Health insurance will pay for Ozempic when it's prescribed for use in Type 2 diabetes as well as related heart issues and kidney issues.
However health insurance does not cover Ozempic for prediabetes or weight loss.
Although in rare cases you might find a health insurance that will cover Ozempic for weight loss, especially if the weight loss is needed medically.
Most commercial health insurance plans do cover Ozempic when the Ozempic has been prescribed by a doctor for treatment of Type 2 diabetes or to reduce risks of kidney problems or cardiovascular issues, especially in diabetic people.
For health insurance to cover Ozempic, there must be prior authorization as well as a review of your medical history and possibly the documentation of high A1c levels or previous treatment failures like from use of metformin.
Ozempic is often not covered by health insurance for it's off label use of weight loss unless the Ozempic is prescribed for medically necessary weight loss, and even then it can be hard to get health insurance to cover the cost of Ozempic.
Most health insurance often denies coverage for Ozempic for weight loss as Ozempic is not FDA approved for weight loss.
However Wegovy is an approved version of Ozempic for weight loss and is much more likely to be covered by health insurance.
Some health insurance plans may cover the cost of Ozempic for weight loss, if you have extensive documentation of obesity, failed weight loss attempts and can prove medical necessity, although it's still a struggle to get health insurance to cover Ozempic for weight loss.
Ozempic is also often a high tier drug, which leads to higher copays and even if coverage is available for Ozempic you may still have to pay deductibles or even coinsurance costs which can range from $0.00 to $1,000.00.