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PacificSource Health

Does PacificSource Health cover Wegovy for Weight Loss?

No. PacificSource Health's policies on file exclude Wegovy for weight loss on Employer and ACA Marketplace plans.

Policy document

  • Employer and ACA Marketplace: Not covered. Use for weight loss (no MACE or MASH diagnosis) is explicitly excluded. Diagnosis of type 1 or type 2 diabe...

Earliest policy review June 10, 2026. How we verify · Check your exact plan

Full requirements: Wegovy for Weight Loss (2 plan types)

Applies to Employer and ACA Marketplace plans.

Not covered

Use for weight loss (no MACE or MASH diagnosis) is explicitly excluded. Diagnosis of type 1 or type 2 diabetes without MACE or MASH is also excluded.

Policy note: Wegovy is explicitly excluded for weight loss unless the patient has a qualifying MACE or MASH diagnosis. Type 1 or type 2 diabetes without MACE or MASH also does not qualify.

Policy effective June 22, 2026 · verified June 10, 2026 · source: Cw577pv8jf · 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 PacificSource Health about a formulary exception.

Questions people ask
Does PacificSource Health cover Wegovy?
No. PacificSource Health's policies on file exclude Wegovy for weight loss on Employer and ACA Marketplace plans.
How current is this information?
The oldest review date among the policies on this page is June 10, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under PacificSource Health: Mounjaro, Ozempic

Wegovy under other plans: Kaiser Permanente Northwest, Oregon Medicaid, Regence, Alabama Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid

All insurance plans · All medications

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