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Rachel Kleinman Rachel Kleinman Published May 22, 2025 Cigna has announced a deal to cap client copays on popular GLP-1 weight loss drugs by Eli Lilly and Novo Nordisk at $200 per month, a sum that would count toward a patient's deductible
Medical Weight Loss is best suited for individuals who have difficulty losing weight using traditional methods such as diet and exercise
Syringes require a prescription label as well
That in itself is a reason for consideration of reversal especially if it involves constantly feeling ill, lacking energy, or not being able to enjoy life
Approval rates (CVS Caremark internal data, 2025): First submission approval: 34% Approval after one appeal: 58% Approval after second appeal or peer-to-peer review: 71% Final denial rate: 29% The most common denial reasons: Insufficient documentation of 90-day lifestyle intervention (41% of denials) BMI does not meet threshold or comorbidity not documented (28%) Step therapy not completed (19%) Prescriber not in-network or not qualified specialty (12%) The prior authorization process takes 3 to 14 business days for standard review
