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Does Clover Health cover Wegovy?

No. Clover Health's policies on file exclude Wegovy for weight loss on Medicare Advantage plans.

Policy document

  • Clover Health Medicare Advantage prior authorization policy

    Clover Health · PA policy · Medicare Advantage

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  • Medicare Advantage: Not covered. Per CMS guidelines, Medicare Part D plans do not currently cover GLP-1 medications prescribed solely for we...

Earliest policy review April 1, 2026. How we verify · Check your exact plan

Full requirements: Wegovy for Weight Loss (1 plan type)

Applies to Medicare Advantage plans.

Not covered

Per CMS guidelines, Medicare Part D plans do not currently cover GLP-1 medications prescribed solely for weight management. Note: Starting July 1, 2026, the Medicare GLP-1 Bridge Program will provide Wegovy coverage at a $50 monthly copay for eligible Part D members meeting BMI criteria. Patients should re-verify coverage on or after that date.

Policy note: Wegovy (semaglutide for weight management) is explicitly excluded from coverage under this Medicare Advantage/Part D plan per CMS rules. This policy only covers GLP-1 RAs for T2DM management. Wegovy is not mentioned by name but the explicit exclusion of GLP-1 RAs for sole obesity treatment effectively excludes it for this indication.

source: Clover Health Medicare Advantage prior authorization policy · View policy document (PDF)

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If weight loss isn't covered on your plan

A prior authorization can't override a benefit exclusion. Ask Clover Health about a formulary exception.

Questions people ask
Does Clover Health cover Wegovy?
No. Clover Health's policies on file exclude Wegovy for weight loss on Medicare Advantage plans.
How current is this information?
The oldest review date among the policies on this page is April 1, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Clover Health: Ozempic

Wegovy under other plans: Alabama Medicaid, California Medicaid, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid, EmblemHealth, Fallon Health Plan, Illinois Medicaid

All insurance plans · All medications

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