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Horizon BCBS · Type 2 Diabetes

Horizon BCBS coverage for Ozempic (Type 2 Diabetes)

Employer / Commercial Insurance

Covered (preferred drug)

What you need to qualify

  • A1C of 6.5% or higher
  • Trial of metformin for at least 90 days, or a documented reason it can't be used (["contraindication", "ASCVD", "heart_failure", "CKD"])
  • Lab results confirming eligibility

Qualification pathways

You can qualify through any one of these.

New Start — Preferred Agent (Ozempic)

All of:

  • Diagnosis of type 2 diabetes
  • A1C >= 6.5% confirmed by lab test
  • Patient will NOT use the requested agent in combination with a DPP-4 containing agent
  • Patient will NOT use the requested agent in combination with another GLP-1 receptor agonist
  • Patient will NOT use the requested agent in combination with OTC weight management products or supplements that may increase GLP hormone
  • Patient does NOT have any FDA labeled contraindications to the requested agent
  • Patient age is within FDA labeling for the requested indication

Plus any one of:

  • Medication history of use in the past 90 days to an agent containing metformin or insulin
  • FDA labeled contraindication to BOTH metformin AND insulin
  • Diagnosis of type 2 diabetes with or at high risk for atherosclerotic cardiovascular disease, heart failure, and/or chronic kidney disease

Continuation of Therapy — Preferred Agent (Ozempic)

All of:

  • Diagnosis of type 2 diabetes
  • A1C >= 6.5% confirmed by lab test
  • Patient will NOT use the requested agent in combination with a DPP-4 containing agent
  • Patient will NOT use the requested agent in combination with another GLP-1 receptor agonist
  • Patient will NOT use the requested agent in combination with OTC weight management products or supplements that may increase GLP hormone
  • Patient does NOT have any FDA labeled contraindications to the requested agent
  • Patient age is within FDA labeling for the requested indication

Plus any one of:

  • Patient has been treated with a preferred agent within the past 90 days (starting on samples is not approvable)
  • Prescriber states patient has been treated with a preferred agent within the past 90 days and patient is at risk if therapy with a preferred agent is discontinued

Documentation to bring

  • Documentation of type 2 diabetes diagnosis
  • Lab result confirming A1C >= 6.5%
  • Documentation of prior metformin or insulin use within past 90 days, OR documentation of FDA labeled contraindication to both metformin AND insulin, OR documentation of T2DM with/at high risk for ASCVD, heart failure, and/or CKD
  • Attestation that patient will not use requested agent in combination with a DPP-4 inhibitor
  • Attestation that patient will not use requested agent in combination with another GLP-1 receptor agonist
  • Attestation that patient will not use requested agent in combination with OTC weight management products or GLP-hormone-increasing supplements
  • Confirmation patient has no FDA labeled contraindications to the requested agent

Quantity limits

  • 2 MG/3ML, 4 MG/3ML, 8 MG/3ML — 1 pen per 28 days
  • 1.5 MG tablet, 4 MG tablet, 9 MG tablet — 30 tablets per 30 days

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • To renew, the plan looks for Continuation eligible if patient has been treated with a preferred agent within the past 90 days (samples not approvable), or prescriber attests patient has been treated with a preferred agent within past 90 days and is at risk if therapy is discontinued.

Not covered when

  • Concurrent use with DPP-4 containing agents
  • Concurrent use with another GLP-1 receptor agonist
  • Concurrent use with OTC weight management products (e.g., orlistat/Alli) or supplements that may increase GLP hormone (e.g., berberine, curcumin, taurine, ginseng, wild bitter gourd)
  • FDA labeled contraindications to the requested agent (personal or family history of MTC or MEN 2; prior serious hypersensitivity reaction)

Policy note: Fill limit of one GLP-1 agent and one strength per 28 days. Ozempic injection is a preferred agent; Ozempic tablets (Rybelsus) share semaglutide tablet quantity limits. The policy covers Ozempic for its FDA-labeled T2DM indication including glycemic control, CV risk reduction in T2DM with established CVD, and CKD risk reduction in T2DM — all under the same PA criteria for type 2 diabetes. The CV and CKD indications listed in the FDA label table are subsumed within T2DM criteria here; no separate CV/CKD pathway with distinct criteria is established in this document. QL approval is up to 12 months; one-time approval for titration dose extensions or when replacing another GLP-1 agent/strength within QL but over fill limit.

Policy effective May 11, 2026 · verified June 5, 2026 · source: NJ_GLP-1_Agonists_PAQL_ProgSum.pdf

All Ozempic policies under Horizon BCBS · Check your card