A 2024 Academy of Managed Care Pharmacy survey showed 78% of commercial plans require prior authorization, with approval rates below 65% for first-time requests [2]Academy of Managed Care Pharmacy, Prior Authorization Survey, amcp.org
The article says Tricare Standard and Prime typically cover semaglutide for type 2 diabetes management with documented glycemic control failure and prior authorization, while coverage for weight loss alone is generally unavailable under standard policies
If the board decides to remove coverage, the benefit would end beginning April 1
This makes it particularly beneficial for areas prone to sagging, such as the abdomen, arms, thighs, and flanks
American College of Allergy, Asthma & Immunology
Irawati N, Wardani RS, Poerbonegoro NL, Rahmawati I