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Cigna

Does Cigna cover Wegovy?

Yes. Cigna covers Wegovy for weight loss 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 Weight Loss (2 plan types)

Applies to Employer and ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Initial Approval - Adult Weight Loss (BMI ≥ 30)

All of:

  • Patient is ≥ 18 years of age
  • Baseline BMI ≥ 30 kg/m2 (prior to any GLP-1 or GLP-1/GIP agonist)
  • Patient has engaged in a trial of behavioral modification and dietary restriction for at least 3 months
  • Medication will be used concomitantly with behavioral modification and a reduced-calorie diet

Initial Approval - Adult Weight Loss (BMI ≥ 27 with comorbidity)

All of:

  • Patient is ≥ 18 years of age
  • Baseline BMI ≥ 27 kg/m2 (prior to any GLP-1 or GLP-1/GIP agonist)
  • Patient has engaged in a trial of behavioral modification and dietary restriction for at least 3 months
  • Medication will be used concomitantly with behavioral modification and a reduced-calorie diet

Plus any one of:

  • At baseline or currently: hypertension
  • At baseline or currently: type 2 diabetes
  • At baseline or currently: dyslipidemia
  • At baseline or currently: obstructive sleep apnea
  • At baseline or currently: cardiovascular disease
  • At baseline or currently: knee osteoarthritis
  • At baseline or currently: asthma
  • At baseline or currently: COPD
  • At baseline or currently: MASLD/NAFLD
  • At baseline or currently: polycystic ovarian syndrome
  • At baseline or currently: coronary artery disease

Initial Approval - Pediatric Weight Loss (age 12-17)

All of:

  • Patient is ≥ 12 years of age and < 18 years of age
  • Baseline BMI ≥ 95th percentile for age and sex (prior to any GLP-1 or GLP-1/GIP agonist)
  • Patient has engaged in a trial of behavioral modification and dietary restriction for at least 3 months
  • Medication will be used concomitantly with behavioral modification and a reduced-calorie diet

Continuation - Adult Weight Loss (BMI ≥ 30)

All of:

  • Patient is ≥ 18 years of age
  • Baseline BMI ≥ 30 kg/m2 (prior to any GLP-1 or GLP-1/GIP agonist)
  • Patient has lost ≥ 5% of baseline body weight
  • Medication will be used concomitantly with behavioral modification and a reduced-calorie diet
  • Patient has completed ≥ 8 months of initial therapy

Continuation - Adult Weight Loss (BMI ≥ 27 with comorbidity)

All of:

  • Patient is ≥ 18 years of age
  • Baseline BMI ≥ 27 kg/m2 (prior to any GLP-1 or GLP-1/GIP agonist)
  • Patient has lost ≥ 5% of baseline body weight
  • Medication will be used concomitantly with behavioral modification and a reduced-calorie diet
  • Patient has completed ≥ 8 months of initial therapy

Plus any one of:

  • At baseline or currently: hypertension
  • At baseline or currently: type 2 diabetes
  • At baseline or currently: dyslipidemia
  • At baseline or currently: obstructive sleep apnea
  • At baseline or currently: cardiovascular disease
  • At baseline or currently: knee osteoarthritis
  • At baseline or currently: asthma
  • At baseline or currently: COPD
  • At baseline or currently: MASLD/NAFLD
  • At baseline or currently: polycystic ovarian syndrome
  • At baseline or currently: coronary artery disease

Continuation - Pediatric Weight Loss (age 12-17)

All of:

  • Patient is ≥ 12 years of age and < 18 years of age
  • Baseline BMI ≥ 95th percentile for age and sex (prior to any GLP-1 or GLP-1/GIP agonist)
  • Patient has had a reduction in BMI of ≥ 1% from baseline
  • Medication will be used concomitantly with behavioral modification and a reduced-calorie diet
  • Patient has completed ≥ 7 months of initial therapy with Wegovy injection, Wegovy HD injection, and/or Wegovy tablet

Documentation to bring

  • Baseline BMI documentation (≥ 30 kg/m2, or ≥ 27 kg/m2 with qualifying comorbidity)
  • Documentation of at least 3-month trial of behavioral modification and dietary restriction (initial therapy)
  • Documentation of qualifying weight-related comorbidity if BMI 27-29.9 kg/m2
  • Documentation of ≥ 5% baseline body weight loss (continuation, adult)
  • Documentation of ≥ 1% BMI reduction from baseline (continuation, pediatric)

Approval and renewal

  • Initial approval: 8 months
  • Renewal: every 12 months
  • Renewal: At least 1% reduction in BMI.
  • Renewal: Adults: must have lost ≥ 5% of baseline body weight. Pediatric (age 12-17): must have had ≥ 1% reduction in BMI from baseline. Baseline BMI/weight re-verified at continuation, but 3-month lifestyle program requirement is not re-checked.

