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Private insurers may follow similar rules, but each one comes with its own twists

however, patients who have incomplete recovery will have obvious cosmetic sequelae and will often be dissatisfied with their outcome

Aetnas typical PA requirements for Wegovy and Zepbound include: Documented BMI of 30 or higher, or BMI of 27 or higher with at least one weight-related comorbidity (type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea) Evidence of participation in a structured weight management program (diet, exercise, behavioral counseling) for a minimum period often 3 to 6 months Documentation that other weight loss interventions have been attempted Prescriber must be a physician, NP, or PA with appropriate prescribing authority Prior authorization is not a denial it is a documentation requirement