Prior Authorization for Weight Loss Medications
Prior authorization is required for weight loss medications. One of the criteria for prior authorization includes participating in a weight management program. The providers, wellness coaches, and nutritionists at the HII Family Health Centers are ready and available to assist you with choosing a program and completing the criteria so that you can reach and maintain your ideal weight goals.
What is prior authorization?
Requiring a patient to get prior authorization for certain medications is a common practice used by insurance companies to ensure safe and appropriate medication use.
How does this affect you?
Some medications require prior authorization, or PA, and it means that your doctor will have to provide additional information on why they are prescribing this medication for you. CVS Caremark reviews this information and, based on your HII medical plan, determines whether or not the medication will be covered. This information and process is confidential. Your medical information is not shared with HII.
Talk with your provider or health center staff to discuss the process for obtaining prior authorization, and to explore alternative medication options if needed. If you have any concerns about the cost of your medication, there may be programs and resources available to help.
What options are available?
We understand that weight loss medications may be necessary for patients with medical conditions that make it difficult to lose weight through lifestyle changes alone. Weight loss medications can be an effective component of a comprehensive weight loss plan that include lifestyle changes, dietary modifications, and exercise. The goal of implementing a weight management program is to support patients in achieving sustained weight loss and improved overall health.
QuadMed Wellness offers 5 weight management options, including:
QuadMed Wellness can provide more information for each program, all of which are available to you at no cost. We encourage you to review the program options with your provider, or a spouse or friend who might be interested in joining you on the road to wellness!
If you have any questions or concerns, please reach out to the health center for assistance.
