in 22 days NovoCare Pharmacy self-pay — Wegovy® tablets (oral semaglutide) 4 mg moves to $199/month See the changelog
WalletNoise

Elevance Health / Anthem (CarelonRx)

Insurer + PBM · updated August 8, 2026

Coverage right now

The stable one: kept Wegovy AND Zepbound dual-preferred (Tier 2, PA/QL) through the 2025 upheavals, and added Foundayo fastest of the majors (May 15, 2026). Coverage still contingent on the employer including a weight-loss benefit. No single national criteria PDF — criteria served per-drug via the Anthem Drug List Search.

Drug status

DrugStatusDetailConfidence
Wegovy® (semaglutide injection)Preferred
from Aug 1, 2026
Tier 2 with PA/QL on the Essential Drug List (inj + oral). 'BE' flag: applies only if plan includes the weight-loss benefit. sourcehigh
Wegovy® tablets (oral semaglutide)Preferred
from Aug 1, 2026
Tier 2 PA/QL. sourcehigh
Zepbound® (tirzepatide)Preferred
from Aug 1, 2026
Tier 2 PA/QL. Device transition underway: KwikPen added at Tier 2 eff 8/1/2026; single-dose pen Tier 3 -> non-formulary eff 10/1/2026 on the CA National list. sourcehigh
Foundayo™ (orforglipron)Preferred
from May 15, 2026
Added NF -> Tier 2 PA/QL across National, Direct, Direct Plus, Direct Preferred lists effective 5/15/2026. sourcehigh
Saxenda® (liraglutide)Non preferred
from Aug 1, 2026
Tier 3 PA/QL; generic liraglutide at Tier 2 PA/QL. sourcehigh
What preferred, covered and exception only mean
Preferred
On the formulary at the plan's best tier for this class. Usually still needs prior authorization — preferred is not the same as automatic.
Covered
On the formulary, but not the plan's first choice for this class. Often a higher copay tier than a preferred drug.
Non preferred
On the formulary at a disadvantaged tier, or reachable only after trying a preferred drug first.
Exception only
Not routinely covered. Obtainable only through a formulary-exception request that meets the plan's published criteria.
Excluded
Not on the formulary at all. A benefit exclusion is a different fight from a PA denial and is appealed differently.
Varies
The payer's own documents differ by plan or line of business, so a single answer here would be wrong.
Unknown
Not yet verified against a primary document. Recorded as absent rather than guessed.
N/A
Not applicable to this payer.

Prior authorization criteria

medium
PA required
Yes — PA flag on all anti-obesity GLP-1s; benefit-exclusion flag means employer opt-in governs.
Initial BMI
BMI >= 30, or >= 27 with >= 1 weight-related comorbidity (no numbered national policy document published; criteria served per-drug via Drug List Search links).
Comorbidities
Type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea.
Lifestyle requirement
3-6 months documented diet/exercise efforts in the medical record.
Initial authorization
~5-6 initial (varies by plan); renewals 12.
Reauthorization
>= 5% weight loss from baseline to continue.
Step therapy
No universal GLP-1 step on national commercial lists; some plans add one.
Quantity limits
QL flag on all listed agents; specific counts served at drug level.

Primary criteria document:findhonestcare.com

Exceptions and appeals

Appeal deadline
180 days
Deadline detail
180 days internal (typical Anthem commercial).
Exception route
ePA via Surescripts (providerportal.surescripts.net), CoverMyMeds, or CenterX (EPIC). Verbal PA 833-293-0659 (M-F 8a-9p ET, Sat 10a-2p).
Turnaround
ePA can auto-approve in real time; standard/expedited clocks are state-mandated and not published nationally.
Where
Per your denial letter (plan-specific).

Source:carelonrx.com

Dated changes

  • May 15, 2026 Foundayo added at Tier 2 PA/QL across major lists — fastest add among the majors source
  • Jan 1, 2026 Anthem CA Medi-Cal terminated weight-loss GLP-1 coverage (Wegovy keeps MASH/CV pathways, Zepbound keeps OSA; Reject Code 70 otherwise) source
  • Oct 1, 2026 Zepbound single-dose pen Tier 3 -> non-formulary (CA National list); presentation switch to KwikPen source
State variation is real (CA DMHC vs CDI lists differ). CarelonRx sells employers an opt-in GLP-1 weight-management program. Criteria questions: druglist@carelon.com.
These are each payer's standard template. Employer plans customize them, so the same PBM can cover a drug for one employer and exclude it for another — a status here is a starting point, not your plan. A benefit exclusion is also a different fight from a PA denial. Always request your own plan's criteria in writing; you are entitled to them.