Insurance coverage checklist

Questions for your insurance plan

Coverage

• Is the medication covered for weight management (not only for diabetes)? Which ones are on the formulary?
• Is medical weight management (visits, counseling) a covered benefit?
• Is bariatric surgery covered under my plan? Can you send the written policy?

Requirements

• Is prior authorization needed? What documents (BMI, conditions, previous programs)?
• Is a supervised lifestyle program required first? For how long?
• Do I need a referral from my primary care doctor?

Costs

• What is my copay or coinsurance for the medication at a network pharmacy?
• Is the clinic in network? What do I pay per visit?
• How much of my deductible is left?

Appeals

• If coverage is denied, how do I appeal and how long does it take?

This tool does not calculate coverage — only your plan can confirm it.