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Ozempic (semaglutide) for type 2 diabetes. Covered under Aetna.
Aetna (CVS Health subsidiary) covers GLP-1s through standard commercial formularies and Aetna Medicare Advantage. Weight-loss indication generally requires BMI documentation.
T2D diagnosis (ICD-10 E11.x). Metformin trial documented unless contraindicated.
Manufacturer copay card brings commercial copay to $25/mo for eligible patients.
Ozempic is the most predictable PA in the category for T2D patients. Off-label weight-loss prescriptions are denied.
Editorial summary, not legal or medical advice. Insurance formularies change quarterly. Verify with your specific plan member services before relying on any single source. Copay ranges reflect typical commercial plans; your plan may differ.