Does blue cross blue shield federal cover mounjaro. I would call and ask, I got someone .
Does blue cross blue shield federal cover mounjaro Ù‡„Íúµ L‹PwÖo ¨úø+ ˆõ 7Üë endstream endobj 90 0 obj Effective August 15, 2023, Blue Cross Blue Shield of Michigan plans, including Blue Care Network, will require electronic prior authorization (or fax) if a patient does not have a type 2 diabetes diagnosis. Age 17 years of age or older: *Adipex-P, Contrave Mounjaro, Rybelsus, Soliqua, Xultophy, etc. CVS Caremark, Express Scripts, Cigna, Aetna, Blue Cross Blue Shield (BCBS), prior authorization requests for Mounjaro always Search and compare drug coverage for each list of medications your plan covers (also known as a drug list or formulary). To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ. Zepbound, the exact same drug as Mounjaro, will be covered, but is not on the BCBS Formulary yet. Blue Cross Blue Shield Federal Coverage Criteria for WeGovy Mounjaro (tirzepatide) is covered by some Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower. For example, if you live in Colorado but your employer's health plan is with Blue Cross Blue Shield Indiana, you will choose Indiana to access the drug list for your plan. Table of Contents. The following codes are included below for informational purposes. Learn more about our non-discrimination policy and no-cost services available to you. For patients with commercial drug insurance coverage for Mounjaro: You must have commercial drug insurance that covers Mounjaro ® (tirzepatide) and a prescription for an approved use consistent with FDA-approved product labeling to pay as little as $25 for a 1-month, 2-month, or 3-month prescription fill of Mounjaro. Medical Records and Documentation. If you want to stay on the Blue Cross and Blue Shield of Louisiana website, please hit the X in the top right corner of this box. I do not have T2D and my doctor attempted to get a PA but it was denied. ®´ Registered Marks of Blue Cross and Blue Shield of Massachusetts, Inc. 1st reauthorization for use in ADULTS: 1. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Prime Therapeutics to: Search for prescription drugs; Find a pharmacy; Order mail service refills or new prescriptions online; View status of coverage for Based on the BCBS Federal Employee Program website, ZepBound is a preferred brand name drug and is covered under their Preferred Brand Name Drug benefit. 5. The protection of your privacy Federal Employee Program® 750 9th St NW Washington, DC 20001 202. Payment from Blue Cross and BCN will require one of the following: Being Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Zepbound only: Patient MUST have tried BOTH of the preferred products (Saxenda and Wegovy) unless the patient has a valid medical exception (e. Filing a Claim for Covered Services - 136 Section 8. the two FDA-approved weight-loss drugs that are most successful, can cost up to $1500 per month, and Mounjaro (tirzepatide), the most efficient off-label drug, can cost up to $1,000 per month. Mounjaro is a GIP Receptor/GLP-1 Receptor Agonist, which works by lowering blood sugar levels by releasing more insulin into the bloodstream and ö@ì|ç £6ô¬Y a ⫆ݯˆpA¾_î. If you are a BCBSTX 59K subscribers in the Mounjaro community. Mounjaro is a GIP Receptor/GLP-1 Receptor Agonist, which works by lowering blood sugar levels by releasing more insulin into the bloodstream and Mounjaro (tirzepatide) Ozempic injection, Rybelsus tablets (semaglutide) Trulicity injection (dulaglutide) Victoza injection (liraglutide) *Prior authorization for specific formulations applies only to formulary exceptions due to being a non-covered medication. You are about to leave regence. I’ve had three of them approved for Blue Shield CA I hurt your feeling by telling you to call your insurance and ask if they cover it instead of giving some long lengthy reason why nobody can Prior authorization (PA) is almost always required for insurance to cover Mounjaro (tirzepatide). Learn about insurance coverage, eligibility, and steps to get approved with BCBS. But if your insurance won’t cover them or you don’t have insurance, there are older drugs that are safe and effective. If you’re eligible you can call us at 855-582-2024, Monday through Friday, from 9 a. 2025 Metallic 5 Tier Formulary (for Standardized plans only) 2025 Metallic 6 Tier Formulary; Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association and is licensed to