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Horizon BCBS · Liver Disease (MASH)

Horizon BCBS coverage for Wegovy (Liver Disease (MASH))

Employer / Commercial Insurance

Covered with requirements

What you need to qualify

  • Age 18 and older
  • BMI of 25 or higher
  • BMI of 23 or higher for patients of Asian descent
  • Prescribed by or in consultation with a specialist
  • Confirmed MASH diagnosis by FIB-4, liver_biopsy, FibroScan_VCTE, ELF_test, and MRE, fibrosis stage F2 to F3
  • Lab results confirming eligibility

Qualification pathways

You can qualify through any one of these.

MASH with F2/F3 fibrosis (Wegovy)

All of:

  • Diagnosis of noncirrhotic NASH or MASH (medical records required)
  • Stage F2 or F3 fibrosis confirmed by BOTH: (1) FIB-4 score consistent with F2 or F3 fibrosis adjusted for age AND (2) one confirmatory test (liver biopsy, VCTE/FibroScan, ELF score, or MRE)
  • Requested agent is Wegovy
  • Patient is an adult (>= 18 years of age)
  • Patient is being monitored and/or treated for any comorbid conditions (e.g., CVD, diabetes, dyslipidemia, hypertension)
  • Patient does NOT have decompensated cirrhosis
  • Patient does NOT have moderate to severe hepatic impairment (Child-Pugh Class B or C)
  • Patient does NOT have any other liver disease (e.g., Wilson's disease, HCC, hepatitis)
  • Prescriber is a specialist (hepatologist, gastroenterologist) OR has consulted with such a specialist
  • Will NOT use in combination with another weight loss agent
  • Will NOT use in combination with another GLP-1 receptor agonist
  • No FDA labeled contraindications to requested agent
  • Currently on low-calorie diet, increased physical activity, and behavioral modifications

Plus any one of:

  • BMI > 25 kg/m2
  • BMI > 23 kg/m2 if patient is of South Asian, Southeast Asian, or East Asian descent
  • If female: alcohol consumption < 20 grams/day
  • If male: alcohol consumption < 30 grams/day

Documentation to bring

  • Medical records confirming diagnosis of noncirrhotic NASH or MASH
  • FIB-4 score consistent with stage F2 or F3 fibrosis (adjusted for age)
  • One of the following confirming F2 or F3 fibrosis: liver biopsy, vibration-controlled transient elastography (VCTE/FibroScan), Enhanced Liver Fibrosis (ELF) score, or magnetic resonance elastography (MRE)
  • Documentation of patient BMI (> 25 kg/m2, or > 23 kg/m2 for South/Southeast/East Asian patients)
  • Documentation of alcohol consumption (< 20 g/day female, < 30 g/day male)
  • Documentation confirming absence of decompensated cirrhosis, Child-Pugh B/C, and other liver diseases
  • Documentation of monitoring/treatment for comorbid conditions (CVD, diabetes, dyslipidemia, hypertension)
  • Documentation of specialist involvement (hepatologist or gastroenterologist) or consultation

Quantity limits

  • 0.25mg, 0.5mg, 1mg — 8 pens per 180 days (84-day)
  • 1.7mg, 2.4mg — 4 pens per 28 days

Approval and renewal

  • Initial approval: 6 months
  • Renewal: every 6 months
  • To renew, the plan looks for Patient must have clinical benefit with the requested agent. Alcohol limits (< 20 g/day female, < 30 g/day male) re-verified at renewal. Absence of decompensated cirrhosis, Child-Pugh B/C, and other liver disease re-verified. Specialist requirement re-verified. Fibrosis staging and BMI are NOT re-verified at renewal.

Not covered when

  • Decompensated cirrhosis
  • Moderate to severe hepatic impairment (Child-Pugh Class B or C)
  • Any other liver disease (e.g., Wilson's disease, hepatocellular carcinoma, hepatitis)
  • Alcohol consumption >= 20 g/day (female) or >= 30 g/day (male)
  • Concomitant use with another weight loss agent
  • Concomitant use with another GLP-1 receptor agonist
  • Any FDA labeled contraindications to the requested agent

Policy note: Fibrosis must be confirmed by BOTH a FIB-4 score consistent with F2/F3 AND at least one of: liver biopsy, VCTE, ELF score, or MRE. Asian BMI threshold is > 23 kg/m2 for South Asian, Southeast Asian, or East Asian patients. One standard alcoholic drink contains roughly 14 grams of pure alcohol. Initial approval is 6 months (all non-obesity indications). Renewal is 6 months.

verified June 5, 2026 · source: glp1-for-non-diabetic-use.pdf

All Wegovy policies under Horizon BCBS · Check your card