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What Insurance Typically Requires: BMI Requirements: Usually 30+ (or 27+ with comorbidities) Prior Authorization: Documentation from your doctor explaining medical necessity Step Therapy: May require trying other weight loss methods first Diagnosis Codes: Must be prescribed specifically for covered conditions Continuous Use: Coverage may end if you stop taking the medication Programs That Accept Insurance: PlushCare: In-network with most major insurers WeightWatchers: Accepts insurance and helps coordinate coverage Form Health: Covered by most insurance including Medicare Nurx: Accepts insurance for medication (not program fees) Found: Accepts some insurance plans Programs That Dont Accept Insurance: TrimRx: Focus on affordable compounded medications (HSA/FSA eligible) Eden: No insurance accepted Hers/Hims: No insurance (HSA/FSA eligible) Noom Med: Some insurance covers through special arrangements Ro: Program fees not covered, but insurance may cover medication Alternative Payment Options: Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) Many programs accept HSA/FSA payments even if they dont take insurance directly

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For them, $1,300 a month for the real thing might have seemed out of reach, but $500 is a reasonable price point