The Checkup by Singlecare
JUNE 6, 2025
With Zepbound’s retail prices averaging $1,524 per month, having insurance coverage can help significantly. However, coverage for weight loss drugs is somewhat limited. Some Kaiser Permanente insurance plans cover Zepbound for weight loss or OSA. Does Kaiser Permanente cover Zepbound?
The Checkup by Singlecare
JUNE 5, 2025
We spot-checked the drug lists of eight BCBS affiliates around the country, and only a couple of the Blue Cross Blue Shield plans we looked at have Zepbound on their formularies, and certain criteria must be met in order to receive and maintain insurance coverage. Or, log into your health insurance portal and look at your documents.
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The Checkup by Singlecare
APRIL 24, 2025
You can consider the following when verifying your insurance coverage for Mounjaro: Review your benefits plan document: Read through your evidence of coverage documents carefully to see if Mounjaro is listed as a covered medication. Pay attention to details about coverage levels and any specific requirements or restrictions.
The Checkup by Singlecare
JUNE 5, 2025
You can also log in to your health insurance portal to access policy documents. If it’s labeled as a “nonpreferred” drug, your plan is more likely to cover an alternate medication for Type 2 diabetes, but it may cover Mounjaro if your doctor advocates for insurance coverage on your behalf.
The Checkup by Singlecare
JULY 16, 2024
If your insurer covers Wegovy or Saxenda but these medications are unavailable, your doctor may be able to appeal and request a formulary exception, citing the shortage of the covered drug. If you don’t have insurance coverage or your insurance company denies your claim for Mounjaro, you may have to pay the retail cost of the medication.
BuzzRx
FEBRUARY 3, 2023
However, your health insurance plan may only cover specific brands or their generic versions. You can call your health plan’s customer service line to find out if they cover your needs. Your local pharmacy can also help answer your coverage questions by running test claims or calling the health plan on your behalf.
The Checkup by Singlecare
NOVEMBER 30, 2023
Medicaid Managed Care in New York New York Medicaid contracts with private health insurers in the state to deliver insurance coverage services, but the companies and plan types vary by county. You can also call and speak to the Marketplace Customer Service Center at (855)355-5777 or the Medicaid Helpline at (800)541-2831.
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