The facts
Weight loss
Generally no
Type 2 diabetes
Not indicated
Prior auth
Required
Typical cost
$50/mo via the Medicare GLP-1 Bridge
Who actually decides this
Not the logo on your card, most of the time. Three parties sit between you and the answer, and knowing which one is saying no tells you who to ask.
- 1
The pharmacy benefit manager
No single PBM to name here, which is itself the finding. Different plans under this name use different benefit managers, so one national statement about the formulary would be wrong.
- 2
Your employer, if the plan comes through work
Weight-loss drugs are usually a category an employer buys or declines, not something the insurer includes by default. That is why two people holding identical cards get opposite answers, and why the useful question for member services is whether your plan includes the weight-loss medication benefit at all, before anything about criteria.
Get your real answer
Ask about the Medicare GLP-1 Bridge by name rather than asking whether Wegovy is on your Part D formulary, because those are different questions with different answers. Your prescriber submits a prior authorization to a CMS central processor, not to Humana. If Wegovy is being prescribed for cardiovascular risk reduction rather than weight, ordinary Part D coverage may apply and is worth checking separately.
Coverage is plan-specific: this page reports what Humana publishes, not a promise about your plan. Not medical or insurance advice.


