WebPrior Authorization is recommended for prescription benefit coverage of Saxenda and Wegovy. Of note, this policy targets Saxenda and Wegovy; other glucagon-like peptide-1 … WebSaxenda ® (liraglutide) injection 3 mg is an injectable prescription medicine used for adults with excess weight (BMI ≥27) who also have weight-related medical problems or obesity (BMI ≥30), and children aged 12-17 years with a body weight above 132 pounds (60 kg) and obesity to help them lose weight and keep the weight off. Saxenda ® should be used with …
Explore Your Prescription Coverage Options - Saxenda
WebFeb 16, 2024 · Prior Authorization. For prescriptions, please visit our Pharmacy page. For mental health/substance abuse services for Generations Advantage Plan members call BHCP at 1-800-708-4532. For mental health/substance abuse services for US Family Health Plan members call BHCP at 1-888-812-7335. Call eviCore at 1-888-693-3211 OR use … Webqualify for Saxenda. The expanded indication makes Saxenda the second drug FDA -approved for weight loss use in pediatric patients. Xenical (orlistat) capsule is also indicated for use in patients aged 12 years and older. Saxenda is covered on the OptumRx Select and Premium F ormularies at Tier 3 with Prior Authorization. hugo boss 6032178
Diabetes Medications for Management of Obesity
WebIf you must take a medication that requires prior authorization right away, there are two options . that may work for you. First, ask your doctor if a sample is available. Or, check with your pharmacy to . request a short-term supply of 5 days or less. Keep in mind, you will be responsible for the full cost . at that time. WebFormulary Exception/Prior Authorization Request Form Patient Information Prescriber Information Patient Name: DOB: Prescriber Name: NPI# Patient ID#: Address: Address: … WebApr 13, 2024 · Providers can use the PA (prior authorization) features on the ForwardHealth Portal to do the following: Submit PA requests and amendments for all services that require PA. View or maintain a PA collaboration (for certain services only). Save a partially completed PA request and return at a later time to finish completing it. hugo boss 5 oz