Coverage at a glance
| Indication | Coverage |
|---|---|
| Obesity / chronic weight management (Wegovy and Zepbound) | Covered with prior authorization |
| Obstructive sleep apnea (Zepbound, SURMOUNT-OSA indication) | Covered with prior authorization |
| Cardiovascular risk reduction (Wegovy, SELECT indication) | Covered with prior authorization |
If your plan denies coverage, two cash programs to check.
No insurance needed.
- Strut Health$149 a month, with auto-refillcompounded semaglutideCheck price →You pick Weight Loss, then a five-minute online visit
- Shed$199 a monthcompounded semaglutideCheck price →Every medication is listed with a starting price
Cheapest GLP-1 without insurance compares the three cash routes. Cheapest GLP-1 ranks every cash price on the chart.
Prior authorization: the plan reviews the prescription before it pays.
Cigna policy IP0206 covers Wegovy and Zepbound for obesity. Your prescriber has to get the plan to sign off first. You need a starting BMI of 30 or more. A BMI of 27 or more also works if you have a weight-related health problem. You also need three months of diet and behavior change. Page one of that same policy says weight-loss drugs are "specifically excluded under many benefit plans." Your own plan document beats the policy, so read it first. This answer covers Commercial employer group and individual and family plans.
Source: Cigna policy IP0206. Checked August 15, 2026.
Where your plan lists it. Cigna's Standard 3-Tier drug list puts Wegovy and Zepbound on tier 2, its preferred brand tier, with prior authorization and a quantity limit. The list's weight management section says not all plans cover prescription weight management medications. Source: Cigna Healthcare Standard 3-Tier Prescription Drug List, coverage starting July 1, 2026. Checked September 6, 2026.
What it costs once they say yes. With commercial insurance the manufacturer savings card takes Wegovy or Zepbound to as little as $25 a month. Your plan sets the copay before the card applies. What Wegovy costs with your plan. What Zepbound costs with your plan.
This varies by plan. Policy IP0206 says your own plan document always wins over Cigna's coverage rules. The same policy says many plans exclude weight-loss drugs outright. That holds on job plans and on plans you buy yourself. So read the drug section of your plan summary first. Express Scripts runs the drug benefit for most Cigna plans.
Coverage by indication
| BMI threshold | Baseline BMI 30 or higher. Baseline BMI 27 or higher also qualifies with at least one weight-related condition. The policy lists hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, cardiovascular disease, knee osteoarthritis, asthma, chronic obstructive pulmonary disease, metabolic dysfunction-associated steatotic liver disease or non-alcoholic fatty liver disease, polycystic ovarian syndrome, or coronary artery disease. Baseline means your BMI before any GLP-1 or GLP-1/GIP agonist. |
| Step therapy | No older weight drug has to fail first. The policy asks for three months of diet and behavior change, and that you keep both going while on the drug. |
| Continuation | 5 percent or more loss of baseline body weight |
| Authorization length | 8 months initial, 1 year continuation, for both Wegovy and Zepbound |
What the prior authorization needs:
- Your plan must include the weight-loss drug benefit, because the policy states these medications are specifically excluded under many benefit plans
- Age 18 or older
- At least 3 months of behavioral modification and dietary restriction
- Documented baseline BMI within the threshold, measured before any GLP-1 or GLP-1/GIP agonist
- Comorbidity documentation when baseline BMI is 27 to 29.9
- No concurrent use with another GLP-1 or GLP-1/GIP agonist
Source: Cigna policy IP0206. Cigna's own coverage policy PDF, all 29 pages, read in full.
| BMI threshold | Baseline BMI 30 or higher |
| Sleep study (AHI) | Apnea-hypopnea index of 15 or more events per hour on a sleep study, which the policy defines as moderate OSA, with 30 or more defined as severe |
| Step therapy | None. You do not have to fail a breathing machine (PAP) first. You do not need a sleep specialist. |
| Continuation | After at least 1 year of therapy: 10 percent or more loss of baseline body weight, plus prescriber-reported stability in obstructive sleep apnea signs or symptoms such as snoring, excessive daytime sleepiness or fatigue |
| Authorization length | 1 year initial, 1 year continuation |
What the prior authorization needs:
- Age 18 or older
- Baseline BMI 30 or higher
- Sleep study documenting moderate to severe OSA with an apnea-hypopnea index of 15 or more
- No central sleep apnea and no Cheyne-Stokes respiration
- Used alongside behavioral modification and a reduced-calorie diet
Source: Cigna policy IP0206. Cigna's own coverage policy PDF, all 29 pages, read in full.
