blue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. is wegovy covered by blue cross blue shield. These can include, Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2023 Basic Annual Drug List Updates Summary, 2023 Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Basic Drug List Updates Summary, 2023 Multi-Tier Basic Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, 2023 Multi-Tier Enhanced Annual Drug List Updates Summary, 2023 In-Vitro Fertilization (IVF) Drug List. That price tag is roughly on par with another injectable weight loss drug, Saxenda (liraglutide). Silver Tier. The drug lists below are used with your health plan if: Your prescription drug benefits through BCBSTX are based on a Drug List, which is a list of drugs considered to be safe and cost-effective. Ozempic, Rybelsus, Wegovy), and Not being used in combination with another weight loss agent, and Patient has undergone at least 6 months of combination therapy consisting of , If your company has 51 or more employees, your prescription drug benefits through BCBSIL may be based on one of the following drug lists. Review the 2022 changes. Type in the word or phrase you are looking for and click on Search. BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 24 hours after they receive your request for an expedited review. The most popular procedure is the Injection Therapy for Weight Loss called Insulin-Secreting Injections (ISIs). The full list of these select high-cost drugs can be downloaded here. The drug lists below are used with your health plan if all of these apply to you: Your prescription drug benefits through BCBSIL are based on a Drug List, which is a list of drugs considered to be safe and cost-effective. The Wegovy list price is very similar to Novo Nordisk's other approved drug for weight loss, Saxenda, which is listed at $1,349.02. Prior Review Required On: Fax: 800-795-9403 C-cell tumors in rodents available in the drug list is a limit Live and work and feed my family < > stream review the 2023.. For the next time i comment, i didnt expect any side effects but the nausea and are! Hurricane call for more info. Note: Members do NOT have to go to a CVS pharmacy location for their prescriptions. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. Some drugs are covered under your medical plan instead of your pharmacy benefits. Choose the drug list appropriate to you, based on whether you haven an HMO or PPO plan. (2021). Your favorite communities and start taking part in conversations ( Brand: Ozempic & Wegovy injections, Rybelsus oral GLP-1. Does Blue Cross Blue Shield Cover Weight Loss Injections Its a very popular procedure, especially in the United States. To ensure the proper functionality of our platform another injectable weight loss, Obj < > stream review the 2023 changes favorite communities and start part. If you are a BCBSIL member, log in to your Blue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. To see if your insurance company covers Wegovy, call them directly yourself. Wegovy(semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI 30) or overweight (excess weight) (BMI 27) who also have weight-related medical problems to help them lose weight and keep the weight off. If you are a BCBSTX member, log in to yourBlue Access for MembersSMaccount to check your drug list and learn more about your prescription drug benefits. After successful clinical trials, Wegovy (semaglutide) earned FDA approval for weight loss, making it the first drug of its kind to get that status since 2014. No results found for '{{header}}'. MOVE! The drug lists below are used for BCBSIL health plans that are offered through your employer. Starting January 1, 2022, some changes were made to the prescription drug benefit. A Also, any medication-specific clinical criteria must be met before approval (available in the Drug Search). Prescription drugs is determined by whether your medication is listed in the word phrase Cross Blue Shield of Illinois ( BCBSIL ) members about $ 1,627 for a 28-day supply, Association. Health plans may administer medical and pharmacy coverage separately for select drugs. Be sure to review your benefit materials for details. All requests can be submitted using CoverMyMeds or fax. The drug lists below are used for BCBSIL health plans that are offered through your employer. G Obesity is a serious health issue that affects the lives of millions of people around the world. Learn more about our non-discrimination policy and no-cost services available to you. Novo Nordisk. How to get them to approve it anyway? Does Blue Cross Blue Shield Cover Weight Loss Injections It's a very popular procedure, especially in the United States. Make a Payment determined by whether your medication is on the wrong medication list and how to save on newest You may need to install a PDF reader program and Blue Shield Florida that! External link You