Does Oscar Health Marketplace Ohio cover Wegovy?
Excluded by the plan
Oscar Health Marketplace Ohio excludes Wegovy from coverage— an exception may be available with clinical justification.
This plan explicitly excludes this medication from coverage. An exception may be available.
Verbatim status from policy: Excluded
Last verified 2026-04-30.
Requirements
- Prior authorization
- Not required
- Step therapy
- Not required
Sources
- Oscar Clinical Guideline: Bariatric Surgery and Revision of Bariatric Surgery (Adolescents: Ages 13 - 17)
Oscar · Effective 2025-09-01 · vCG009, Ver. 11
- Oscar Clinical Guideline: Weight Loss Agents
Oscar Health · Effective 2026-05-01 · vPG070, Ver. 9
- Oscar Clinical Guideline: Medical Nutrition Therapy (Dietary Evaluation & Counseling) (CG010, Ver. 11)
Oscar · Effective 2024 (based on references and copyright context) · vCG010, Ver. 11
- Oscar Clinical Guideline: Bariatric Surgery and Revision of Bariatric Surgery (Adults)
Oscar Health · vCG008, Ver. 11
- Oscar Clinical Guideline: Weight Loss Agents (PG070, Ver. 9); Oscar Clinical Guideline: Wegovy (semaglutide) for Cardiovascular Risk Reduction or Metabolic Dysfunction-Associated Steatohepatitis (MASH) (PG194, Ver. 6)
Oscar · Effective 2026-05-01 · vPG070 Ver. 9; PG194 Ver. 6
What to do next
Even when a plan says no, an exception or appeal is often possible — especially when there's a strong clinical case. Your prescriber can request a coverage determination.