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Zepbound (tirzepatide) for chronic weight management, OSA with obesity. Covered with PA under Aetna.
Aetna (CVS Health subsidiary) covers GLP-1s through standard commercial formularies and Aetna Medicare Advantage. Weight-loss indication generally requires BMI documentation.
BMI ≥ 30 or BMI ≥ 27 with comorbidity. OSA pathway: sleep study with AHI ≥ 15 + BMI ≥ 30.
LillyDirect vials: $349-499/mo cash-pay.
OSA pathway typically has higher approval rate than weight-loss-only PA. Get a sleep study if you snore.
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.