Coverage not yet verified
- Tier
- —
- Cash-pay
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MedMutual — Medical Mutual of Ohio
PPO
Showing all 14 medications.
| Medication | Coverage | Requirements | Tier | Lowest cash-pay | Details |
|---|---|---|---|---|---|
| anti-obesity agents (general) | Coverage not yet verified | — | — | — | View |
| Saxenda liraglutide | Covered with prior authorization |
| — | $372·GoodRx | View |
| Victoza liraglutide | Coverage not yet verified | — | — | — | View |
| Contrave naltrexone/bupropion | Covered with prior authorization |
| — | Price varies·Cost Plus | View |
| Foundayo orforglipron | Coverage not yet verified | — | — | $149·LillyDirect | View |
| Xenical / Alli orlistat | Covered with prior authorization |
| — | — | View |
| Adipex-P / Lomaira phentermine | Covered with prior authorization |
| — | $15·Cost Plus | View |
| Qsymia phentermine/topiramate | Covered with prior authorization |
| — | Price varies·GoodRx | View |
| Wegovy semaglutide | Covered with prior authorization |
| Unknown | $349·NovoCare | View |
| Ozempic semaglutide | Covered | No restrictions on file | — | $349·NovoCare | View |
| Wegovy HD semaglutide (7.2 mg injection) | Coverage not yet verified | — | — | $399·NovoCare | View |
| Wegovy (oral) semaglutide (oral, 1.5/4/9/25 mg tablets) | Coverage not yet verified | — | — | $149·NovoCare | View |
| Mounjaro tirzepatide | Covered | No restrictions on file | — | $299·LillyDirect | View |
| Zepbound tirzepatide | Covered with prior authorization |
| Unknown | $299·LillyDirect | View |