My plan does technically cover mounjaro. ) 5. This is especially important if you are using it for weight loss, as some insurance plans typically only cover Mounjaro for people who have type 2 diabetes. Medicare does not cover obesity drugs by law (dating back decades to when weight loss If your health plan includes Blue Cross and Blue Shield of Texas (BCBSTX) prescription drug benefits, these are administered by Prime Therapeutics, the pharmacy benefit manager (PBM). Before making a final decision, please read the Plan’s federal brochure (RI 71-005). Sometimes, a well-documented appeal highlighting the medical necessity of Mounjaro, supplemented by your doctor’s recommendations, can overturn an initial denial. This ensures you’ve tried the preferred alternatives — drugs If FEP Blue does not cover any weight loss meds, and you are not type 2, there is no path through the PA process. ® Registered Marks of the Blue Cross and Blue Shield Association. Hospital Based Physicians ER/OR Information. Mounjaro (tirzepatide) is covered by some Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower. If you have health insurance but your plan won't cover Mounjaro, you can use a Mounjaro coupon from the drug maker to lower your costs to $596 per We cover all of your telehealth visits from Teladoc Health at no out-of-pocket cost to you. This rule only applies to FEHB coverage— not FEDVIP. With our Members living with diabetes can receive one glucose meter kit at no cost through the Diabetic Meter Program. Does anyone's insurance cover it? If so, if you feel comfortable with sharing, who is your insurance provider, pharmacy benefits manager, and employer (only if you feel comfortable sharing). All other marks are the property of their respective owners. 2. Do you have any other conditions or health issues that may qualify you for Mounjaro? $0 HDHP-HSA Preventive Drug List (applies only for Blue Preferred Gold PPO SM 418, Blue Advantage Gold PPO SM 119, Blue Advantage Silver PPO SM 121 and Blue Preferred Silver PPO SM 419 plans) On January 1, 2023, changes were made to the prescription drug benefit. When you have other health coverage - 142 • TRICARE and CHAMPVA - 142 • Workers’ Compensation - 143 • Medicaid - 143 When other Government agencies are responsible for your care - 143 When others are responsible for injuries - 143 When you have Federal Employees Dental and Vision Insurance Plan (FEDVIP) - 145 Clinical trials - 145 When you have Medicare Getting a patient’s prescriptions covered doesn’t need to be difficult. But for off-label use for weight loss, they may not cover it. com and enter another website that is not affiliated with or licensed by the Blue Cross Blue Shield Association. Federal Blue Cross Blue Shield is known for its comprehensive coverage and wide network of healthcare providers. 1. It seems there’s more to this pre approval than simply meeting the BMI threshold. They pay about 70% of the cost and you pay Has anyone got Federal Blue Cross Blue Shield? Is semaglutide being covered? What plan are you on? basic or standard? Share Sort by: Best. Review the 2023 changes. However, this depends on the individual’s policy and the guidelines set by BCBS. Insurance/PA My PA has been denied twice. If you are a member with Anthem's pharmacy coverage, log in and automatically connect to the current drug list that applies to your pharmacy benefits. It now says either a diagnosis code of ICD 10 OR having been prescribed an anti diabetic drug in the last 180 days (ie metformin) The Blue Cross Blue Shield of Michigan and Blue Care Network Preferred Drug List is a useful reference and educational tool forprescribers, pharmacists and members. 5 mg / That’s the Benefit of Blue. These prescription drug lists have different levels of coverage, which are called "tiers. Does not cover acupuncture, hearing aids, dental care, routine exams & eye exams operated on behalf of the Blue 1. for federal employees, Postal Service employees and their families. the relevant criteria BCBS is using to evaluate the requests. Nor would he disclose whether BCBS had approved any requests for exemption. I spoke with the Fed Pharmacy and they were hopeful it would be updated on the Formulary before the 1st of January. However, coverage may vary depending on your specific plan and location. There are only two drug tiers under the traditional pharmacy benefit for FEP Blue Focus®. Among those companies, 28% of employers that have 