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From 2020 to 2025, prior authorization for #GLP1-RAs became near-universal and out-of-pocket costs rose substantially in 2025, as plans increasingly required coinsurance. https://ja.ma/4pS755h
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If you're covered by the State Health Benefit Plan (SHBP) and take a weight-loss GLP-1 medication (like Wegovy or Zepbound), a change is coming. Starting February 1, 2026, SHBP will require these
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Medicare GLP-1 Drug Coverage
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How to Manage Pharmacy Benefit Spend in a GLP-1 World
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Prior authorization and medical necessity explained : r/Zepbound
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Administrative costs of prior authorizations for glucagon-like peptide-1 agonists
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What are the criteria for insurance approval for using Glucagon-like peptide-1 (GLP-1) receptor agonists, such as liraglutide (Victoza) or semaglutide (Ozempic), for weight loss?
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