Insurance pre-check
Enter your insurance carrier, the medication you're considering, and a few clinical details. We'll estimate the likelihood of prior authorization approval and link you to the full carrier coverage page.
Insurance pre-check
Quick heuristic estimate. Not a guarantee — final approval is at your insurer's discretion based on your specific plan and prior-auth review.
Approval is plan-dependent. Some plans within this carrier cover; others don't. Verify with your specific plan's formulary or call the number on your insurance card before assuming.
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.
Read full Aetna Wegovy coverage →How this works
The estimate combines published carrier coverage patterns with the clinical criteria you enter (BMI, comorbidity, lifestyle history). It's a heuristic, not a guarantee. Actual approval depends on your specific plan and prior-auth review. Plans within the same carrier vary widely based on what the employer or plan sponsor included.
What to do with the result
- Likely: Ask your prescriber to submit the prior authorization. Approval is usually 1-4 weeks.
- Possible: Confirm coverage with your specific plan before assuming. The carrier coverage page lists what to ask.
- Unlikely: Request a medical necessity letter from your prescriber emphasizing comorbidities, prior weight-management attempts, and clinical urgency. Run manufacturer self-pay programs in parallel as a fallback.
- Blocked: Federal law excludes this combination (e.g., Medicare + Wegovy for weight loss). Appeals will fail. Manufacturer self-pay or commercial supplemental coverage are the practical alternatives.