Employer / Commercial Insurance
Covered (preferred drug)What you need to qualify
- Age 12 and older
Approval and renewal
- Initial approval: 7 months
Policy note: This policy explicitly states Wegovy is NOT targeted and is not indicated for diabetes treatment. The policy explicitly does not recommend approval of GLP-1 agonists for weight loss without a type 2 diabetes diagnosis. No PA criteria are provided for Wegovy under this policy.
source: Pa policy