Employer / Commercial Insurance
Covered with requirements
What you need to qualify
- Age 18 and older
- 3 months of a documented diet and exercise program
- Prescribed by or in consultation with a specialist
- Confirmed MASH diagnosis by FibroScan_VCTE, ultrasound elastography, MRE, and liver_biopsy, fibrosis stage F2 to F3
Qualification pathways
You can qualify through any one of these.
MASH with F2/F3 fibrosis refractory to lifestyle changes
All of:
- Prescriber is a Hepatologist or Gastroenterologist
- Age >= 18 years
- Diagnosis of MASH with fibrosis stage F2 or F3 confirmed by transient elastography, ultrasound elastography, MRI elastography, and/or liver biopsy
- Persistent fibrosis (F2/F3) refractory to at least 3 months of lifestyle changes and/or structured weight loss program (diet, exercise, medication for weight loss with goal of >=5% weight loss)
- No significant alcohol consumption within 1 year (females: <=7 drinks [98g alcohol]/week; males: <=14 drinks [196g alcohol]/week)
- No regular use of drugs associated with MAFLD (amiodarone, methotrexate, systemic glucocorticoids >5mg/day, tamoxifen, high-dose estrogen, anabolic steroids [except testosterone replacement], valproic acid, known hepatotoxins)
- No active serious medical disease with life expectancy <2 years
- No ALT/AST >5x ULN likely due to other chronic liver disease
- Not pregnant, breastfeeding, or planning pregnancy
- No personal or family history of MTC or MEN2
- No prior or current pancreatitis or gallbladder disease/gallstones
- No bariatric surgery within the last 6 months
Documentation to bring
- Documentation that prescriber is a Hepatologist or Gastroenterologist
- Patient age documentation (>=18 years)
- MASH diagnosis with fibrosis stage F2 or F3 confirmed by transient elastography, ultrasound elastography, MRI elastography, and/or liver biopsy
- Documentation that fibrosis is persistent (F2/F3) and refractory to at least 3 months of lifestyle changes and/or structured weight loss program
- Documentation of absence of significant alcohol consumption within 1 year (females <=7 drinks/week [98g]; males <=14 drinks/week [196g])
- Documentation of absence of regular use of drugs associated with MAFLD
- Documentation of absence of active serious medical disease with life expectancy <2 years
- ALT/AST levels confirming not >5x ULN due to other chronic liver disease
- Confirmation of absence of pregnancy/breastfeeding/planning pregnancy
- Confirmation of no personal or family history of MTC or MEN2
- Confirmation of no prior or current pancreatitis or gallbladder disease/gallstones
- Confirmation of no bariatric surgery within past 6 months
Approval and renewal
- Initial approval: 12 months
- Renewal: every 12 months
- To renew, the plan looks for Clinically significant benefit defined as: NAFLD Activity Score (NAS) decreased by at least 2 points from baseline OR reduction in fibrosis stage. AND specialist follow-up in the last 12 months. Initial criteria (e.g., F2/F3 fibrosis documentation, alcohol consumption exclusion, specialist prescriber requirement) are NOT explicitly re-verified for existing members who have previously met criteria.
Not covered when
- Bariatric surgery within the last 6 months
- Significant alcohol consumption within 1 year (>7 drinks/week [>98g] for females; >14 drinks/week [>196g] for males)
- Regular use of drugs associated with MAFLD (amiodarone, methotrexate, systemic glucocorticoids >5mg/day, tamoxifen, high-dose estrogen, anabolic steroids [except testosterone replacement], valproic acid, known hepatotoxins)
- Active serious medical disease with life expectancy <2 years
- ALT/AST >5x ULN likely due to other chronic liver disease
- Breastfeeding
- Planning to become pregnant
- Personal or family history of MTC or MEN2
- Prior or current pancreatitis or gallbladder disease/gallstones
- Pregnancy
- Bariatric surgery
Policy note: Applies to Wegovy injectable ONLY — oral tablets are NOT covered for MASH indication. Fibrosis confirmation methods include transient elastography (FibroScan), ultrasound elastography, MRI elastography, and/or liver biopsy. No explicit lookback period stated for confirmatory testing. Continuation requires specialist follow-up within last 12 months plus documented clinical benefit (NAS decrease >=2 points or fibrosis stage reduction).
