Coverage not yet verified
- Tier
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- Cash-pay
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UHC — UnitedHealthcare
PPO
Identifiers on file
We match plans by RxBIN, group ID, and other ID-card fields, but don’t show the values publicly.
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 |
| Tier 4 (Non-Preferred) | $372·GoodRx | View |
| Victoza liraglutide | Coverage not yet verified | — | — | — | View |
| Contrave naltrexone/bupropion | Covered | No restrictions on file | Tier 2 (Preferred Brand) | Price varies·Cost Plus | View |
| Foundayo orforglipron | Pending formulary review | No restrictions on file | — | $149·LillyDirect | View |
| Xenical / Alli orlistat | Covered | No restrictions on file | Tier 1 (Generic) | — | View |
| Adipex-P / Lomaira phentermine | Covered |
| Tier 1 (Generic) | $15·Cost Plus | View |
| Qsymia phentermine/topiramate | Covered with prior authorization |
| Tier 3 (Non-Preferred Brand) | Price varies·GoodRx | View |
| Wegovy semaglutide | Covered with prior authorization |
| Tier 4 (Non-Preferred Specialty) | $349·NovoCare | View |
| Ozempic semaglutide | Covered with prior authorization |
| Tier 3 (Preferred Specialty) | $349·NovoCare | View |
| Wegovy HD semaglutide (7.2 mg injection) | Covered with prior authorization |
| Tier 4 (Non-Preferred Specialty) | $399·NovoCare | View |
| Wegovy (oral) semaglutide (oral, 1.5/4/9/25 mg tablets) | Pending formulary review | No restrictions on file | — | $149·NovoCare | View |
| Mounjaro tirzepatide | Covered with prior authorization |
| Tier 3 (Preferred Specialty) | $299·LillyDirect | View |
| Zepbound tirzepatide | Not covered | No restrictions on file | — | $299·LillyDirect | View |