Learn how insurance covers obesity medications
Learn how coverage works.
Insurance language is dense on purpose. These guides translate prior authorization, step therapy, denials, and appeals into plain English so you can advocate for the medication your doctor prescribed.
Reviewed and written by Jon Thompson, MD — obesity medicine physician.
What Is Prior Authorization? (And Why Your GLP-1 May Need It)
Prior authorization is an insurance requirement that your doctor must get approval before a medication is covered. Here's how it works for GLP-1s.
6 min readWhy Was My Wegovy or Zepbound Denied? The 5 Most Common Reasons
Insurance denials for Wegovy and Zepbound are frustrating but often fixable. Here are the five most common reasons — and what you can do about each one.
7 min readStep Therapy Explained: When Your Plan Says "Try Something Else First"
Step therapy requires you to try lower-cost medications before your insurance will cover the one your doctor prescribed. Here's how it works and how to navigate it.
6 min readFormulary 101: How to Read Your Insurance Drug List
Your insurance formulary is the list of drugs your plan covers — and it determines what you pay. Here's how to read it and find out if your GLP-1 is covered.
6 min readThe Difference Between Wegovy, Ozempic, Mounjaro, and Zepbound (in Plain English)
Wegovy and Ozempic contain the same drug but have different FDA approvals. The same is true for Zepbound and Mounjaro. Here's what that means for your coverage.
7 min readHow to Read a Prior Authorization Denial Letter
Insurance denial letters are full of jargon, but they contain the exact information you need to fight back. Here's how to decode one, section by section.
6 min readWhat to Do if Your Plan Doesn't Cover Obesity Medications At All
If your insurance explicitly excludes weight-loss medications, you still have options. Here's how to explore manufacturer programs, exceptions, and plan alternatives.
7 min readCommercial Insurance vs. Medicare vs. Medicaid: How GLP-1 Coverage Differs
GLP-1 coverage rules are completely different depending on whether you have commercial insurance, Medicare, or Medicaid. Here's what each type of coverage means for you.
8 min readOpen Enrollment: How to Pick a Plan That Covers Your Medication
Choosing an insurance plan based on drug coverage takes more than comparing premiums. Here's a step-by-step approach to finding a plan that actually covers your GLP-1.
7 min readThe Anatomy of a Successful Appeal Letter
A well-written appeal letter directly addresses each denial reason with clinical documentation. Here's how to structure one that gives you the best chance of winning.
8 min read
Ready to check your plan?
Look up coverage decisions for Wegovy, Zepbound, Saxenda, and more across 15 insurers.