Obesity and its related health conditions affect millions of Americans, creating significant burdens. With the emergence of advanced treatments like Wegovy, an injectable weight loss medication, many are left wondering: Will UnitedHealthcare cover Wegovy? The answer isn’t always straightforward, as insurance coverage for weight loss drugs can vary based on plan type, employer decisions, and individual medical criteria.
Understanding UnitedHealthcare (UHC) Coverage for Weight Loss Medications
Coverage for weight loss medications under UnitedHealthcare varies by plan. Some plans may cover FDA-approved medications, such as Wegovy® (semaglutide) or Zepbound® (tirzepatide), but they often require prior authorization or proof of medical necessity.
To find your UHC coverage details, log in to your UHC health plan account online. You can also call the UHC member services number on the back of your insurance card to verify your specific insurance policy coverage.
Prescription Drug List (PDL)
A Prescription Drug List (PDL) - also called a formulary - is a list of commonly used medications, organized into cost levels, called tiers. These costs are decided by your employer or health plan. Sign into your member account or call the number on your health plan ID card to see your PDL and get specific information about your pharmacy benefits.
Preventive Care Medications
As part of Health Care Reform, health plans must cover certain Preventive Care Medications at no cost to you. The health reform law (Affordable Care Act) requires most health plans to pay for birth control (contraceptives and sterilization) for women at no cost to you. Some organizations can choose not to cover birth control (contraceptives) as part of their group health plan for religious reasons.
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The below lists contain preventive medications that may be covered under your plan. If your plan has one of these lists, your insurance benefit may be applied before you meet your deductible for the listed preventive medications.
This list includes certain classes of preferred drugs offered at no out-of-pocket cost to you.
Wegovy: A Detailed Overview
Wegovy (semaglutide) is an FDA-approved prescription medication that has transformed the way clinicians approach obesity treatment. It belongs to a class of medications called GLP-1 receptor agonists, which mimic a natural hormone that helps regulate blood sugar, insulin levels, and most importantly, appetite.
Semaglutide, the active ingredient in Wegovy, is a GLP-1 agonist that regulates appetite and blood sugar. Wegovy is intended to be taken weekly alongside a balanced diet and increased physical activity.
Wegovy is an injectable prescription medication approved to treat obesity in adults and children ages 12 and older. It is also approved for adults who are overweight with at least one weight-related health condition, such as diabetes or high blood pressure. Wegovy may also be covered by insurance to reduce the risk of heart disease-related events like stroke and heart attack in people who are obese or overweight and have heart disease.
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Cost of Wegovy
Wegovy typically costs close to $1,850 for a one-month supply without insurance, but the retail cost can vary depending on the quantity prescribed and the pharmacy location. Without health insurance, the typical cash price of Wegovy is approximately $1,847 for a 30-day supply (four injector pens), although that cost varies by pharmacy and doesn’t include any discounts. Even with insurance, Wegovy’s cost and coverage vary by insurance plan-contact your insurance provider for details.
Coverage Criteria
Whether UnitedHealthcare (UHC) covers Wegovy depends largely on your individual insurance plan. Even when Wegovy is covered, prior authorization is almost always required, meaning UHC needs to verify that you meet certain medical and lifestyle criteria before approving the prescription. If these requirements are met, your healthcare provider can submit a request to UnitedHealthcare. If approved, you’ll receive a 4-month supply of Wegovy.
Insurance coverage can vary greatly from plan to plan. Coverage for Wegovy may also depend on whether you have private insurance, Medicare, or Medicaid.
If your plan does not initially cover it, are exceptions or appeals accepted?
UHC Medicare plans aren’t likely to cover Wegovy because Medicare doesn’t cover obesity medications. Although Medicare doesn’t cover Wegovy for weight loss as of March 2025, legislators are trying to change that with the Treat and Reduce Obesity Act of 2023. If you have a UHC Medicaid plan, you may have coverage for Wegovy.
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Prior Authorization
Prior authorization is an important topic to discuss with your insurance company. Insurance plans have different requirements for weight loss medications. Some may cover Wegovy with no restrictions, while others may need prior authorization.
For those looking to streamline prior authorization for Wegovy, assemble a history of your chronic weight management efforts and sharing them with your healthcare provider. This information will be invaluable for your medical team in expediting the prior authorization process.
Strategies for Managing Wegovy Costs
If your United Healthcare plan doesn’t cover Wegovy in its formulary, consider using a SingleCare coupon card to make it more affordable. A SingleCare Wegovy coupon card offers sizable savings. Depending on the pharmacy, you can save nearly $600 per month on out-of-pocket costs.
Novo Nordisk has a program called NovoCare that offers support for people using Wegovy. This program might help lower the cost of a 28-day supply, depending on your insurance. It’s a good idea to look into this offer to see how it could help you save money.
