Insurance
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How insurance works with the Body Program
We know insurance can be a headache, which is why we have a dedicated concierge who will work to find you insurance coverage for medication. But how does it all work and how long will it take? Let’s get into it!
We help you lose weight by pairing revolutionary medication with coaching, care, and healthy lifestyle changes to make it last.
The cost of medication is not included in the monthly program fee.
When you get approved, our partner goes to work
You’re approved for treatment, now what?
If a Ro-affiliated provider writes you a prescription, our concierge will coordinate with your insurance to help get medication costs covered. They'll verify your benefits and handle any paperwork (including submitting for prior authorization, if needed). It typically takes between 1-3 weeks. When coverage is determined, our concierge will send your prescription to your pharmacy to be filled.
Here’s how our insurance concierge gets you covered and finds medication
Liaise with your insurance
They'll take care of communicating with your insurance company, and even handle the paperwork.
Find solutions to get you started
If your provider writes you another prescription, our concierge will work with your insurer to try and get it covered. If all attempts fail, we'll walk you through cash payment options.
Explore medication options
If your insurance denies one medication, your provider may recommend another option for you.
Send your prescription to your pharmacy
If your pharmacy doesn't have medication due to national shortages, you'll join their waitlist, and our concierge will contact your pharmacy periodically to check on your prescription.
How Ro helps you lose weight
We’re pushing every day to get medication to our patients faster. Here’s a quick rundown: It takes 4-6 weeks to start if you’re not using insurance. If your provider orders a lab test, it may extend the timeline depending on how quickly you complete the labs. If you’d like to use your insurance, it can take an additional 2-3 weeks to determine coverage. We’ll handle the paperwork and work hard to get that coverage for you.
Getting started
Answer health questions and complete your online visit
Share your health history and weight loss goals with us online to get started. A Ro-affiliated provider will review your answers and get back to you within a few days. Depending on your health review, a provider may order a metabolic lab test before moving forward with treatment.
Provider writes an Rx (if appropriate)
After reviewing your results, your provider will determine if you’re eligible for medication. If you are, they’ll tailor a program with prescription treatment best suited to your unique biology.
Try to get insurance coverage
If you'd like to try to use insurance, our concierge partner connects with your insurance company to help get the cost of medication covered. If coverage is denied, we'll help you understand your options, including paying cash.
Ongoing monthly care
Access medication
If you're prescribed compounded semaglutide, our partner pharmacy will ship your medication in 1-4 days. If you're prescribed a branded GLP-1 medication, you'll get your prescription from your preferred pharmacy. Medication costs are not included.
Ongoing care and support
You’ll have everything you need during treatment, including on-demand provider access via video or messaging, medication management, and ongoing refill support.
Insurance 101
Do you accept insurance?
Ro does not accept insurance for the Body Program, which is cash pay only. Insurance concierge services for the cost of medications are provided through the Body Program. Our partner will work directly with your insurance provider to help with the process of determining coverage for your GLP-1 medication, which is paid for separately from the Body Program. At this time, those with any form of government healthcare coverage (including programs such as Medicare, Medicare Supplement Plans, Medicaid or TRICARE), whether primary or secondary, are not eligible for the Body Program. These plans typically do not cover the type of medication the Body Program may prescribe. Unfortunately, this means that those on Medicare or eligible for Medicare cannot join the Body Program.
Federal employees who receive their health insurance through the Federal Employee Health Benefits Program (FEHB) may participate in the Body Program.
What if my insurance doesn’t cover the medication?
If for some reason your insurance will not cover the cost of your medication, you’ll have the option to either pay for the medication out of pocket (typically $900–$1,600/month, depending on the medication) or cancel your Body Program membership. Given the cost of initial diagnostics, ongoing provider support, and insurance assistance, we are unable to offer refunds for previously incurred monthly membership fees.
How is Ro responding to medication shortages?
Ro and Ro-affiliated providers are taking additional steps to support new and existing patients on their weight loss journeys.
If you’re prescribed Wegovy or Saxenda:
Your pharmacy will add you to their waitlist for medication if they don’t have supply.
Your provider may also make adjustments to your treatment plan if they determine it’s clinically appropriate. These adjustments may include prescribing alternate GLP-1 medications (if appropriate), working with you to create a personalized treatment plan, or recommending adjustments to diet, lifestyle, and current fitness activities.
If you’re just getting started:
The first steps in the Body Program are unaffected by the supply shortages — including taking a metabolic lab test and connecting with a provider to review their health history. If a provider ultimately determines Wegovy or Saxenda is a good fit, the sooner you join the program, the sooner our team can send your prescription to get filled at your preferred pharmacy.
Remember that we’re also expanding our medication offerings to include Zepbound and compounded semaglutide. Contact your provider in your Ro account chat if you’re interested in either medication.
How does getting insurance coverage for medication work?
