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UHC’s typical prior authorization requirements for Wegovy and Zepbound include: BMI documentation — A documented BMI of 30 or higher, or BMI of 27 or higher with at least one weight-related comorbidity such as type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea Comorbidity evidence — Clinical records documenting the specific comorbidities that support the medical necessity of treatment Supervised weight management history — Evidence of participation in a structured weight management program, which may include diet, exercise, and behavioral counseling, typically for 3 to 6 months prior to the request Prescriber qualifications — The prescriber must be a physician, nurse practitioner, or physician assistant with appropriate prescribing authority UHC reviews prior authorizations against specific clinical policy bulletins

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[DOI] [PMC free article] [PubMed] [Google Scholar] 87.Colhoun H.M., Hasenour C., Riddle M.C., Branch K., Konig M., Atisso C., Lakshmanan M., Mody R., Gerstein H.C