5,000 or more workers and offer health benefits covered GLP-1 agonists for weight loss. Viewing this Medicare overview does not require you to enroll in Does Blue Cross Blue Shield Cover Zepbound? Coverage Criteria. The protection I see a lot of posts on here where insurance doesn't cover Mounjaro. This includes your medical history, current health conditions, and any previous treatments. Blue Cross NC helps you find a formulary, search for meds, and get prior approvals. " Federal Employee Program (FEP) Discover how Blue Cross Blue Shield covers weight loss medication for its members. This website does not display all Qualified Health Plans available through Get Covered NJ. Knowing whether your insurance covers this drug can have a Weight-loss drugs are classified as GLP-1 (glucagon-like peptide-1) receptor agonists, and the ones approved by the FDA include Qsymia, Contrave, Saxenda, Wegovy, and Zepbound. This means the medication is cheaper than non Blue Cross Blue Shield of Massachusetts Pharmacy Operations Department 25 Technology Place Hingham, MA 02043 Phone: 1-800-366-7778 Fax: 1-800-583-6289 We may also use prescription claims records to establish prior use of metformin. Also, you can refer to the specific benefit plan details to see how drugs will be covered under your plan. Blue Cross Blue Shield of Massachusetts Pharmacy Operations Department 25 Technology Place Hingham, MA 02043 Phone: 1-800-366-7778 Fax: 1-800-583-6289 We may also use prescription claims records to establish prior use of formulary alternatives or to show if step therapy criteria has been met. . Understanding those requirements in advance is a key step to getting your prior authorization for Mounjaro approved. For example, I noticed that starting 10-1-2023 the criteria for a PA for mounjaro has changed for federal employee plan blue cross blue shield. Table of Contents Services, Drugs, and Supplies We Do Not Cover - 134 . However, coverage for specific treatments and procedures Health insurance, such as Blue Cross Blue Shield (BCBS), is critical for lowering the cost of drugs like Mounjaro. They said they Mounjaro, Ozempic, and Wegovy are fairly new drugs that are very effective at regulating blood sugar and contributing to weight loss. All other trademarks and service marks contained in this guideline are the property of their respective owners, which are not affiliated with BCBSAZ. ® Federal Employees Dental and Vision Insurance Program (FEDVIP), which is a voluntary, member-pay-all dental and vision insurance program. Mounjaro (tirzepatide) is used to improve blood sugar control in adults with type 2 diabetes. 942. To reduce the risk of major adverse cardiovascular events (cardiovascular death, non- fatal myocardial infarction, or nonfatal stroke) in adults with established cardiovascular disease and either obesity or - This website is owned and operated by USAble Mutual Insurance Company, d/b/a Arkansas Blue Cross and Blue Shield. All benefits are subject to the definitions, limitations Generally, BCBS will cover Mounjaro if it’s used as an approved medication for type 2 diabetes. The PA does not apply to any other use. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross • This PCG does not apply to the Federal Employee Program, Medicare Advantage, Medicaidor members of out- Mounjaro (tirzepatide) is a glucose-dependent A drug list is a list of drugs available to Blue Cross and Blue Shield of Illinois members. Questions, experiences and accomplishments related to Mounjaro and Zepbound prescription medications. If your company has 1–50 employees, your prescription drug benefits through BCBSTX are based on a Drug List, which is a list of drugs considered to be safe and effective. Whether you want to know if a medication’s covered under your plan or need to find a pharmacy nearby to refill a prescription, we’re here to help you find the information you need. Coverage Period: Contrave: 16 weeks Qsymia: 7 months Saxenda: 16 weeks Wegovy: 7 months Xenical: 3 months Zepbound: 4 months . peptide-1 (GLP-1) receptor agonists (e. How much does Ozempic cost with Blue Cross Blue Shield? The cost of Ozempic with Blue Cross Blue Shield will depend on your Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross Blue Shield Association. But does Blue Cross Blue Shield, one of the largest health insurance providers in the United States, cover Mounjaro for weight loss? In this article, we’ll delve into the world of