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What the rider covers: FDA-approved obesity medications including Wegovy, Saxenda, and Contrave (naltrexone/bupropion) Bariatric surgery (gastric bypass, sleeve gastrectomy, adjustable gastric banding) with prior authorization Nutritional counseling (up to 26 visits per year with a registered dietitian) Behavioral therapy for obesity (up to 12 sessions per year) What the rider does NOT cover: Compounded semaglutide or tirzepatide Off-label use of diabetes medications for weight loss (Ozempic, Mounjaro) Over-the-counter weight-loss supplements or meal replacements Cosmetic procedures following weight loss (skin removal surgery) The cost structure: employers pay an additional $52-$78 PMPM for the rider, depending on group size and geographic region
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Pack Size:1 Bottle
This slows payment cycles and increases the workload for appeals