| BMI threshold | Baseline BMI 27 or higher |
| Cardiovascular criteria | One of these three. A past heart attack. A past stroke, but not a mini-stroke: the policy rules out a transient ischemic attack. Or leg artery disease with symptoms. That means cramping leg pain on walking with an ankle-brachial index below 0.85, a procedure to restore blood flow in a leg, or an amputation caused by clogged arteries. |
| Step therapy | None. But your prescriber has to confirm your heart medicines are already optimized for your condition. |
| Authorization length | 1 year |
What the prior authorization needs:
- Age 18 or older
- Baseline BMI 27 or higher
- Documented prior heart attack, prior stroke, or symptomatic peripheral arterial disease
- Prescriber confirms your heart medicines are already optimized
- Used alongside behavioral modification and a reduced-calorie diet
Source: Cigna policy IP0206. Cigna's own coverage policy PDF, all 29 pages, read in full.
Recent change: The version of IP0206 that runs today started on June 1, 2026. It now covers six drugs: the Wegovy shot, the Wegovy HD shot, the Wegovy tablet, Zepbound, liraglutide (Saxenda and generic) and Foundayo (orforglipron). All six need the plan to sign off first.
Ozempic, Mounjaro and Rybelsus on Cigna plans
Ozempic, Mounjaro and Rybelsus are approved for type 2 diabetes, not weight loss.
Does Cigna cover Ozempic?
Yes, with prior approval. Cigna pays for Ozempic once your prescriber gets the plan to sign off.
Cigna covers Ozempic for type 2 diabetes if you are 18 or older. The plan has to sign off first. Approvals run for one year at a time. Cigna will not cover Ozempic for weight loss. It is not FDA-approved for that, and the policy calls it not medically necessary. That use belongs to Wegovy, the same semaglutide at a higher dose. Your tier, your copay and any step therapy or quantity limits come from your employer's benefit document. Check myCigna or your plan documents.
Checked August 27, 2026.
What Cigna requires for Ozempic
| Step therapy | Not required |
What the prior authorization needs:
- Prior authorization required
- Patient must be 18 years of age or older
- Coverage is for the type 2 diabetes indication
- Approval granted for 1 year
Source: Cigna policy CNF 360. Cigna's own prior authorization policy PDF.
Does Cigna cover Mounjaro?
Yes, with prior approval. Cigna pays for Mounjaro once your prescriber gets the plan to sign off.
Cigna and Express Scripts cover Mounjaro for type 2 diabetes. The plan has to sign off first, under Cigna National Formulary policy CNF749. Approval runs for one year at a time. You have to be 18 or older. Cigna will not cover Mounjaro for weight loss. The policy says weight loss without type 2 diabetes is not covered. For weight loss, the covered drug is Zepbound. It is the same tirzepatide, approved by the FDA for obesity.
Checked August 27, 2026.
What Cigna requires for Mounjaro
| Step therapy | Not required |
What the prior authorization needs:
- Confirmed diagnosis of type 2 diabetes mellitus
- Patient is 18 years of age or older
- Prior authorization approval is granted for one year
- Not covered for weight loss, type 1 diabetes, prediabetes, or metabolic syndrome in a patient without type 2 diabetes
Source: Cigna policy CNF749. Cigna's own prior authorization policy PDF.
Recent change: Cigna policy CNF749 was reviewed on 06/07/2023 and revised on 07/05/2023. That is still the version Cigna publishes for its National Formulary. Single employer plans and Express Scripts plans can add step therapy or quantity limits on top.
Does Cigna cover Rybelsus?
Yes, with prior approval. Cigna pays for Rybelsus once your prescriber gets the plan to sign off.
Cigna covers Rybelsus for type 2 diabetes through Express Scripts. The plan has to sign off first. Approval runs for one year at a time. You have to be 18 or older. The standard rules do not require step therapy or a minimum A1C. Rybelsus is not covered for weight loss. It is FDA-approved for type 2 diabetes only. The weight-loss semaglutide is Wegovy. It runs under its own Cigna policy.
Checked August 27, 2026.
What Cigna requires for Rybelsus
| Step therapy | Not required |
What the prior authorization needs:
- Prior authorization required
- Patient is 18 years of age or older
- Diagnosis of type 2 diabetes (FDA-approved indication)
- Approval granted for 1 year
- Not combined with another GLP-1 agonist or GLP-1/GIP agonist
Source: Cigna policy CNF 360. Cigna's own prior authorization policy PDF.