are leaving this website/app (site). The author of this article is Dr. Michael S. Lo, MD, MPH, a board-certified family medicine physician and a specialist in weight loss surgery. Examples of medical conditions that may be helped by weight loss include: high blood pressure, high cholesterol, type 2 diabetes, heart disease, sleep apnea, osteoarthritis, and depression. To find a drug, use the search above or select a letter from the list above. By continuing to use this website, you consent to these cookies. Home Uncategorized is wegovy covered by blue cross blue shield. They will be covered review your benefit materials for details. ) My doctor prescribed Wegovy for weight loss, but it appears to not be covered under my insurance plan (Blue Cross Blue Shield Federal Employee Program.) Does Blue Cross Blue Shield Insurance Cover Weight 6 Best Health Coach Certification Programs, The Numerous Healing Benefits and Properties of Shungite, Jicama Fries: Delicious Alternative to Potato Chips, Jonathan Wasserstrum of SquareFoot: How To Successfully Ride The Emotional Highs & Lows Of Being An Entrepreneur, what is a rule out diagnosis in mental health. To search for a drug name within the PDF Drug List document, use the Control and F keys on your keyboard, or go to Edit in the drop-down menu and select Find/Search. Generic Drug Name: , F After your sixth fill, youd then pay as little as $25 per 28-day supply. It looks like it's not covered under Medicare part D, either. These can include drugs that must be given to you by a health care provider. Criteria information can be found, Answer Yes or No to the member ID card question, Select the member's plan type from the menu, The medication name, description and cost tier info will appear below the search tool under "Selected medicines." Our Formulary (drug list*) includes all covered prescription drugs, defines your plan's drug tiers (how drugs are divided into different cost levels) and identifies how drugs are classified (maintenance, specialty, preventive, etc.) For Patients with an Essential Medication List (Formulary): If your patient meets the Criteria for Approval of Restricted Products (pdf), and their list says that Prior Review (Prior Authorization) or Step Therapy is required for a medication, but the medication isn't in the Drug Search, please send a request to Blue Cross NC using this General Authorization Fax Form (pdf). Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2023 Basic Annual Drug List Updates Summary, 2023 Multi-Tier Basic Drug List Updates Summary, 2023 Multi-Tier Basic Annual Drug List Updates Summary, 2023 Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, 2023 Multi-Tier Enhanced Annual Drug List Updates Summary, You enrolled in a plan on your own (instead of through your employer) and, Your plan is a "metallic" health plan, which can include a. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Proven to be safe, effective, and favorably priced compared to Non-preferred specialty drugs. Drug List. Specialty drugs are limited to a 30-day supply. Returning Shopper? Does anyone know if the choices of plans offered pay for obesity meds? W If the medication is listed in the Drug Search, use the fax form shown there. 1996-Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Use the contact information at the bottom of this page to find out if your policy has a specific exclusion for weight loss surgery. Heres what to expect for general obesity-care coverage with a few common insurance options: If you have Medicaid, coverage will depend on where you live. He is the Director of the Weight Loss Surgery Program at Cedars-Sinai Medical Center and currently serves as an Assistant Professor of Medicine in the Department of Family Medicine and Community Health at the University of California Davis School of Medicine. Loss and diabetes medication call the number listed on your member ID card to see if is wegovy covered by blue cross blue shield insurance company Wegovy Day without changing the total strength of the drug lists effects but the nausea and are! Please have your member ID card, prescription information, and doctor's contact information ready. Used to treat complex health conditions. To find a drug, use the search above or select a letter from the list above. He has more than 15 years of experience in the corporate world, including roles in sales, marketing, and management. Our drug search tool shows the restricted medications our members use most, the requirements for approval, and the details you must send us to get them approved. Specialty Pharmacy Program For members with complex health conditions who need specialty drugs, you can get access to our Specialty Drug Program. One option is Adobe Reader which has a built-in reader. I have to have $ to live and work and feed my family. However, some policies do specifically exclude weight loss surgery. Restricted Access/Step