How long does a prior authorization take to get a decision?
For any name-brand GLP-1 medication, such as Wegovy or Ozempic, most insurance companies will require a prior authorization in order to cover the cost of the medication. Keep in mind that coverage isn't guaranteed, and if your insurance plan does not cover weight-loss medications, we still have great options for you such as compounded semaglutide.
If you choose a name-brand GLP-1 Medication as your preference, we will proactively call your insurance company to understand your coverage. This is prior to your provider writing a prescription, and we do this to know what is or isn't covered. Typically we see that about 20% of patients have some type of coverage. Our insurance specialists work Monday-Friday, which mirrors the hours/days of most insurance companies.
Once your first prescription is written for a medication, we will electronically submit a Prior Authorization on your behalf. The insurance company typically renders a decision in 2-5 business days, but often times we receive a response sooner.