Recent change: On January 30, 2026, the FDA approved a name change. Rybelsus 1.5 mg, 4 mg and 9 mg tablets became Ozempic tablets. Rybelsus 3 mg, 7 mg and 14 mg tablets stay on the market. They stay covered under this policy for type 2 diabetes.
What to do next
If you qualify under one of the covered indications above, prior authorization is the path. Match the documentation in the requirements list then have your prescriber submit it. Plans that approve reassess at renewal, so know your long-term maintenance dose before you start.
- Browse the prior-authorization letter library for a template that matches your plan and indication.
- Read why plans say no and the four ways to appeal in the GLP-1 insurance guide.
- Your plan may treat another GLP-1 differently. The Cigna coverage check lists all 4, with the source for each.
- If the plan denies it, the appeal letter library has a template for each reason a plan gives. That covers the peer-to-peer call with a plan doctor, the Level 1 and Level 2 appeals inside the plan, and the outside review that follows them.
- Call the number on your insurance card and ask whether your specific plan includes the weight-management drug benefit before you submit.
- If your plan does not cover the indication you need, compare cash prices in the cost guide or check whether a clinical trial near you fits. Neither one goes through your insurer. Clinical trials cost nothing and many pay you for your time.
What it costs without insurance
The programs below bill you directly. Prices checked every Monday.
Frequently asked questions
Does Cigna cover Wegovy for weight loss?
Yes, if your plan buys the benefit. Under Cigna policy IP0206, in force since June 1, 2026, Wegovy is approved for adults 18 and up. You need three months of diet and behavior change first. You also need a starting BMI of 30, or 27 with a weight-related health problem. The first approval runs 8 months. To keep it another year you have to lose 5 percent of your starting weight. The catch is on page one of the same policy: weight-loss drugs are "specifically excluded under many benefit plans," and your plan document beats the policy. Check that the benefit is there before you count on the rules.
Does Cigna cover Zepbound?
Yes, on the same terms as Wegovy. IP0206 asks for age 18 or older, three months of diet and behavior change, and a starting BMI of 30, or 27 with a listed health problem. The first approval runs 8 months and the next runs a year, and you have to lose 5 percent of your starting weight to get it. Zepbound has a second route for sleep apnea, approved for a year. That one asks for a BMI of 30 or more and a sleep study showing 15 or more events an hour. It leaves out central sleep apnea and Cheyne-Stokes breathing. Staying on it is harder: 10 percent weight loss, plus a note from your prescriber that the apnea is steady or better.
What BMI does Cigna require for GLP-1 coverage?
A starting BMI of 30 or more. Or 27 or more, with one weight-related health problem. Cigna's list is a long one, and worth reading before you rule yourself out: high blood pressure, type 2 diabetes, high cholesterol, sleep apnea, heart disease, knee arthritis, asthma, COPD, fatty liver disease, PCOS and blocked heart arteries. The full list, in the policy's own words, is in the coverage table above. Starting means your BMI before any GLP-1, so weight you already lost on one does not count against you.
Does Cigna require step therapy before approving Wegovy or Zepbound?
No. Cigna policy IP0206 does not make you fail phentermine, orlistat or any other older weight drug first. What it does ask for is three months of diet and behavior change, and that you keep both going on the drug. That is the national rule. Cigna publishes separate policies for particular plan designs, so a single employer plan can ask for more. Check your own plan documents rather than assuming the national rule applies as written.
Does Cigna cover Zepbound for sleep apnea?
Yes, with prior authorization. Cigna states this in Cigna Drug Coverage Policy IP0206, Weight Loss: Glucagon-Like Peptide-1 Agonists BMI 30, effective June 1, 2026, read August 2026.
Coverage for other payers
See the full payer coverage index for every plan we have sourced.
How we built this page
Every page here comes from the payer's own policy, a federal law, or KFF's plan research. Each row links its source and gives the date we read it. Some plan files load at the address the payer gives but will not open. We check those against a second source and mark the row lower confidence. Job-based plans also choose whether to add the weight-drug benefit at all, so those rows say varies by plan rather than a flat yes.
This is reference information, not medical or legal advice, and not a guarantee of coverage. GLP-1 coverage policies change often. Always confirm the current policy with your insurer using the number on your card before you rely on this page. If your experience differs from what is shown here, email hello@glpchart.com with the details and we will re-verify.