Not covered when

  • Concomitant use with other GLP-1 agonists or GLP-1/GIP agonists is not covered
  • Any use not meeting FDA-approved indications or criteria above is not medically necessary

Policy note: Wegovy injection (including Wegovy HD injection) and Wegovy tablet are both covered under the same weight loss criteria. Wegovy HD injection is intended for patients who have tolerated Wegovy 2.4 mg SC for ≥ 4 weeks and require additional weight reduction. Pediatric approval applies to Wegovy injection only (not Wegovy tablet, which is not FDA-approved for pediatric use). Initial approval is for 8 months; continuation is for 1 year. For pediatric continuation, patient must have completed ≥ 7 months of initial therapy (note: policy states 7 months in the pediatric continuation note, while adult states 8 months).

Policy effective April 15, 2026 · verified June 2, 2026 · source: Cigna — GLP-1 coverage criteria (Policy 684) · View policy document (PDF)

Open on its own page →

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 - Established CVD with Overweight or Obesity

All of:

  • Patient is ≥ 18 years of age
  • Baseline BMI ≥ 27 kg/m2 (prior to any GLP-1 or GLP-1/GIP agonist)
  • According to prescriber, medication will be used in combination with optimized pharmacotherapy for established cardiovascular disease
  • Medication will be used concomitantly with behavioral modification and a reduced-calorie diet

Plus any one of:

  • Prior myocardial infarction
  • Prior stroke (not including TIA)
  • History of symptomatic peripheral arterial disease with intermittent claudication and ankle-brachial index < 0.85
  • History of symptomatic peripheral arterial disease with peripheral arterial revascularization procedure
  • History of symptomatic peripheral arterial disease with amputation due to atherosclerotic disease

Documentation to bring

  • Baseline BMI documentation (≥ 27 kg/m2, prior to any GLP-1 or GLP-1/GIP agonist)
  • Documentation of qualifying established CV event (prior MI, prior stroke [not TIA], or symptomatic PAD with ABI < 0.85, peripheral arterial revascularization, or amputation due to atherosclerotic disease)
  • Prescriber attestation that medication will be used in combination with optimized pharmacotherapy for established cardiovascular disease

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: Initial and continuation criteria are combined into a single 1-year approval; no separate weight loss response threshold is required for renewal. Baseline BMI ≥ 27 kg/m2, established CV disease, and GDMT use are the ongoing requirements. Diabetes exclusion does NOT apply — patients with or without diabetes may qualify.

Not covered when

  • Transient ischemic attack (TIA) does not qualify as prior stroke
  • Concomitant use with other GLP-1 agonists or GLP-1/GIP agonists is not covered

Policy note: Both Wegovy injection (including Wegovy HD injection) and Wegovy tablet are approved for this indication with identical criteria. Approval is for 1 year. Policy does not exclude patients with diabetes for this indication (unlike the SELECT trial population which excluded diabetes). No separate weight loss response threshold is required for renewal.

Policy effective April 15, 2026 · verified June 2, 2026 · source: Cigna — GLP-1 coverage criteria (Policy 684) · View policy document (PDF)

Open on its own page →

Full requirements: Wegovy for Liver Disease (MASH) (2 plan types)

Applies to Employer and ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Initial Approval - MASH/NASH with F2-F3 Fibrosis

All of:

  • Patient is ≥ 18 years of age
  • Patient does not have cirrhosis (F4)
  • Patient has stage F2 or F3 fibrosis confirmed by an accepted diagnostic test prior to initiating treatment [documentation required]
  • Patient has one or more metabolic risk factors managed per standard of care (central obesity, hypertriglyceridemia, reduced HDL-C, hypertension, or elevated fasting plasma glucose/diabetes/pre-diabetes)
  • Medication will be used in combination with appropriate diet and exercise therapy
  • Medication prescribed by or in consultation with an endocrinologist, gastroenterologist, or hepatologist

Plus any one of:

  • Liver biopsy within 3 years preceding treatment showing F2 or F3 fibrosis [documentation required]
  • VCTE within 6 months preceding treatment showing F2 or F3 fibrosis [documentation required]
  • MRE within 6 months preceding treatment showing F2 or F3 fibrosis [documentation required]
  • ELF test within 6 months preceding treatment with score ≥ 9.2 to ≤ 10.5 [documentation required]

Initial Approval - MASH/NASH Alcohol Limit (Female)

All of:

  • Female patient: alcohol consumption < 20 grams/day

Initial Approval - MASH/NASH Alcohol Limit (Male)

All of:

  • Male patient: alcohol consumption < 30 grams/day

Continuation - MASH/NASH (Year 2+)

All of:

