Employer / Commercial Insurance
Covered with requirementsWhat you need to qualify
- Age 18 and older
- BMI of 30 or higher
- BMI of 27 or higher with a weight-related condition
- Established cardiovascular disease (CV death, nonfatal MI, and nonfatal stroke)
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_ProgSum.pdf