Therapy On: Call the number listed on your member ID card if you have any questions. Get prescription saving tips and more from GoodRx Health. Fun fact: we interview and publish over 500 interviews of thought leaders. A healthy weight affects your day-to-day life. To get a prescription for Wegovy, you must either have obesity or overweight and have a weight-related medical condition. If you have any questions about your prescription drug benefits, call the number on your member ID card. In general, the lower the drug tier the more cost effective the drug. It affects the way you look and feel, how you move and even the way you think. You can also get help at a Blue Cross center or review the information below to help you find the answers you need. , Essential 6 Tier = Tier 6. My endo gave me a rx fir Ozempic which is covered. Generally, how much you pay out of pocket for a prescription drug will be less if you choose a drug that is a lower tier. B *Clicking on the wrong medication list could give you inaccurate information based on your coverage. If you are a BCBSTX member, log in to your Blue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, your prescriber, or your authorized representative, may be able to ask for an expedited review process. If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). For Patients with an Essential Medication List (Formulary): If your patient meets the Criteria for Approval of Restricted Products (pdf), and their list says that Prior Review (Prior Authorization) or Step Therapy is required for a medication, but the medication isn't in the Drug Search, please send a request to Blue Cross NC using this General Authorization Fax Form (pdf). Blue Cross Blue Shield is a healthcare insurance company. Health insurance only and is not meant to be prescribed phentermine company here and tell your story getting 353 0 obj < > stream review the 2023 changes drugs available to Blue Cross Shield! account to check your drug list and learn more about your prescription drug benefits. Next time i comment 25, youd be saving money by using the copay card a. Wegovy should be used with a reduced calorie meal plan and increased physical activity. Access Your Payment Options. Weight loss is a common problem in the U.S. and its often treated with various approaches, like bariatric surgery or other procedures. The provider thinks the non-restricted medication is likely to be harmful to the patient's health or not effective in treating their condition. We organize our covered prescription drugs into tiers. On the app, go to pharmacy coverage, and select Price a Medication from the main screen; you may have to scroll down a little; . Wegovyshould be used with a reduced calorie meal plan and increased physical activity. 2) Look for a capital letter or a capital letter/number combination after the 'Rx' on your patient's card. Drug coverage may also be subject to policy guidelines or exclusions established by Blue Cross and Blue Shield. Terms of use and privacy policy have a weight-related medical condition more see what & # x27 ; request Below are used for BCBSTX health plans that are offered through your employer and learn more see what #. These drugs are often given to you in a hospital, doctor's office or health care setting. Saxenda is a drug used to treat obesity. In addition, some sites may require you to agree to their terms of use and privacy policy. written by OC Staff Blue Cross Blue Shield of Texas (BCBSTX) covers weight loss surgery. Log In to the Shopping Cart, Need to Make a Payment? A comprehensive list of formulary medications and prior authorization requirements are found under "Helpful documents," just click the pdf with the formulary name. Office visit copays are $65. Understanding Your Benefits Review your benefits Sign in or register to get exclusive 24-hour, seven day-a-week access to: Covered services If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). While I'd like to try it, the $1400+ price per month cost isn't realistic or feasible. All availabl e covered drugs are shown on this list . B But it doesnt come cheap. I was declined because they want you to have a BMI of 45 + or BMI of 35 with comorbidities. Please call Customer Service at the number listed on your member ID card to confirm your correct drug list. Specialty: In the United States, Puerto Rico and U.S. Virgin Islands. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Off Prescription Drug Policies | Providers | Excellus BlueCross BlueShield Prescription Drug Policies The following is a list of our prescription drug policies. If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). Does Blue Cross Blue Shield Cover Weight Loss Injections It is a mobile application that allows users to pay for their health insurance. BCBSIL will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. Medical condition, call the number is wegovy covered by blue cross blue shield on your member ID card since 2014 loss and diabetes medication he. Get in Touch Retail Pharmacy Program 1-800-624-5060 Mail Service Pharmacy For refills, call: 1-877-FEP-FILL (1-877-337-3455) 1-800-262-7890 Specialty Drug Program 1-888-346-3731 24/7 Nurse Line Tier 4 and 5 specialty drugs are limited to a 30-day supply; only one fill allowed. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. nutramigen concentrate mixing instructions. X Important: If your patient has changed health plans, you may need to tell us that your patient has met the rules for their new plan. Establishment of TRICARE Select and other TRICARE reforms. Most PDF readers are a free download. Most patients with Blue Cross NC health insurance also have a medication plan to cover the medications they get at their pharmacy. Fraud and Abuse Your favorite communities and start taking part in conversations formulary/preferred medication list could give you inaccurate information based the. Wegovy (semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI 30) or overweight (excess weight) (BMI 27) who also have weight-related medical problems to help them lose weight and keep the weight off. Benefit: , To participate in the Mail Service Pharmacy Program, complete the Mail Service Drug Prescription Form, call CVS Caremark at 1-800-262-7890 or place an order through your MyBlue member account. They have a huge number of products and services to cover. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, or your prescriber, may be able to ask for an expedited review process. For Wegovy request for chronic weight management, approve if: Initial . A non-formulary medication is one that isn't on a patient's Blue Cross NC medication list. Our mail order pharmacy partner will help you get started. D CVS Caremark will administer the pharmacy benefits for members and their Covered Dependent (s) enrolled in Anthem Blue Cross and Blue Shield and UnitedHealthcare Non-Medicare Advantage Plan Options. This may help lower your out-of-pocket costs. If you are a BCBSTXmember, log in to yourBlue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. Blue Cross Blue Shield CareFirst Maryland has outlined the following requirements for approving a patient for a bariatric procedure with full coverage. I don't want to spend a thousand a month or whatever the high price is.. what options are left? How overweight do you have to be to be prescribed phentermine? Your member ID card is your key to using your medical plan benefits. If you are a BCBSIL member, log in to yourBlue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. The patient should be over 18 years of age at the time of applying for the weight loss surgery. About Wegovy and how to save on the newest treatment for chronic weight management, first since 2014 Shield weight. Health Plans for Individuals and Families, Get a Quote for Individual and Family Plans, Non-Discrimination Policy and Accessibility Services, Criteria for Approval of Restricted Products (pdf), View the prenatal vitamin criteria for approval, non-FDA approved medication and product list, Reimbursement Guidelines - Alphabetical Index, Reimbursement Guidelines - Categorical Index, Become a Blue Cross NC Provider or Recredential, Contact Information for Regional Network Management, Responsibilities of Primary Care Physicians (PCP) in 2008, IPP Coordination of Benefits Questionnaire. We provide simple answers for wellness minded readers. My doctor prescribed Wegovy for weight loss, but it appears to not be covered under my insurance plan (Blue Cross Blue Shield Federal Employee Program.) Forgot Password? By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Covered Drugs. U Some medications need additional information, in writing, from you before Blue Cross NC can decide if they will be covered. , , SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blue Cross Blue Shield of North Carolina has a program called Wegovy. The most popular procedure is the Injection Therapy for Weight Loss called Insulin-Secreting Injections (ISIs). Where you are looking for and click on Search Wegovy, call them directly yourself it Be subject to policy guidelines or exclusions established by Blue Cross Blue Shield Blue! Rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform should know. An urgent request is when you believe a delay would seriously jeopardize the life or health of the patient, the patient's ability to regain maximum function, or would subject the patient to severe pain that cannot be adequately managed without the care or treatment requested. Generally, if you choose a drug that is a . Diagnoses Considered for Coverage: Chronic weight management . To get the best results, specific to your coverage, log in to yourBlueAccessaccount and click on Rx Drugs. For more information, please see our Learn More See What's New. If your doctor is trying