Does Cigna cover Zepbound?

Yes. Cigna covers Zepbound for obstructive sleep apnea (OSA) with prior authorization if your BMI is 30 or higher. Other policy requirements and your plan's benefits also apply.

How long does a Zepbound approval last with Cigna?

Obstructive Sleep Apnea (OSA) — Applies to Employer and ACA Marketplace plans. Initial approval: 12 months. Renewal: every 12 months.

What does Cigna require to renew Zepbound?

Obstructive Sleep Apnea (OSA) — Applies to Employer and ACA Marketplace plans. Continuation requires: ≥ 10% baseline body weight loss AND prescriber attestation of stability in OSA signs or symptoms (e.g., snoring, excessive daytime sleepiness, fatigue). Patient must have completed ≥ 1 year of initial therapy. PAP therapy status is NOT re-evaluated at continuation. OSA AHI is not re-measured 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.

Cigna coverage for Zepbound (Obstructive Sleep Apnea

Applies to Employer and ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Initial Approval - Moderate to Severe OSA with Obesity

All of:

Patient is ≥ 18 years of age
Baseline BMI ≥ 30 kg/m2 (prior to any GLP-1 or GLP-1/GIP agonist)
Sleep study showing diagnosis of moderate to severe OSA
Sleep study showing apnea-hypopnea index (AHI) ≥ 15 events per hour
Patient does NOT have central sleep apnea
Patient does NOT have Cheyne Stokes respiration
Medication will be used concomitantly with behavioral modification and a reduced-calorie diet

Continuation - Moderate to Severe OSA with Obesity

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 completed ≥ 1 year of therapy with Zepbound
Patient has lost ≥ 10% of baseline body weight
Prescriber attests patient has stability in OSA signs or symptoms
Medication will be used concomitantly with behavioral modification and a reduced-calorie diet

Documentation to bring

Baseline BMI documentation (≥ 30 kg/m2, prior to any GLP-1 or GLP-1/GIP agonist)
Sleep study results documenting moderate to severe OSA diagnosis
Sleep study results documenting AHI ≥ 15 events per hour
Confirmation patient does not have central sleep apnea or Cheyne Stokes respiration
Documentation of ≥ 10% baseline body weight loss (continuation)
Prescriber attestation of stability in OSA signs or symptoms (continuation)

Approval and renewal

Initial approval: 12 months
Renewal: every 12 months
Renewal: Continuation requires: ≥ 10% baseline body weight loss AND prescriber attestation of stability in OSA signs or symptoms (e.g., snoring, excessive daytime sleepiness, fatigue). Patient must have completed ≥ 1 year of initial therapy. PAP therapy status is NOT re-evaluated at continuation. OSA AHI is not re-measured at continuation.

Not covered when

Central sleep apnea is excluded
Cheyne Stokes respiration is excluded
Concomitant use with other GLP-1 agonists or GLP-1/GIP agonists is not covered

Policy note: PAP/CPAP trial is NOT required prior to approval; patients using PAP therapy or not using PAP therapy are both eligible. Sleep study must document AHI ≥ 15 events/hour but there is no specific timeframe requirement for how recent the sleep study must be (a prior requirement for within 1 year was removed in May 2025). Moderate OSA = AHI ≥ 15; Severe OSA = AHI ≥ 30. Continuation requires ≥ 10% body weight loss (higher than the 5% threshold for weight loss indication). No pediatric indication for OSA.

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

Does Cigna cover Zepbound for Obstructive Sleep Apnea (OSA)?

Policy document

Applies to Employer and ACA Marketplace plans.

Qualification pathways

Documentation to bring

Approval and renewal

Not covered when