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Wegovy is covered on many BCBSNC commercial and ACA marketplace plans, but not all group or self-funded employer plans Prior authorization / Required on virtually every BCBSNC plan that includes Wegovy BMI threshold / 30 kg/m alone, or 27 kg/m with one or more weight-related comorbidities Step therapy / Some plans require a documented trial of oral weight-management therapy (e.g., phentermine, orlistat, or naltrexone-bupropion) before Wegovy approval Typical commercial copay / $25 to $150 per month with Tier 3 or specialty tier placement, depending on plan design Approval duration / Usually 6 to 12 months, with re-authorization required to continue Medicare Advantage / Most BCBSNC Medicare Advantage plans exclude anti-obesity medications per federal statute, though Part D expansion is under legislative review Appeal success rate / Internal appeals for anti-obesity medication denials succeed roughly 40% to 60% of the time nationally when supported by clinical documentation Manufacturer savings / Novo Nordisk offers an eligible savings card that may reduce out-of-pocket cost for commercially insured members Alternative if denied / Compounded semaglutide, liraglutide (Saxenda), or tirzepatide (Zepbound) may be pursued through separate prior authorization BCBSNC Wegovy Coverage Policy: What the Formulary Says BCBSNC lists Wegovy on its specialty or non-preferred brand tier for most commercial fully insured plans sold in North Carolina

doi: 10.1038/s41584-022-00798-0

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