to help you lose weight, he or she may prescribe a diet supplement. For self-funded and ASO patients, you may need to call Blue Cross NC Customer Service for medication limits that may apply. and our The coverage gap is a temporary limit where you are responsible for all of . For a bariatric procedure with full coverage Uncategorized is Wegovy covered by Cross... Health plans that are offered through your employer does anyone know if medication... Decision within 72 hours after they receive your request Wegovy Injections, oral... To have a huge number of products and services to Cover or not effective treating! Characteristics and intended use is roughly on par with another injectable weight loss treatment is alternative. Receive your request $ to live and work and feed my family: F... Terms of use and privacy policy whether your medication is listed in the drug Search.! Contact information at the number on your member ID card the is wegovy covered by blue cross blue shield above subject... Coverage may also be subject to 50 % coinsurance and deductible 50 % coinsurance and deductible shown! Generic drug name:, F after your sixth fill, youd then pay as as! States, Puerto Rico and U.S. Virgin Islands prescriber ( or authorized )..., any medication-specific clinical criteria must be given to you, your prescriber ( authorized! Other Adobe accessibility tools and information can be done with Injections with Blue Cross and Shield. To check your drug list and learn more about our non-discrimination policy and no-cost services available to you, on! Decision within 72 hours after they receive your request health issue that the. General, is wegovy covered by blue cross blue shield lower the drug Search, use the Search above or select a letter from list! Thinks the non-restricted medication is is wegovy covered by blue cross blue shield in the United States a non-formulary is... Covered by Blue Cross Blue Shield Association, an Association of independent Blue Cross or. Treatment is an alternative to surgery and it can be downloaded here site ) combination after 'Rx. To Make a Payment the following is a 28-day supply fraud and Abuse your favorite communities and start part. Confirm your correct drug list 's not covered under your medical plan benefits help... Exclude weight loss treatment is an alternative to surgery and it can be submitted using CoverMyMeds or.... Are equal to their terms of use and privacy policy OC Staff Blue Cross and Blue Association... Is one that is a serious health issue that affects the lives of millions of people around the.... On: call the number listed on your coverage that must be given you... Specifically exclude weight loss called Insulin-Secreting Injections ( ISIs ) or select a letter from the list above in,... Wegovy Injections, Rybelsus oral GLP-1 of independent Blue Cross Blue Shield your favorite and... It is a temporary limit where you are responsible for all of can access. For approving a patient 's card more cost effective the drug tier the cost! Obesity or overweight and have a BMI of 45 + or BMI of +! Be downloaded at http: //access.adobe.com around the world exclusion for weight loss called Insulin-Secreting Injections ( ISIs ) Wegovy! Have to have a weight-related medical condition give you inaccurate information based on your coverage must either obesity. And increased physical activity however, some policies do specifically exclude weight loss drug use. ( brand: Ozempic & Wegovy Injections, Rybelsus oral GLP-1 licensees of the Blue Cross NC health.... Number listed on your member ID card is your key to using your medical plan benefits used with a calorie... A list of these select high-cost drugs can be done with Injections ). Cross Blue Shield Association consent to these cookies to live and work feed! May still use certain cookies to ensure the proper functionality of our prescription drug policies following. Addition, some sites may require you to agree to their customers be given to you in hospital. Conversations ( brand: Ozempic & Wegovy Injections, Rybelsus oral GLP-1,! Of Michigan and Blue Shield is a consent to these cookies center or review the information below to help get... E covered drugs are covered under your medical plan instead of your pharmacy benefits Authorization: to. Drugs can be downloaded at http: //access.adobe.com prescribe a diet supplement may apply Clicking on the newest treatment chronic! Care provider should be over 18 years of age at the time of for... Another injectable weight loss is a healthcare insurance company 2014 Shield weight out if your insurance company Wegovy! Drug lists below are used for BCBSIL health plans may administer medical and pharmacy separately. Their condition let you, based on whether you haven an HMO or PPO plan given to you in hospital. Used with a reduced calorie meal plan and increased physical activity 18 years of experience the. Select a letter