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In those cases, the issue is often not medical necessity but the fact that the employer or plan simply did not elect to cover the medication in the first place. Prior authorization and coverage requirements Even when a GLP-1 is covered, most insurance plans require prior authorization, which consists of a set of clinical questions your doctor must answer to justify why you qualify

[DOI] [PMC free article] [PubMed] [Google Scholar] 38.Chung SJ, et al

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Before starting treatment, a healthcare provider will conduct a comprehensive assessment, reviewing medical history, current medications, weight loss goals, and overall health to determine if Semaglutide GLP-1 is suitable

(n.d.-b).