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BCBS North Dakota

Does BCBS North Dakota cover Wegovy for Heart Disease Risk Reduction?

Yes. BCBS North Dakota covers Wegovy for heart disease risk reduction with prior authorization if your BMI is 30 or higher, or 27 or higher with a related condition. Other policy requirements and your plan's benefits also apply.

Policy document

  • Employer and ACA Marketplace: Covered with requirements. See the qualification pathways below.

Earliest policy review June 2, 2026. How we verify · Check your exact plan

Full requirements: Wegovy for Heart Disease Risk Reduction (2 plan types)

Applies to Employer and ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

CV risk reduction in adults with established CV disease and obesity or overweight

All of:

  • Adult patient (age ≥ 18)
  • Established cardiovascular disease
  • Obesity (BMI ≥ 30) or overweight (BMI ≥ 27)

Documentation to bring

  • Documentation of established cardiovascular disease
  • Documentation of BMI ≥ 27 kg/m2 (overweight or obese)

Not covered when

  • Coadministration with other semaglutide-containing products is not recommended
  • Coadministration with any other GLP-1 receptor agonist is not recommended

Policy note: FDA indication listed in document for CV risk reduction: to reduce the risk of major adverse CV events (CV death, non-fatal MI, or non-fatal stroke) in adults with established CV disease and either obesity or overweight. Available as both tablet and subcutaneous injection formulations. Full PA criteria beyond FDA indication summary not enumerated in provided document text.

Policy effective April 20, 2026 · verified June 2, 2026 · source: Nd Weight Management Paql Prog Sum · View policy document (PDF)

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Questions people ask
Does BCBS North Dakota cover Wegovy?
Yes. BCBS North Dakota covers Wegovy for heart disease risk reduction with prior authorization if your BMI is 30 or higher, or 27 or higher with a related condition. Other policy requirements and your plan's benefits also apply.
How current is this information?
The oldest review date among the policies on this page is June 2, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under BCBS North Dakota: Mounjaro, Ozempic, Zepbound

Wegovy under other plans: North Dakota Medicaid, BCBS Alabama, BCBS Arizona, BCBS Arkansas, BCBS Louisiana, BCBS Massachusetts, BCBS Michigan, BCBS Minnesota

All insurance plans · All medications

Summary of BCBS North Dakota's written policy, not a guarantee of coverage. Plans vary by employer and benefit design.