Does Aetna cover Wegovy?
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Aetna's Wegovy policy (4774-C) approves adults with a baseline BMI of 30 or more, or 27 or more with a weight-related condition, after at least 6 months in a comprehensive weight management program. The first approval lasts 7 months. Whether your plan includes weight-loss drugs at all depends on your plan.
What Aetna specifically requires
- Age 18 or older
- Baseline BMI of 30 or more, or 27 or more with at least one weight-related condition (e.g., hypertension, type 2 diabetes, dyslipidemia)
- At least 6 months in a comprehensive weight management program (behavior change, reduced-calorie diet, more physical activity) before starting
- First approval: 7 months
- Renewal: at least 5% loss from baseline, or keeping an earlier 5% loss; renewed for 12 months
- Supply limit: one box of 4 pens per 21 days
Sources: Aetna Wegovy prior authorization policy 4774-C (May 1, 2024); Aetna Wegovy (cardiovascular) policy 6410-C (Mar 2024)
About Aetna coverage
- Wegovy's first approval runs 7 months and requires at least 6 months in a comprehensive weight management program before starting (policy 4774-C). Aetna Wegovy prior authorization policy 4774-C, May 1, 2024
- Zepbound's first approval runs 8 months; renewal requires at least 3 months on a stable maintenance dose and 5% weight loss from baseline (policy 6192-C). Aetna Zepbound prior authorization policy 6192-C, Dec 19, 2024
- CVS Caremark removed Zepbound from its formulary effective July 1, 2025 and named Wegovy as the covered alternative. Massachusetts GIC: CVS Caremark removes Zepbound from its formulary, Jun 10, 2025
- Aetna keeps a separate Wegovy policy for cardiovascular risk reduction (6410-C), apart from its weight-loss policy. Aetna Wegovy (cardiovascular) policy 6410-C, Mar 2024
- Wegovy supply limit: one box of 4 pens per 21 days, or 3 boxes per 63 days (policy 4774-C). Aetna Wegovy prior authorization policy 4774-C, May 1, 2024
Where to get Wegovy
Telehealth services that handle Wegovy, useful while prior auth processes or as a cash-pay alternative. We may earn a commission. See disclosure.
Ro
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Hims
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Hims Weight Loss, branded GLP-1 on a monthly membership
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Coverage varies between carriers and even between plans at the same carrier. Compare GLP-1 coverage across 20 US insurers and programs, or run the insurance pre-check to estimate your specific plan's odds.
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Frequently asked
Does Aetna cover Wegovy?+
Aetna's Wegovy policy (4774-C) approves adults with a baseline BMI of 30 or more, or 27 or more with a weight-related condition, after at least 6 months in a comprehensive weight management program. The first approval lasts 7 months. Whether your plan includes weight-loss drugs at all depends on your plan.
Does Aetna require prior authorization for Wegovy?+
Yes. Aetna requires prior authorization for Wegovy. Your prescriber submits the request with the documentation listed in the Aetna criteria on this page.