Does Aetna cover Wegovy?
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Aetna covers Wegovy on most commercial plans when the patient meets clinical criteria and prior authorization is approved. The obesity-drug benefit must be included in the specific employer plan.
Typical requirements
- BMI ≥30, or BMI ≥27 with weight-related comorbidity
- Documented 6-month lifestyle modification attempt
- Prior authorization approval before dispensing
Typical out-of-pocket
$25-$80/month with coverage; varies by plan tier. Actual copay depends on your specific plan's pharmacy benefit tier.
If you're denied
If denied, your prescriber submits a letter of medical necessity citing BMI, comorbidities, and prior lifestyle interventions. Aetna appeal turnaround is typically 30 days.
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
from $145/mo- Best for insured patients
- Best for clinical oversight
Ro Body — branded GLP-1 weight care program
Hims
from $199/mo- Best for cash-pay
- Best for speed
Hims Weight Loss — compounded GLP-1 from $199/mo
Noom Med
from $179/mo- Best for coaching
- Best for maintenance
Noom Med — GLP-1 + behavioral psychology coaching
Aetna not the right plan?
Coverage varies dramatically between carriers and even between plans at the same carrier. Compare GLP-1 coverage across 10 major US insurers, or run the insurance pre-check to estimate your specific plan's odds.
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Frequently asked
Does Aetna cover Wegovy?+
Aetna covers Wegovy on most commercial plans when the patient meets clinical criteria and prior authorization is approved. The obesity-drug benefit must be included in the specific employer plan.
Does Aetna require prior authorization for Wegovy?+
Yes. Aetna requires prior authorization before dispensing Wegovy. Your prescriber submits the request with documentation of medical necessity (BMI, comorbidities, prior therapy). Turnaround is typically 1-4 weeks.
What if Aetna denies my Wegovy prescription?+
If denied, your prescriber submits a letter of medical necessity citing BMI, comorbidities, and prior lifestyle interventions. Aetna appeal turnaround is typically 30 days.
What is the Wegovy copay with Aetna?+
$25-$80/month with coverage; varies by plan tier. Actual copay depends on your specific plan tier and any pharmacy benefit manager carve-outs.