Benefily

Does Medicare Part D cover Wegovy?

Wegovy appears on the Medicare Part D formularies of 17 payers in the corpus. 17 require prior authorization on every covering plan, 0 on some plans, and 0 on none.

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

PayerPlans coveringRequire prior authStatus
Triple S Advantage, INC.2222Prior authorization required
Aetna (CVS Health)1010Prior authorization required
Fallon Community Health Plan88Prior authorization required
Independent Health Association, INC.33Prior authorization required
Amerihealth Caritas Vip Next, INC.22Prior authorization required
South Country Health Alliance22Prior authorization required
Vista Health Plan, INC.22Prior authorization required
Troy Health, INC.22Prior authorization required
Alameda Alliance For Health11Prior authorization required
Amerihealth Caritas Louisiana, INC.11Prior authorization required
Select Health Of South Carolina, INC.11Prior authorization required
Contra Costa County Medical Service Dba Contra Costa Health11Prior authorization required
Orange County Health Authority11Prior authorization required
San Mateo Health Commission11Prior authorization required
Amerihealth Michigan, INC.11Prior authorization required
Amerihealth Caritas Florida, INC.11Prior authorization required
Amerihealth Caritas North Carolina, INC.11Prior authorization required

“Require prior auth” counts a plan when any Wegovy product on its formulary needs authorization.

Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
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.