Policy effective June 2, 2026 · verified June 5, 2026 · source: hmo-exchange-prior-authorization-criteria-en.pdf
ACA Marketplace
Covered with requirements
What you need to qualify
- Age 18 and older
- 3 months of a documented diet and exercise program
- Prescribed by or in consultation with a specialist
- Confirmed MASH diagnosis by FibroScan_VCTE, ultrasound elastography, MRE, and liver_biopsy, fibrosis stage F2 to F3
Qualification pathways
You can qualify through any one of these.
MASH with F2/F3 fibrosis refractory to lifestyle changes
All of:
- Prescriber is a Hepatologist or Gastroenterologist
- Age >= 18 years
- Diagnosis of MASH with fibrosis stage F2 or F3 confirmed by transient elastography, ultrasound elastography, MRI elastography, and/or liver biopsy
- Persistent fibrosis (F2/F3) refractory to at least 3 months of lifestyle changes and/or structured weight loss program (diet, exercise, medication for weight loss with goal of >=5% weight loss)
- No significant alcohol consumption within 1 year (females: <=7 drinks [98g alcohol]/week; males: <=14 drinks [196g alcohol]/week)
- No regular use of drugs associated with MAFLD (amiodarone, methotrexate, systemic glucocorticoids >5mg/day, tamoxifen, high-dose estrogen, anabolic steroids [except testosterone replacement], valproic acid, known hepatotoxins)
- No active serious medical disease with life expectancy <2 years
- No ALT/AST >5x ULN likely due to other chronic liver disease
- Not pregnant, breastfeeding, or planning pregnancy
- No personal or family history of MTC or MEN2
- No prior or current pancreatitis or gallbladder disease/gallstones
- No bariatric surgery within the last 6 months
Documentation to bring
- Documentation that prescriber is a Hepatologist or Gastroenterologist
- Patient age documentation (>=18 years)
- MASH diagnosis with fibrosis stage F2 or F3 confirmed by transient elastography, ultrasound elastography, MRI elastography, and/or liver biopsy
- Documentation that fibrosis is persistent (F2/F3) and refractory to at least 3 months of lifestyle changes and/or structured weight loss program
- Documentation of absence of significant alcohol consumption within 1 year (females <=7 drinks/week [98g]; males <=14 drinks/week [196g])
- Documentation of absence of regular use of drugs associated with MAFLD
- Documentation of absence of active serious medical disease with life expectancy <2 years
- ALT/AST levels confirming not >5x ULN due to other chronic liver disease
- Confirmation of absence of pregnancy/breastfeeding/planning pregnancy
- Confirmation of no personal or family history of MTC or MEN2
- Confirmation of no prior or current pancreatitis or gallbladder disease/gallstones
- Confirmation of no bariatric surgery within past 6 months
Approval and renewal
- Initial approval: 12 months
- Renewal: every 12 months
- To renew, the plan looks for Clinically significant benefit defined as: NAFLD Activity Score (NAS) decreased by at least 2 points from baseline OR reduction in fibrosis stage. AND specialist follow-up in the last 12 months. Initial criteria (e.g., F2/F3 fibrosis documentation, alcohol consumption exclusion, specialist prescriber requirement) are NOT explicitly re-verified for existing members who have previously met criteria.
Not covered when
- Bariatric surgery within the last 6 months
- Significant alcohol consumption within 1 year (>7 drinks/week [>98g] for females; >14 drinks/week [>196g] for males)
- Regular use of drugs associated with MAFLD (amiodarone, methotrexate, systemic glucocorticoids >5mg/day, tamoxifen, high-dose estrogen, anabolic steroids [except testosterone replacement], valproic acid, known hepatotoxins)
- Active serious medical disease with life expectancy <2 years
- ALT/AST >5x ULN likely due to other chronic liver disease
- Breastfeeding
- Planning to become pregnant
- Personal or family history of MTC or MEN2
- Prior or current pancreatitis or gallbladder disease/gallstones
- Pregnancy
- Bariatric surgery
Policy note: Applies to Wegovy injectable ONLY — oral tablets are NOT covered for MASH indication. Fibrosis confirmation methods include transient elastography (FibroScan), ultrasound elastography, MRI elastography, and/or liver biopsy. No explicit lookback period stated for confirmatory testing. Continuation requires specialist follow-up within last 12 months plus documented clinical benefit (NAS decrease >=2 points or fibrosis stage reduction).