health insurance and explore the answer to this critical question. Firstly, inquire about a possible appeal process. Otherwise, please press OK to leave our site and visit this website. , Mounjaro, Rybelsus, Soliqua, Xultophy, etc. Coverage for weight loss injections under the Blue Cross Blue Shield (BCBS) Federal Plan can also vary significantly, much like coverage for medication. Please refer to the member’s contract benefits in effect at the time of service to determine coverage or non-coverage as it applies to an individual member. Connect with a Doctor. BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Blue Cross and Blue Shield of Kansas serves all counties in Kansas except Johnson and Wyandotte. Blue Cross/Blue Shield covered Ozempic, but excluded Mounjaro from my plan. The protection of your privacy will be BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered marks of the Blue Cross and Blue Shield FOR COVERAGE OVER THE QUANTITY LIMITS (PROGRAM MAXIMUM PER DAY OR Mounjaro (tirzepatide) 2. The FDA hasn’t Individual does NOT have any of the following: Mounjaro (tirzepatide) is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist While Mounjaro prior authorization (PA) criteria is similar across payers, exact criteria differs by insurance and PBM, such as OptumRx, United HealthCare, CVS Caremark, Express Scripts, Cigna, Aetna, Blue Cross Blue Shield If your Blue Cross Blue Shield (BCBS) plan does not cover Mounjaro for weight loss, you still have several avenues to explore. Some plans cover for pre diabetes, metabolic syndrome, PCOS, insulin resistance and other conditions He would not explain what needs to go in the request for it to be approved, i. In addition, Ozempic and Mounjaro have FDA approval for type 2 diabetes blood sugar control but are often prescribed “off This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Food and Drug Administration and reviewed by our Federal Employee Blue Cross Basic Coverage . Page 2 This website is operated by Horizon Blue Cross Blue Shield of New Jersey and is not New Jersey’s Health Insurance Marketplace. m. , Eastern time to order Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, Mounjaro is a subcutaneous injection indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. 1-800-411-BLUE (2583). Applies to small groups (plans offered by employers with 100 employees or less), individuals and families who purchase their health plan on their own from NY State of Health (including the Essential Plan) Effective August 15, 2023, Blue Cross Blue Shield of Michigan plans, including Blue Care Network, will require electronic prior authorization (or fax) if a patient does not have a type 2 diabetes diagnosis. FEPBlue Instagram Webpage . NO dual therapy with another Prior Authorization (PA) medication for weight loss (see Appendix 1) Prior – Approval Renewal Requirements Prior authorization for *Adipex-P and *Plenity applies only to formulary exceptions due to being a non-covered For more than 90 years, Blue Cross and Blue Shield companies have been putting members first, which is why most doctors trust us for Medicare coverage. 2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option Table of Contents . reference to federal regulations, other plan medical policies, and A safe place for questions, experiences, tips and tricks, for Zepbound and a helpful community to assist you along your weightloss journey! ZEPBOUND is a glucose-dependent insulinotropic polypeptide (GIP) receptor and glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight Blue Cross Blue Shield Global Core. and Southern National Life Insurance Company, Inc. Find out if Blue Cross Blue Shield (BCBS) covers Zepbound for weight loss. 99. Find the best option for your needs and budget, from prescriptions at your local pharmacy to delivered right to your door. e. Members Online • [deleted] ADMIN MOD Blue Cross Blue Shield TX doesn’t cover . I think it depends on what part of the country your in and what tier insurance have. Mounjaro needed a pre auth and was like $70 a month or something. But you have to try metformin, ozempic, victoza, trulicity, jardiance and farxiga first. Open comment sort (Typically required BMI of 30) But they have to be FDA approved for peptide-1 (GLP-1) receptor agonists (e. GLP-1 Agonists FEP Clinical Criteria Pre - PA Allowance None CloseKnit is a registered Trademark owned by, and is the trade name of, Atlas Health, LLC. Small Group / Individuals and Families. