Coverage not yet verified
- Tier
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- Cash-pay
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Aetna Select HMO obesity-medication coverage
Aetna
Aetna Select HMO
HMO
Pharmacy benefit manager
CVS Caremark
PBM owned by CVS Health. Members manage prescriptions and check formulary at caremark.com.
Visit CVS Caremark →Identifiers on file
- RxBINon file
- RxPCNon file
- RxGRPon file
- Group IDon file
- Group nameon file
We match plans by RxBIN, group ID, and other ID-card fields, but don’t show the values publicly.
Pick the medications you want to see
Showing all 27 medications.
Coverage & pricing
| Medication | Coverage | Requirements | Tier | Lowest cash-pay | Details |
|---|---|---|---|---|---|
| anti-obesity agents (general) | Coverage not yet verified | — | — | — | View |
| Trulicity dulaglutide | Coverage not yet verified | — | — | — | View |
| Jardiance empagliflozin | Coverage not yet verified | — | — | — | View |
| Bydureon Bcise exenatide | Coverage not yet verified | — | — | — | View |
| glipizide | Coverage not yet verified | — | — | — | View |
| glyburide | Coverage not yet verified | — | — | — | View |
| Tradjenta linagliptin | Coverage not yet verified | — | — | — | View |
| Saxenda liraglutide | Coverage not yet verified | — | — | $372·GoodRx | View |
| Victoza liraglutide | Coverage not yet verified | — | — | — | View |
| Glucophage XR metformin | Coverage not yet verified | — | — | — | View |
| Contrave naltrexone/bupropion | Excluded by the plan | No restrictions on file | — | Price varies·Cost Plus | View |
| Foundayo orforglipron | Excluded by the plan | No restrictions on file | — | $149·LillyDirect | View |
| Xenical / Alli orlistat | Coverage not yet verified | — | — | — | View |
| Alli orlistat | Coverage not yet verified | — | — | — | View |
| Adipex-P / Lomaira phentermine | Coverage not yet verified | — | — | $15·Cost Plus | View |
| Qsymia phentermine/topiramate | Coverage not yet verified | — | — | Price varies·GoodRx | View |
| pioglitazone | Coverage not yet verified | — | — | — | View |
| pr7 consumer winner mpiuoqa06orq | Coverage not yet verified | — | — | — | View |
| Onglyza saxagliptin | Coverage not yet verified | — | — | — | View |
| Ozempic semaglutide | Covered with prior authorization |
| Tier 3 | $349·NovoCare | View |
| Wegovy semaglutide | Excluded by the plan | No restrictions on file | — | $349·NovoCare | View |
| Wegovy HD semaglutide (7.2 mg injection) | Excluded by the plan | No restrictions on file | — | $399·NovoCare | View |
| Wegovy (oral) semaglutide (oral, 1.5/4/9/25 mg tablets) | Excluded by the plan | No restrictions on file | — | $149·NovoCare | View |
| Rybelsus semaglutide (oral) | Coverage not yet verified | — | — | — | View |
| Januvia sitagliptin | Coverage not yet verified | — | — | — | View |
| Zepbound tirzepatide | Excluded by the plan | No restrictions on file | — | $299·LillyDirect | View |
| Mounjaro tirzepatide | Coverage not yet verified | — | — | $299·LillyDirect | View |
- TrulicityCoverage not yet verifieddulaglutide
- Tier
- —
- Cash-pay
- —
- JardianceCoverage not yet verifiedempagliflozin
- Tier
- —
- Cash-pay
- —
- Bydureon BciseCoverage not yet verifiedexenatide
- Tier
- —
- Cash-pay
- —
- Coverage not yet verified
- Tier
- —
- Cash-pay
- —
- Coverage not yet verified
- Tier
- —
- Cash-pay
- —
- TradjentaCoverage not yet verifiedlinagliptin
- Tier
- —
- Cash-pay
- —
- SaxendaCoverage not yet verifiedliraglutide
- Tier
- —
- Cash-pay
- $372·GoodRx
- VictozaCoverage not yet verifiedliraglutide
- Tier
- —
- Cash-pay
- —
- Glucophage XRCoverage not yet verifiedmetformin
- Tier
- —
- Cash-pay
- —
- ContraveExcluded by the plannaltrexone/bupropion
- Tier
- —
- Cash-pay
- Price varies·Cost Plus
- FoundayoExcluded by the planorforglipron
- Tier
- —
- Cash-pay
- $149·LillyDirect
- Xenical / AlliCoverage not yet verifiedorlistat
- Tier
- —
- Cash-pay
- —
- AlliCoverage not yet verifiedorlistat
- Tier
- —
- Cash-pay
- —
- Adipex-P / LomairaCoverage not yet verifiedphentermine
- Tier
- —
- Cash-pay
- $15·Cost Plus
- QsymiaCoverage not yet verifiedphentermine/topiramate
- Tier
- —
- Cash-pay
- Price varies·GoodRx
- Coverage not yet verified
- Tier
- —
- Cash-pay
- —
- Coverage not yet verified
- Tier
- —
- Cash-pay
- —
- OnglyzaCoverage not yet verifiedsaxagliptin
- Tier
- —
- Cash-pay
- —
- OzempicCovered with prior authorizationsemaglutide
- Tier
- Tier 3
- Cash-pay
- $349·NovoCare
- Prior auth
- WegovyExcluded by the plansemaglutide
- Tier
- —
- Cash-pay
- $349·NovoCare
- Wegovy HDExcluded by the plansemaglutide (7.2 mg injection)
- Tier
- —
- Cash-pay
- $399·NovoCare
- Wegovy (oral)Excluded by the plansemaglutide (oral, 1.5/4/9/25 mg tablets)
- Tier
- —
- Cash-pay
- $149·NovoCare
- RybelsusCoverage not yet verifiedsemaglutide (oral)
- Tier
- —
- Cash-pay
- —
- JanuviaCoverage not yet verifiedsitagliptin
- Tier
- —
- Cash-pay
- —
- ZepboundExcluded by the plantirzepatide
- Tier
- —
- Cash-pay
- $299·LillyDirect
- MounjaroCoverage not yet verifiedtirzepatide
- Tier
- —
- Cash-pay
- $299·LillyDirect