Does Cigna cover Wegovy for weight loss?

Wegovy (semaglutide) has a high out-of-pocket price, costing around $1,350 per month without insurance. So, if you’ve been prescribed Wegovy for weight loss, you’re probably wondering (er, hoping) if your insurance covers it. Insurance plans can differ in their coverage of weight loss medications, and Cigna is no exception.

So, does Cigna cover Wegovy? It depends. Keep reading to learn how to find out whether Cigna will cover Wegovy for weight loss, how the prior authorization process works, and what to do if Cigna won’t cover the medication.

Again, it depends. Weight loss medications, including weight loss injections like Wegovy, are specifically excluded under many Cigna insurance plans, including employer-sponsored plans. However, some Cigna healthcare plans do cover Wegovy for weight loss—and when they do, prior authorization is typically required. 

Cigna’s prescription drug coverage for weight loss drugs can depend on the plan and the drug. Some health benefit plans cover weight loss injections like Wegovy, Saxenda (liraglutide), and Zepbound (tirzepatide). These medications are also known as glucagon-like peptide-1 agonists, or GLP-1s for short. Some Cigna plans cover weight loss pills like Adipex-P (phentermine), Contrave (naltrexone/bupropion), Qsymia (phentermine/topiramate), and Xenical (orlistat).

Yes, Cigna typically requires prior authorization for Wegovy. This means you’ll likely need to work with your healthcare provider to submit paperwork to Cigna demonstrating that Wegovy is medically necessary before the insurance company will cover the medication. 

In an effort to (hopefully) achieve coverage, your healthcare provider will need to document that you meet all of the following requirements for prior authorization:

1. You are at least 18 years old

2. You have been making lifestyle changes, including a reduced-calorie diet, to lose weight for at least 3 months.

3. You either have a body mass index (BMI) of 30 or above, or you have a BMI of 27 or above and a weight-related health condition (e.g. high blood pressure, type 2 diabetes, high cholesterol, obstructive sleep apnea, heart disease, knee osteoarthritis, asthma, chronic obstructive pulmonary disease, non-alcoholic fatty liver disease, polycystic ovarian syndrome, or coronary artery disease).

4. You plan to use Wegovy in addition with lifestyle changes, such as diet and exercise.

If you meet these requirements, Cigna may approve your prior authorization for Wegovy for up to seven months. 

To continue getting prescription coverage for Wegovy, you’ll need to resubmit for prior authorization again. You’ll need to show that you still meet all four of the requirements above, plus one additional requirement: that you’ve lost at least 5% of your body weight since starting treatment with Wegovy. If you meet these requirements, Cigna may approve your prior authorization for Wegovy for up to 12 months.

In addition, Cigna may deny a prior authorization request for Wegovy if you’re already taking another weight loss medication. The company’s requirements state that Wegovy shouldn’t be used at the same time as other injections or pills for weight loss. 

Note: These are the prior authorization requirements for adults taking Wegovy for weight loss. The prior authorization requirements differ for children (ages 12+) taking Wegovy for weight loss, as well as adults taking Wegovy to reduce their cardiovascular risk. 

The best way to check if your Cigna plan covers Wegovy is to contact your insurance directly. You can call the number on the back of your insurance card, or login to the Member Portal on the Cigna website. There, you should be able to view your plan documents and drug formulary. The drug formulary includes a full list of the drugs covered by your Cigna plan, and their associated tier or coverage requirements. The drug tier gives you an idea of the copay you’ll owe, while the requirements will outline whether prior authorization is required (look for the abbreviation “PA” in this column). 

If Cigna won’t cover Wegovy, you’ll have to pay out-of-pocket for your prescription. That means you’ll need to pay close to the list price for Wegovy—$1,349.02 for a 28-day supply—less any pharmacy discounts or savings cards you have (more on these in the next section). 

Another option is to ask your healthcare provider if another weight loss medication could be a good fit for you. Depending on the medication, some may be covered by your plan. Even if they’re not covered, they could still be more affordable than Wegovy. For example, Zepbound (tirzepatide) is a weight loss injection made by Eli Lilly. It costs $1,059.87 for a 28-day supply without insurance. And some Cigna plans do cover oral appetite suppressants, such as Qsymia, Contrave, or Xenical. 

If your Cigna plan doesn’t cover Wegovy, there are still ways to save on Wegovy. Novo Nordisk, the maker of Wegovy, has a Wegovy Savings Offer that lowers the price of Wegovy to $650 for those with insurance, but without coverage for Wegovy (certain restrictions apply).

You can also price-shop around different pharmacies in your area to find the lowest price for Wegovy. Some websites, including GoodRx, SingleCare, and Optum Perks, offer pharmacy-specific discount cards that can bring the price down further.

Compounded semaglutide is another affordable alternative to Wegovy. Compounded medications contain the same active ingredient as the brand name drug (in this case, semaglutide). Though they are not approved by the FDA, compounded medications are allowed under federal law to meet the needs of an individual patient or to boost supply during a drug shortage. Companies such as Ro offer compounded semaglutide for those who qualify. The cost starts at $249 for the first month, and is $299 monthly going forward.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

October 17, 2024

Written by

Amelia Willson

Fact checked by

Patricia Weiser, PharmD

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About the medical reviewer

Patricia Weiser, PharmD

Patricia Weiser, PharmD, is a licensed pharmacist, health content writer, and medical reviewer with more than a decade of clinical experience in community and hospital pharmacy.