What To Know
- As you embark on your weight loss journey, you may encounter questions about the coverage of medications like Saxenda.
- Saxenda, also known as liraglutide, is a prescription medication used for weight management in conjunction with a reduced-calorie diet and increased physical activity.
- If Saxenda is not covered by your Passport plan or you are not a suitable candidate, there are other weight loss medications that may be covered.
As you embark on your weight loss journey, you may encounter questions about the coverage of medications like Saxenda. Understanding the complexities of health insurance can be daunting, but we’re here to guide you through the intricacies of Passport and Saxenda coverage.
What is Saxenda?
Saxenda, also known as liraglutide, is a prescription medication used for weight management in conjunction with a reduced-calorie diet and increased physical activity. It is injected once daily and works by suppressing appetite and reducing food cravings.
Does Passport Cover Saxenda?
The coverage of Saxenda under Passport plans varies depending on the specific plan you have. However, in general, Passport may cover Saxenda if:
- You have a diagnosis of obesity (BMI ≥ 30 kg/m²) or overweight (BMI ≥ 27 kg/m²) with at least one obesity-related comorbidity, such as type 2 diabetes, high blood pressure, or high cholesterol.
- You have tried and failed to lose weight with other methods, such as diet and exercise.
- Your doctor believes that Saxenda is medically necessary for your weight loss.
How to Check Your Coverage
To determine if your Passport plan covers Saxenda, you can:
- Contact your insurance company directly.
- Check your plan’s online portal or mobile app.
- Speak with your doctor or pharmacist.
Step-by-Step Guide for Coverage
If you believe you qualify for Saxenda coverage, follow these steps:
1. Consult with Your Doctor: Discuss your weight loss goals and determine if Saxenda is an appropriate treatment option.
2. Obtain a Prescription: Your doctor will provide you with a prescription for Saxenda.
3. Submit a Prior Authorization: Most Passport plans require prior authorization for Saxenda coverage. This involves submitting documentation to your insurance company to demonstrate medical necessity.
4. Appeal a Denial: If your prior authorization is denied, you can appeal the decision by providing additional medical information or documentation.
Alternatives to Saxenda
If Saxenda is not covered by your Passport plan or you are not a suitable candidate, there are other weight loss medications that may be covered. These include:
- Wegovy (semaglutide)
- Ozempic (semaglutide)
- Contrave (naltrexone/bupropion)
- Qsymia (phentermine/topiramate)
Conclusion: Empowering Your Weight Loss Journey
Navigating health insurance coverage for weight loss medications can be complex. By understanding the nuances of Passport and Saxenda coverage, you can empower yourself to make informed decisions about your weight loss journey. Remember, you are not alone in this endeavor, and there are resources available to guide you every step of the way.
Frequently Asked Questions
Q: What is the cost of Saxenda?
A: The cost of Saxenda varies depending on the dosage and your insurance coverage. You can expect to pay between $1,000 and $1,500 per month without insurance.
Q: What are the side effects of Saxenda?
A: Common side effects of Saxenda include nausea, diarrhea, constipation, and injection site reactions. Serious side effects are rare but can include pancreatitis and gallbladder disease.
Q: How long does it take for Saxenda to work?
A: It can take several weeks to see noticeable results from Saxenda. However, some people may experience weight loss within the first few weeks of treatment.