  • Patient has completed ≥ 1 year of therapy with Wegovy injection, Wegovy HD injection, and/or Wegovy tablet
  • Prescriber attests patient has not had worsening of fibrosis or MASH/NASH
  • Prescriber attests patient does not have cirrhosis (F4)
  • Prescriber attests metabolic risk factors are managed per standard of care
  • Medication will be used in combination with appropriate diet and exercise therapy
  • Medication prescribed by or in consultation with an endocrinologist, gastroenterologist, or hepatologist

Plus any one of:

  • Female patient: alcohol consumption < 20 grams/day
  • Male patient: alcohol consumption < 30 grams/day

Documentation to bring

  • Documentation of stage F2 or F3 fibrosis prior to treatment initiation [documentation required]
  • Liver biopsy report within 3 years preceding treatment (if biopsy used for staging) [documentation required]
  • VCTE results within 6 months preceding treatment (if VCTE used for staging) [documentation required]
  • MRE results within 6 months preceding treatment (if MRE used for staging) [documentation required]
  • ELF test result within 6 months preceding treatment with score ≥ 9.2 to ≤ 10.5 (if ELF used for staging) [documentation required]
  • Prescriber attestation of one or more metabolic risk factors managed per standard of care
  • Prescriber attestation of alcohol consumption limits (female < 20 g/day; male < 30 g/day)
  • Documentation that medication is prescribed by or in consultation with endocrinologist, gastroenterologist, or hepatologist
  • Confirmation patient does not have cirrhosis (F4)

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: Continuation requires: patient has completed ≥ 1 year of therapy; prescriber attests no worsening of fibrosis or MASH/NASH; no cirrhosis (F4); metabolic risk factors managed per standard of care; alcohol limits maintained; diet and exercise ongoing; specialist prescribing/consultation. Fibrosis staging documentation NOT re-required at continuation. ELF score, biopsy, VCTE, or MRE documentation NOT re-required at continuation.

Not covered when

  • Cirrhotic (F4) MASH is excluded
  • Alcohol consumption ≥ 20 g/day (female) or ≥ 30 g/day (male) is excluded
  • Concomitant use with other GLP-1 agonists or GLP-1/GIP agonists is not covered

Policy note: Applies to both Wegovy injection (including Wegovy HD injection) and Wegovy tablet. Specialist prescribing or consultation required (endocrinologist, gastroenterologist, or hepatologist). Documentation is required as noted throughout criteria. ELF score range of 9.2 to 10.5 is specifically required (not just ≥ 9.2). For continuation, fibrosis documentation is NOT re-required; prescriber attestation of no worsening is sufficient. Rezdiffra (resmetirom) is referenced as an alternative MASH treatment in the fibrosis staging lookback criteria.

Policy effective April 15, 2026 · verified June 2, 2026 · source: Cigna — GLP-1 coverage criteria (Policy 684) · View policy document (PDF)

Open on its own page →

Questions people ask
Does Cigna cover Wegovy?
Yes. Cigna covers Wegovy for weight loss 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 long does a Wegovy approval last with Cigna?
Weight Loss — Applies to Employer and ACA Marketplace plans. Initial approval: 8 months. Renewal: every 12 months. Heart Disease Risk Reduction — Applies to Employer and ACA Marketplace plans. Initial approval: 12 months. Renewal: every 12 months. Liver Disease (MASH) — Applies to Employer and ACA Marketplace plans. Initial approval: 12 months. Renewal: every 12 months.
What does Cigna require to renew Wegovy?
Weight Loss — Applies to Employer and ACA Marketplace plans. At least 1% reduction in BMI. Adults: must have lost ≥ 5% of baseline body weight. Pediatric (age 12-17): must have had ≥ 1% reduction in BMI from baseline. Baseline BMI/weight re-verified at continuation, but 3-month lifestyle program requirement is not re-checked. Heart Disease Risk Reduction — Applies to Employer and ACA Marketplace plans. Initial and continuation criteria are combined into a single 1-year approval; no separate weight loss response threshold is required for renewal. Baseline BMI ≥ 27 kg/m2, established CV disease, and GDMT use are the ongoing requirements. Diabetes exclusion does NOT apply — patients with or without diabetes may qualify. Liver Disease (MASH) — Applies to Employer and ACA Marketplace plans. Continuation requires: patient has completed ≥ 1 year of therapy; prescriber attests no worsening of fibrosis or MASH/NASH; no cirrhosis (F4); metabolic risk factors managed per standard of care; alcohol limits maintained; diet and exercise ongoing; specialist prescribing/consultation. Fibrosis staging documentation NOT re-required at continuation. ELF score, biopsy, VCTE, or MRE documentation NOT re-required at continuation.
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 Cigna: Mounjaro, Ozempic, Zepbound

Wegovy under other plans: Aetna, Centene, Medicare GLP-1 Bridge (CMS), UnitedHealthcare, Alabama Medicaid, BCBS Alabama, BCBS Arizona, BCBS Arkansas

All insurance plans · All medications

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