The first step is to study the fine print of your current plan. Our insurance concierge reviews it to see if your GLP-1 costs can be covered without prior authorization (specific approval from your insurance company to cover your medication). This is the benefits verification stage, and at this point, nothing has been submitted to your insurance.
If the fine print doesn’t show automatic coverage for your GLP-1 medication, the next step is to submit a prior authorization request to your insurance company. Prior authorization is a decision by your health insurer that your medication is medically necessary. This allows your insurer to evaluate if the treatment is covered as a plan benefit (and if they can assist with payment).
It can be a complicated process that varies by insurer. That’s why we work with our insurance concierge to do the hard work of gathering your information, submitting your prior authorization request, and going back and forth with your insurance company.
How long does the review take?
It can take about 2–9 days, but once your insurer reviews the request, there are a few possible outcomes:
Approved with co-pay
Approved with no co-pay
Denied
What happens after I get approved?
Due to several factors, it’s difficult to say precisely when you’ll get medications after prior authorization is approved. One we learn that you’re approved, we’ll send your prescription to your preferred pharmacy and they’ll confirm that there’s medication in stock. If your pharmacy doesn’t have supply, they’ll add you to a waitlist for when medication becomes available.
What happens if I get denied?
Our partner will continue to explore all possible options. At this point, your provider will determine whether another GLP-1 medication is clinically appropriate for you. If so, your provider will write a new prescription and the prior authorization process begins again. If all attempts for coverage have been denied and there are no other options, we’ll help you understand cash pay options to see if continued treatment is right for you.
What is prior authorization?
Prior authorization is a decision by your health insurer or plan that a health care service, treatment plan, or prescription drug is medically necessary. In our case, prior authorizations allow your insurance company to evaluate if a GLP-1 medication is covered.
The process for obtaining prior authorization varies by insurer, but involves submission of administrative and clinical information by the treating practitioner. Behind the scenes, our insurance concierge partner does the hard work of gathering your information, submitting your prior authorization request, and going back and forth with your insurance company.
How long does prior authorization take?
Our top priority is getting patients insurance coverage, so our partners and affiliated providers do their best to maximize the likelihood of approval.
The prior authorization process usually takes 2-3 weeks but it can be longer if the initial coverage request is denied.
Our partner submits to your insurance company right away. But the process can take longer if more information about your insurance or pharmacy benefits is needed or if there's a secondary plan you want to try.
If your insurance company approves your GLP-1 treatment after that first step, great! If they don't, our partner will continue to work on your behalf. Our partner will see if your insurer requires additional information or will cover a different GLP-1 medication if prescribed.
How much does it cost to pay cash for GLP-1 medication?
It depends on which medication is prescribed:
Compounded semaglutide costs $299 per month of treatment.
Compounded tirzepatide costs $399 per month of treatment.
Branded GLP-1s (like Ozempic, Zepbound, Wegovy, and Saxenda) typically cost about $900–$1,500 per month of treatment without insurance.
These costs do not include the monthly Body membership fee of $145/mo. There are savings cards that branded GLP-1 drug manufacturers may provide to help reduce costs. Each pharmacy may apply these savings cards differently, so your final costs can vary depending on where the medication is ultimately filled.
If my prior authorization is approved, when will I get my medication?
Due to several factors, it's difficult to say precisely when you'll get medications after prior authorization is approved. Our partner works with a nationwide network of pharmacies to find the fastest way of getting you started with your medication.
What if I know of a pharmacy that has available supply?
Great! Let us know by messaging the pharmacy information to your healthcare team via your Ro account chat, and we’ll look into whether that pharmacy can fill your prescription.
What happens after my insurance approves coverage for the medication?
If you’re prescribed a branded GLP-1 (like Ozempic, Zepbound, Wegovy, or Saxenda) and your coverage is approved, we’ll send your prescription to your preferred pharmacy and they’ll confirm that there’s medication in stock. If your pharmacy doesn’t have supply, they’ll add you to a waitlist for when medication becomes available.
Due to medication shortages, patients prescribed Wegovy and Saxenda are often waiting more than a month for their medication to be filled.
To help you get medication faster, we’ve expanded our medication offerings to include:
Zepbound: A new FDA-approved medication for weight loss. The active ingredient is tirzepatide, which is the same as Mounjaro. If prescribed, you’ll get it at your preferred pharmacy.
Compounded semaglutide: The active ingredient is semaglutide, which is the same as Ozempic and Wegovy. If prescribed, it will be shipped to you within 5-7 days.
If you’re interested in either of these options, send your provider a message in your Ro account chat. They’ll walk you through the next steps to see if another medication is right for you.
Can you give me the prescription to take to a pharmacy myself?
Unfortunately, no. You can access and download a copy of your prescription in your Ro account, but it’s for reference only and cannot be used to fill or transfer your prescription.
Can I have my prescription sent to my local pharmacy?
Yes, but they may not be able to fill it. You can opt to send your prescription straight to a pharmacy of your choice during your online visit. You can also check with any pharmacy of your choice and let us know if they have your GLP-1 medication in stock. We'll work with our partners to see if it can be filled at that location.