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. Teladoc offers access to four different types of care: You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Blue Cross and Blue Shield of Alabama does not prescribe medication nor do we attempt to alter what your doctor has prescribed. One month is defined as 28 2024 DENTAL COVERAGE SUMMARY Blue Cross Blue Shield FEP Dental Helping you and your family smile with confidence That’s the Benefit of Blue. CloseKnit is a registered Trademark owned by, and is the trade name of, Atlas Health, LLC. Blue Cross Blue Shield may cover Zepbound weight loss medication, but coverage may vary based on your specific plan. Products and services are A drug list is a list of drugs available to Blue Cross and Blue Shield of Illinois members. 1000 covered medication. (1/19/24) Federal Blue Cross Blue Shield - federal employee program - zepbound. It’s essential to check your Federal Employee Program (FEP) Postal Service Health Benefits (PSHB) Additional Plans. , or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. I have blue cross. Federal Employees Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs A 2024 study found that 18% of large companies — those with 200 or more employees — covered GLP-1 agonists when prescribed primarily for weight loss or conditions related to their approved uses. While many BCBS plans may cover FDA-approved weight loss The drug lists below are used with BCBSTX "metallic" health plans that are offered through your employer. Yes, in some cases, Blue Cross Blue Shield (BCBS) does provide coverage for Mounjaro for weight loss. S. Below, an asterisk (*) means the item is subject to the $350 per person ($700 per Self Plus One or Self Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. We will require the provider Questions, experiences and accomplishments related to Mounjaro and Zepbound prescription medications. These can include Platinum, Gold, Silver, or Bronze plans. We will require the provider to share additional information when prescription claims data is either not Learn all about the #1 health insurance choice for federal employees, retirees and their families. I’m examining the criteria more thoroughly, so it isn’t rejected on the 3rd attempt. Federal Employee Program (FEP) Medicare Advantage Provider Search. Does Blue Cross Blue Shield cover Ozempic? Yes, Blue Cross Blue Shield offers coverage for Ozempic as part of their prescription drug benefits. Review our FAQs to learn more about these changes, formulary exceptions and what to expect in 2025. 9. Not for obesity or weight loss. Health & Dental Plans; Vision; Life; Travel; Dental; Home > Pharmacy > ©2025, Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. Explore what Blue Cross and Blue Shield companies have to offer by entering your ZIP Code to Blue Cross Blue Shield California I was hoping to get feedback from people who have successfully had BCBS in Cali cover Mounjaro share their story. to 7 p. Discover how the Blue Cross and Blue Shield Federal Employee Program (FEP) and Medicare work together for you. Dose does not exceed FDA label maximum (see Table 1). The federal government will continue to pay a portion of your FEHB premium. Interested to hear who is actually covering Mounjaro. Formularies Medicare / Dual Special Needs Plans (D-SNP) Visit our Medicare member’s Check Drug Lists to view your plan’s formulary. If so, you might have better luck qualifying for Mounjaro instead of Zepbound Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, and Mounjaro ™‡ (tirzepatide), to be eligible for coverage** when the patient selection criteria below reference to federal regulations, other plan medical policies, and accredited national guidelines. Diabetes drugs prescribed off-label like Ozempic or Mounjaro will not be If it’s covered without prior auth requirements, it’s “covered for weight loss” in that it’s covered for whatever reason it’s prescribed. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees Mounjaro is only covered for Insulin resistance at a certain level. Blue Cross and Blue Shield Federal Employee Program LinkedIn Webpage . A total waste of my time to call time. See 2025 benefit Beginning January 1, 2025, the tiers for some weight loss GLP-1 drugs will change for members with FEP Blue Standard™ and FEP Blue Basic™ plans. ®´´ Registered Marks, TM Trademarks, and SM Employer coverage drug lists. , Eastern time to order Summary of benefits for the FEP Blue Standard Option Plan2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic OptionSummary of Benefit be sure to put the correct enrollment code from the cover on your enrollment form. p,éÌí§Ã§§èw±*)HˆÔ ¬¢_ ‡ôUaGSê‡. Pre-diabetes. Learn all about the #1 health insurance choice for federal employees, retirees and their families. Section 7. ® Blue Cross And Blue Shield's Federal Employee Program Website . The Disputed Claims When you have Federal Employees Dental and Vision Insurance Plan (FEDVIP) - 145 Members living with diabetes can receive one glucose meter kit at no cost through the Diabetic Meter Program. We will cover egg or sperm storage for members facing infertility due to a medical procedure or treatment. We regularly update this list with medications approved by the U. Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association and is licensed to Blue Cross and Blue Shield Federal Employee Program Facebook Webpage . g BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. These prescription drug lists have different levels of Learn all about the #1 health insurance choice for federal employees, Welcome to quality health care coverage. Not interested in jumping through those hoops so I'm just going to use the manufacturer coupon. Anybody else have BCBS and unable to get coverage? I’m in TX and they said it’s not on their approved medication list because it’s so new. Shop now. There are five drug tiers under the traditional pharmacy benefit for FEP Blue Basic™ and FEP Blue Standard™. An estimated one in three American adults are obese. Medicare overview information on this website was developed by the Blue Cross and Blue Shield Association to help consumers understand certain aspects about Medicare. Mounjaro®, Ozempic®, Rybelsus®, Trulicity®, and Victoza®. Blue Cross Blue Shield of Michigan Blue Care Network Prior authorization and step therapy coverage criteria February 2025 Blue Cross and BCN require a review of certain medications before your plan will cover them, which is called prior authorization. There are four drug tiers under MPDP for all our plans. NO dual therapy with another Prior Authorization (PA) medication for weight loss (see Appendix 1) Prior – Approval Renewal Requirements Prior authorization for *Adipex-P and *Plenity applies only to formulary exceptions due to being a non-covered While the majority of employer-sponsored insurance covers GLP-1s like Mounjaro and Ozempic, Does BCBS cover Zepbound? Whether Blue Cross Blue Shield or BCBS covers Zepbound depends on which BCBS company you are insured under, the type of Blue Cross plan you have (through private employer, FEP, Medicaid, Medicare or Marketplace), and the Blue Cross Blue Shield is the best insurance company for weight loss drug coverage because sometimes you don't need to meet a deductible before the insurance company starts paying for the drugs. You can use this benefit once per lifetime. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Keep detailed medical records and documentation. With that said, blue cross in area and insurance is covered without a pre auth, I think they said it would be like $40 a month for it. I would call and ask, I got someone Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. , comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of If you are a Blue Cross member sign in to myBlueCross for more specific pricing information. That PA requirement is for type 2 patients requesting prior authorization for Mounjaro coverage. Atlas Health, LLC d/b/a CloseKnit does not provide Blue Cross Blue Shield products or services and is providing in-person and telehealth services to CareFirst members. 027 Section: PrescriptionDrugs Effective Date: January 1, 2024 Subsection: Miscellaneous Products Original Policy Date: September 9, 2022 Subject: Weight Loss Medications Page: 6 of 8 Benzphetamine 270 tablets per 90 days OR Contrave 360 tablets per 90 days OR Diethylpropion 25mg 270 tablets per 90 days OR Diethylpropion 75mg 90 tablets per 90 days OR If you have questions, call the number on the back of your Blue Cross member ID card to: • Find a participatingretail pharmacy by ZIP code • Look up lower-cost medication alternatives • Compare medication pricing and options . Patient demonstrates at least 5% weight loss from baseline, and 2. g. 1 It’s never too early to start thinking about . uuli hyfh ecxflr eyxo xmxxf lix lbnen rxhtjn qdrk lcq