Policy effective June 2, 2026 · verified June 5, 2026 · source: hmo-exchange-prior-authorization-criteria-en.pdf
Federal Employee Program
Covered with requirements
What you need to qualify
- Age 18 and older
- 3 months of a documented diet and exercise program
- Prescribed by or in consultation with a specialist
- Confirmed MASH diagnosis by FibroScan_VCTE, ultrasound elastography, MRE, and liver_biopsy, fibrosis stage F2 to F3
Qualification pathways
You can qualify through any one of these.
MASH with F2/F3 fibrosis refractory to lifestyle changes
All of:
- Prescriber is a Hepatologist or Gastroenterologist
- Age >= 18 years
- Diagnosis of MASH with fibrosis stage F2 or F3 confirmed by transient elastography, ultrasound elastography, MRI elastography, and/or liver biopsy
- Persistent fibrosis (F2/F3) refractory to at least 3 months of lifestyle changes and/or structured weight loss program (diet, exercise, medication for weight loss with goal of >=5% weight loss)
- No significant alcohol consumption within 1 year (females: <=7 drinks [98g alcohol]/week; males: <=14 drinks [196g alcohol]/week)
- No regular use of drugs associated with MAFLD (amiodarone, methotrexate, systemic glucocorticoids >5mg/day, tamoxifen, high-dose estrogen, anabolic steroids [except testosterone replacement], valproic acid, known hepatotoxins)
- No active serious medical disease with life expectancy <2 years
- No ALT/AST >5x ULN likely due to other chronic liver disease
- Not pregnant, breastfeeding, or planning pregnancy
- No personal or family history of MTC or MEN2
- No prior or current pancreatitis or gallbladder disease/gallstones
- No bariatric surgery within the last 6 months
Documentation to bring
- Documentation that prescriber is a Hepatologist or Gastroenterologist
- Patient age documentation (>=18 years)
- MASH diagnosis with fibrosis stage F2 or F3 confirmed by transient elastography, ultrasound elastography, MRI elastography, and/or liver biopsy
- Documentation that fibrosis is persistent (F2/F3) and refractory to at least 3 months of lifestyle changes and/or structured weight loss program
- Documentation of absence of significant alcohol consumption within 1 year (females <=7 drinks/week [98g]; males <=14 drinks/week [196g])
- Documentation of absence of regular use of drugs associated with MAFLD
- Documentation of absence of active serious medical disease with life expectancy <2 years
- ALT/AST levels confirming not >5x ULN due to other chronic liver disease
- Confirmation of absence of pregnancy/breastfeeding/planning pregnancy
- Confirmation of no personal or family history of MTC or MEN2
- Confirmation of no prior or current pancreatitis or gallbladder disease/gallstones
- Confirmation of no bariatric surgery within past 6 months
Approval and renewal
- Initial approval: 12 months
- Renewal: every 12 months
- To renew, the plan looks for Clinically significant benefit defined as: NAFLD Activity Score (NAS) decreased by at least 2 points from baseline OR reduction in fibrosis stage. AND specialist follow-up in the last 12 months. Initial criteria (e.g., F2/F3 fibrosis documentation, alcohol consumption exclusion, specialist prescriber requirement) are NOT explicitly re-verified for existing members who have previously met criteria.
Not covered when
- Bariatric surgery within the last 6 months
- Significant alcohol consumption within 1 year (>7 drinks/week [>98g] for females; >14 drinks/week [>196g] for males)
- Regular use of drugs associated with MAFLD (amiodarone, methotrexate, systemic glucocorticoids >5mg/day, tamoxifen, high-dose estrogen, anabolic steroids [except testosterone replacement], valproic acid, known hepatotoxins)
- Active serious medical disease with life expectancy <2 years
- ALT/AST >5x ULN likely due to other chronic liver disease
- Breastfeeding
- Planning to become pregnant
- Personal or family history of MTC or MEN2
- Prior or current pancreatitis or gallbladder disease/gallstones
- Pregnancy
- Bariatric surgery
Policy note: Applies to Wegovy injectable ONLY — oral tablets are NOT covered for MASH indication. Fibrosis confirmation methods include transient elastography (FibroScan), ultrasound elastography, MRI elastography, and/or liver biopsy. No explicit lookback period stated for confirmatory testing. Continuation requires specialist follow-up within last 12 months plus documented clinical benefit (NAS decrease >=2 points or fibrosis stage reduction).
Policy effective June 2, 2026 · verified June 5, 2026 · source: hmo-exchange-prior-authorization-criteria-en.pdf