Alternative Weight Loss Options
If your UHC plan doesn’t cover Wegovy, there are other options for weight loss, such as Saxenda (liraglutide) and Adipex-P (phentermine). Some medications are approved for other conditions but also help manage weight. For example, Mounjaro is approved to treat Type 2 diabetes, but it also reduces appetite. Without a weight-related condition, you might not be eligible for insurance coverage, but your healthcare provider may be able to prescribe it off-label. You’ll most likely need prior authorization, depending on the medication prescribed.
UnitedHealthcare's Real Appeal Program
For added support, UHC offers Real Appeal, a healthy lifestyle and weight management program. Real Appeal is free through participating UHC insurance plans and provides online coaching, on-demand workouts, and science-backed health resources. Call the number on the back of your UHC membership card to see if your plan is eligible for Real Appeal benefits.
Shapely and UnitedHealthcare Partnership
Shapely is an in-network provider with UnitedHealthcare, making evidence-based weight loss care more accessible and affordable for millions of Americans. Through this partnership, eligible UnitedHealthcare PPO members can receive personalized medical care, lifestyle coaching, and expert weight loss support-all covered by their insurance plan.
As an in-network provider for UnitedHealthcare, Shapely helps patients access physician-led weight loss care, including medical consultations, lifestyle coaching with a dietitian, and weight loss prescriptions.
At Shapely, their team specializes in completing prior authorizations to help you maximize your insurance benefits. If your plan does not cover weight loss medications, they offer affordable alternatives through our compounding pharmacy partners at a fraction of the cost of brand-name options.
Shapely Membership
What’s included:
- Monthly video visits with expert weight loss provider
- Weight loss prescriptions (if appropriate)
- Support getting meds covered by insurance
- Assistance finding meds at local pharmacies
- 1:1 access to a personalized dietitian
- Unlimited support via chat and our app
Shapely memberships do not include:
- Labs (typically covered by insurance or $75)
- Medications we prescribe: Semaglutide, Tirzepatide, Wegovy®, Ozempic ®, Zepbound ®, Mounjaro ®, Contrave®
Prescriptions are at the medical provider’s discretion and may not be appropriate for everyone. Individual results may vary.
Who is eligible to join Shapely?
Currently Shapely serves adults age 18 and older in the states of California, Florida, New York, and Texas. They will soon be expanding to all 50 US states!
What does my insurance cover?
They navigate insurance on your behalf and are able to work with the vast majority of insurances to get cost-effective access to GLP-1 medications like Wegovy® and Zepbound® . For patients with commercial insurance, medication co-pays are typically $25 per month but depending on the plan may be higher. At this time, Medicare only covers these medications for patients with diabetes, cardiovascular disease (such as stroke or heart attack), and obstructive sleep apnea.
If you do not have insurance, or if insurance doesn't cover the cost of medications, they offer an accessibility program and can send your prescriptions to a compounding pharmacy. Labs are also typically covered by insurance though there may be a co-pay. For patients without insurance, they offer labs for a flat-rate of $75, requiring you to go to a Labcorp location for lab draw.
For members choosing to use insurance for their visits with Shapely, insurance covers any visits with their expert team of providers and dietitians, though you may be responsible for any cost-sharing.
Employer Considerations Regarding GLP-1 Drugs
With the steady increase in obesity rates, GLP-1 drugs seem like a convenient solution. With 2 in 5 adults and 1 in 5 children considered obese, the numbers speak for themselves: Obesity is prevalent in America.
Chief Data & Analytics Officer Craig Kurtzweil and Chief Medical Officer Dr. Rhonda Randall have a word of caution for employers: Don’t rush to make decisions about covering these drugs. GLP-1s shouldn’t be looked at as a single-point solution. Individuals who take these drugs are more successful at achieving and maintaining their weight loss goals when they are part of a comprehensive lifestyle management program.
The average cost of GLP-1 drugs can exceed $1,000 per patient per month. The combination of high drug costs and a large patient population may have profound implications for employers’ overall health care spend. As a result, employers may find it difficult to decide whether they should cover these drugs or exclude them.
Weight-loss programs that take a whole-person approach - including pharmaceutical, clinical and behavioral support - can be more effective at treating all aspects of a person’s health. While employers may be feeling pressure from employees to cover GLP-1s, it’s imperative for them to consider the costs and adherence challenges associated with these drugs.
Real Appeal Rx®
Real Appeal Rx® provides whole-person support addressing medication adherence, nutrition, physical activity and the emotional and social experiences of the GLP-1 weight loss medication journey.
- Coaching: Live 1:1 and/or group coaching, providing members with personalized support and expert guidance.
- WeightWatchers for Business: Which offers flexible, self-directed methods for achieving weight loss goals and provides access to online communities for support.
- Content library: Robust library of recipes, meal plans and tools for meal selection.
The Future of Weight Loss Medications
GLP-1 medications for weight loss are currently available only as injections, but pill forms are in development. These new forms could improve accessibility and enhance the user experience.