Can Ro send my prescription to a compounding pharmacy?
Ro can only offer compounded GLP-1s that are filled at one of our partner compounding pharmacies, as they have been vetted for quality. If you're interested in switching to the compounded medication offered by Ro, you can reach out to your provider in your account chat.
Which pharmacy is filling my prescription?
If you’re prescribed a branded GLP-1 (like Ozempic, Zepbound, Wegovy, or Saxenda), we’ll send your prescription to your preferred pharmacy. Once sent, we’ll reach out with the pharmacy’s details (name and phone number) in your Ro account chat.
If you’re prescribed a compounded GLP-1, we’ll send your prescription to our partner compounding pharmacy to be filled. You’ll get it shipped to you within 1-4 days.
When will I get my medication?
If you’re prescribed a branded GLP-1 (like Ozempic, Zepbound, Wegovy, or Saxenda), we’ll send your prescription to your preferred pharmacy and they’ll confirm that there’s medication in stock. If your pharmacy doesn’t have supply, they’ll add you to a waitlist for when medication becomes available.
Due to nationwide medication shortages, patients prescribed Wegovy and Zepbound are often having trouble filling their prescriptions.
To help you get medication faster, we've expanded our medication offerings in some states to include compounded semaglutide, which contains the same active ingredient as Ozempic and Wegovy, and compounded tirzepatide, which contains the same active ingredient as Zepbound. If prescribed, the medication will be shipped to you within 1-4 days.
If you’re interested in compounded GLP-1s, send your provider a message in your Ro account chat.
How much will it cost?
If you’re using insurance to help cover medication costs, know that copays can range substantially and depend on your insurance coverage and fulfilling pharmacy. If your insurance company shares estimated copay information with our team, we'll pass it along to you.
If you decide to pay cash for your medication, costs are:
Compounded GLP-1 offered through Ro: $299/mo of treatment
Compounded tirzepatide offered through Ro: $399/mo of treatment
Branded GLP-1 (like Ozempic, Zepbound, Wegovy, and Saxenda): ~$900–$1,500/mo of treatment
This does not include the monthly cost of the Body membership fee. To learn more about estimating medication costs, go to this section of your Body Program Guide.
What are savings cards and how can I use them?
Some drug manufacturers offer savings cards that can help offset the price of the medication. Review the information in the link carefully to see if you're eligible for savings.
For Ozempic, you cannot use the savings card from Novo Nordisk when you pay out of pocket — only for insurance-approved prescriptions. Eligible patients can save up to $150/month on Ozempic when using the savings card.
For Zepbound, Eli Lilly is offering a savings card program that can help lower the cost for eligible patients with insurance through the end of 2024. The potential savings amount will depend on whether your plan covers Zepbound or not.
For Wegovy, Novo Nordisk is offering a savings card program that can lower the cost to $650 per month when you're paying with cash.
Savings cards are not guaranteed and may vary by pharmacy. When coordinating payment for your medication, let the pharmacist know that you'll be using a savings card. Pharmacists usually require that you provide certain information detailed on the card.
Savings cards only apply for branded medications when using commercial insurance. Because compounded GLP-1s through Ro are cash-pay only, savings cards are not applicable.
If one GLP-1 medication is not covered by my insurance, can I resubmit to my insurance for another medication?
Yes, we do this for you! Ro-affiliated providers survey the clinically appropriate medication options between Wegovy, Ozempic, and Saxenda. If your insurer denies your request for coverage for one of those medications, your provider will see if you’re eligible for the other (if clinically appropriate). Our insurance concierge will resubmit your prior authorization request if you’re eligible.
Can I pay cash for GLP-1 medications?
Cash pay is always an option if:
GLP-1 medication is not a covered benefit under your plan.
Prior authorization is denied, and there are no other options for coverage.
You're uninsured or do not want to go through insurance (and also do not have a government health plan).
You want to get started as soon as possible and are interested in compounded GLP-1s (which cost $299 or $399 per month depending on the medication and are not covered by insurance).
You’re willing to pay about $900–$1,500 a month for branded GLP-1s like Ozempic, Zepbound, Wegovy, and Saxenda.
Paying cash for the medication does not change your Body membership experience, including pharmacy support, ongoing care, and coaching through the Ro platform. The separate membership cost is $145/mo.
Please note that those with government insurance plans, whether it’s a primary or secondary plan, are ineligible for weight loss treatment through Ro. Regulatory restrictions around these plans prevent covered patients from accessing treatment through Ro even if they are willing to pay out of pocket for medication.
How much does metabolic testing cost?
If your provider orders a metabolic health test, testing at any Quest location is included in the cost of the Body Program. Or you can purchase an at-home blood collection kit through Ro for $75.
If you live in a state where Quest is not available, we’ll automatically send you an at-home collection kit for no charge.