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Track your metrics weekly but evaluate progress monthly

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Per Humana's pharmacy policy (effective 1/20/2025), coverage requires ALL of the following: [4] Moderate-to-severe OSA diagnosis (AHI 15 on polysomnogram or REI 15 on home sleep test) BMI 27 kg/m (lower threshold than FDA label's obesity requirement) Using Zepbound with lifestyle modifications (reduced-calorie diet + physical activity) NO diabetes diagnosis (type 1 or type 2)this is an exclusion criterion Use diagnosis code G47.33 for OSA as the primary diagnosis, with obesity as secondary

[DOI] [PubMed] [Google Scholar] 793.Bozkurt A., Naslund E., Holst J.J., Hellstrom P.M

First, it suggests that the benefits require ongoing treatment rather than producing permanent changes

The reasons people stop are worth naming plainly: Cost and coverage gaps: the most common driver