Fact-checked by Adam Kennah, M.D. on . See our fact-checking policy.
Kaiser Permanente is an integrated delivery system: medications must be prescribed by Kaiser physicians and dispensed through Kaiser pharmacies. Coverage policies are set by Kaiser's pharmacy and therapeutics committee.
Generally covered for T2D. Kaiser physicians prescribe through Kaiser pharmacy.
Kaiser covers Wegovy and Zepbound for weight indication under specific eligibility criteria, prescribed by Kaiser obesity-medicine clinicians. The integrated model means access is gated through Kaiser primary care or obesity specialist referral.
Coverage under March 2024 Wegovy CV indication available for Kaiser members meeting SELECT criteria.
Coverage of Zepbound for OSA expanding within Kaiser.
Kaiser eligibility criteria are typically similar to other commercial PAs but evaluated by Kaiser clinicians.
Cash-pay compounded GLP-1 from external telehealth providers is an alternative path if Kaiser-internal coverage is not workable.
The most reliable way to verify coverage is to call the member services number on your insurance card and ask: (1) Is [Wegovy/Zepbound/Ozempic/Mounjaro] on my formulary? (2) What tier? (3) What are the prior authorization criteria? (4) What's my expected copay at each tier? Document the date, the rep's name, and any reference number.
If insurance coverage is unworkable, see our price index for current cash-pay compounded options. Our editor's pick, NexLife, runs $145–$215/month flat-rate.