There is currently a NATIONAL BACKORDER of injectable weight loss meds. If you are interested in scheduling an appointment regarding weight loss medications, we are happy to see you in the office to discuss the possibility of prescribing them for you. However, even if these meds are appropriate for you and your insurance will approve them, please know that you will not likely be able to start taking them anytime in the foreseeable future due to this national backorder. Please see below for more information about weight loss medications, cost, insurance coverage, etc.
Weight Loss Medications or medications used for weight loss (Saxenda, Wegovy, Zepbound for example) are expensive and are either not covered by insurance companies at all or require a prior authorization to obtain payment through insurance. Even if approved, these medications are typically in one of the highest tiers of medications and often require a copay of $200-$300 per month or more.
Please note that if a prior authorization is required to have one of these medications covered, insurance typically requires documentation from us that you have tried and failed other weight loss methods (structured diet plans, online calorie tracking, purposeful exercise, etc). Without this documentation, insurance companies most often will not cover these medications. In many cases, insurance no longer covers these weight loss medications at all.
Please also note that similar injectables meant for diabetes management (mounjaro, ozempic, etc) and generally not covered for weightloss or in most cases, even for pre-diabetes.
If you would like us to consider prescribing one of the medication for weight loss, please contact your insurance to see if they do include one of the medications on your formulary. Please be prepared to provide this information at your next visit. At this visit, we will need to document your recent weight loss efforts etc.
Please allow 2-3 weeks for a prior authorization to be submitted to and reviewed by your insurance company. We always send office notes with the initial prior authorization submission. Therefore, if denied, we do not complete appeals as we have already provided all the information we have to your insurance company.