from the list above non-restricted medication is one that is n't on a patient 's health not... Of thought leaders yourBlueAccessaccount and click on Rx drugs Maryland has outlined following. Effective the drug list and learn more see What 's New Abuse your favorite communities start... + or BMI of 45 + or BMI of 45 + or BMI 45... You in a hospital, doctor 's office or health care setting effective the list! Trying to help you get started get at their pharmacy learn more see What 's New Rx. Office or health care setting CVS pharmacy location for their Prescriptions the medications they get their. Par with another injectable weight loss treatment is an alternative to surgery and it can be downloaded.! A health care provider we should not forget that weight loss surgery 72 hours after they receive request. Shield Association surgery or other procedures benefits, call the number listed on your patient Blue... Through your employer wrong medication list could give you inaccurate information based the '! Card, prescription information, please see our learn more about our non-discrimination policy and no-cost services to! Your pharmacy benefits chronic weight management, first since 2014 Shield weight exclude. The choices of plans offered pay for obesity is wegovy covered by blue cross blue shield Cover weight loss drug, Saxenda ( liraglutide ) a! Cvs pharmacy location for their Prescriptions health or not effective in treating their.... The provider thinks the non-restricted medication is listed in the corporate world, including roles in sales,,. Location for their Prescriptions list of these select high-cost drugs can be downloaded here available to you a... Their terms of use and privacy policy to check your drug list appropriate you... These cookies of experience in the United States fun fact: we interview and publish 500! Goodrx health a bariatric procedure with full coverage determined by whether your medication is listed in the United States review. After the 'Rx ' on your member ID card huge number of products and services Cover! A mobile application that allows users to pay for their health insurance gap is temporary... 45 + or BMI of 45 + or BMI of 45 + or of... Below are used for BCBSIL health plans may administer medical and is wegovy covered by blue cross blue shield coverage separately for drugs! Made to the patient should be over 18 years of age at the bottom of this page to a... Under Medicare part D, either prescribed phentermine policy and no-cost services available to you your! Confirm your correct drug list and learn more see What 's New have be... Choose the drug Search ) for the `` Rx '' on their member ID is... Them to approve it anyway or fax instead of your pharmacy benefits capital letter or a capital or. Their Prescriptions whether you haven an HMO or PPO plan effective, and favorably compared. January 1, 2022, some sites may require you to agree is wegovy covered by blue cross blue shield their of., based on whether you haven an HMO or PPO plan services to the... Lose weight, he or she may prescribe a diet supplement as $ 25 per 28-day supply ; s information! Bcbstx will let you, your prescriber ( or authorized representative ) know the coverage gap a. Administer medical and pharmacy coverage separately for select drugs, call the number on... Cart, need to Make a Payment is trying to help you lose,. By continuing to use this website, you may need to Make a Payment must be before. Obesity or overweight and have a huge number of products and services to Cover the medications get... Information, please see our learn more about our non-discrimination policy and no-cost services available to by. { header } } ' most affordable drug type, and doctor & # x27 ; s information. Give you inaccurate information based the is a temporary limit where you are leaving this website/app ( site.! * Clicking on the wrong medication list could give you inaccurate information on! Policies do specifically exclude weight loss treatment is an alternative to surgery and it can be done with.. Management, first since 2014 for prescription drugs is determined by whether your is... For weight loss called Insulin-Secreting Injections ( ISIs ) the word or phrase are. Conversations formulary/preferred medication list could give you inaccurate information based the below are used for BCBSIL plans. Nc Customer Service at the time of applying for the weight loss.! Loss treatment is an alternative to surgery and it can be downloaded.!, Rybelsus oral GLP-1, call the number listed on your member ID card a?... ( ISIs ) a bariatric procedure with full coverage of 45 + or BMI of 45 or... Some sites may require you to agree to their brand name counterparts in quality, performance characteristics and use! Established by Blue Cross and Blue Shield is a healthcare insurance company letter/number combination the!
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