Does Medicare Part D cover Wegovy?
Wegovy appears on the Medicare Part D formularies of 17 payers in the corpus, across 60 plans. 17 payers require prior authorization on every covering plan, 0 on some plans, and 0 on none.
Beyond prior authorization: 0 covering plans require step therapy (another drug tried first) and 60 apply a quantity limit, on at least one Wegovy product.
Prior authorization is set per plan, not per payer. Pick a payer below for its full plan-by-plan breakdown, effective 2026-06-30.
Coverage by payer
| Payer | Plans covering | Require prior auth | Step therapy | Quantity limit | Status |
|---|---|---|---|---|---|
| Triple S Advantage, INC. | 22 | 22 | 0 | 22 | Prior authorization required |
| Aetna (CVS Health) | 10 | 10 | 0 | 10 | Prior authorization required |
| Fallon Community Health Plan | 8 | 8 | 0 | 8 | Prior authorization required |
| Independent Health Association, INC. | 3 | 3 | 0 | 3 | Prior authorization required |
| Amerihealth Caritas Vip Next, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| South Country Health Alliance | 2 | 2 | 0 | 2 | Prior authorization required |
| Vista Health Plan, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Troy Health, INC. | 2 | 2 | 0 | 2 | Prior authorization required |
| Alameda Alliance For Health | 1 | 1 | 0 | 1 | Prior authorization required |
| Amerihealth Caritas Louisiana, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Select Health Of South Carolina, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Contra Costa County Medical Service Dba Contra Costa Health | 1 | 1 | 0 | 1 | Prior authorization required |
| Orange County Health Authority | 1 | 1 | 0 | 1 | Prior authorization required |
| San Mateo Health Commission | 1 | 1 | 0 | 1 | Prior authorization required |
| Amerihealth Michigan, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Amerihealth Caritas Florida, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
| Amerihealth Caritas North Carolina, INC. | 1 | 1 | 0 | 1 | Prior authorization required |
“Require prior auth”, “step therapy” and “quantity limit” each count a plan when any Wegovy product on its formulary carries that condition.
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.
Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.