Employer / Commercial Insurance
Covered with requirementsWhat you need to qualify
- Age 12 and older
- BMI of 30 or higher
- BMI of 27 or higher with a weight-related condition (HTN, T2DM, dyslipidemia, OSA, CVD, and MASH)
- BMI of 23 or higher for patients of Asian descent
- BMI at or above the 95th percentile for age and sex
Qualification pathways
You can qualify through any one of these.
Adult obesity
All of:
- Age >= 18 years
- BMI >= 30 kg/m2
Adult overweight with comorbidity
All of:
- Age >= 18 years
- BMI >= 27 kg/m2
Plus any one of:
- Hypertension
- T2DM
- dyslipidemia
- OSA
- CVD
- MASH
Pediatric obesity (age 12+)
All of:
- Age >= 12 years
- BMI at or above 95th percentile for age and sex
Asian adult overweight/obesity
All of:
- BMI >= 23 kg/m2 (South Asian, Southeast Asian, or East Asian adults)
Documentation to bring
- Baseline BMI documentation
- Documentation of weight-related comorbidity if BMI 27–29.9 kg/m2
- Age documentation (>= 12 years for pediatric; >= 18 years for adult)
Approval and renewal
- To renew, the plan looks for at least 5% weight loss from the starting weight, Continuation recommended only for patients achieving at least 5% weight loss and tolerating therapy, assessed after 12 weeks at a therapeutic dose, and at least 12 weeks on therapy before the first renewal. Make sure your starting weight and date are in the chart now — renewal is measured against it.
Not covered when
- Concomitant use with other semaglutide-containing products not recommended
- Concomitant use with any other GLP-1 receptor agonist not recommended
Policy note: Document covers both Wegovy injection and Wegovy tablet formulations. Wegovy HD (high-dose semaglutide) is also listed as a separate formulation for weight loss in adults. Efficacy should be assessed after 12 weeks at therapeutic dose; continuation only if >= 5% weight loss achieved and therapy tolerated. Pediatric patients aged 12+ with obesity (BMI >= 95th percentile) are included per FDA labeling.
Policy effective May 4, 2026 · verified June 2, 2026 · source: RI_Weight_Management_ProgSum.pdf