Incretin Prescribing Assistant (GLP-1 / GIP)

Commercial plan PA (employer opt-in)

• ?Typical PA: BMI ≥30, or ≥27 + comorbidity — enter BMI
• ?Document lifestyle program participation (plans commonly require 3–6 months)

• Weight-loss coverage is an employer opt-in — many plans exclude it entirely; check the member formulary or run a test claim
• If covered: renewal typically requires ≥5% weight loss
• Manufacturer savings card drops copay to $0–25/mo for commercially insured patients

Cash fallback — LillyDirect: $149–349/mo depending on dose

Commercial plan PA (employer opt-in)

• ?Typical PA: BMI ≥30, or ≥27 + comorbidity — enter BMI
• ?Document lifestyle program participation (plans commonly require 3–6 months)

• Weight-loss coverage is an employer opt-in — many plans exclude it entirely; check the member formulary or run a test claim
• If covered: renewal typically requires ≥5% weight loss
• Manufacturer savings card drops copay to $0–25/mo for commercially insured patients

Cash fallback — Generic liraglutide + GoodRx: varies — often cheapest GLP-1 cash route

Commercial plan PA (employer opt-in)

• ?Typical PA: BMI ≥30, or ≥27 + comorbidity — enter BMI
• ?Document lifestyle program participation (plans commonly require 3–6 months)

• Weight-loss coverage is an employer opt-in — many plans exclude it entirely; check the member formulary or run a test claim
• If covered: renewal typically requires ≥5% weight loss
• Manufacturer savings card drops copay to $0–25/mo for commercially insured patients

Cash fallback — NovoCare Pharmacy: $199/mo first 2 fills (0.25/0.5 mg, through 12/31/2026), then $349/mo (0.25–2.4 mg)

Commercial plan PA (employer opt-in)

• ?Typical PA: BMI ≥30, or ≥27 + comorbidity — enter BMI
• ?Document lifestyle program participation (plans commonly require 3–6 months)

• Weight-loss coverage is an employer opt-in — many plans exclude it entirely; check the member formulary or run a test claim
• If covered: renewal typically requires ≥5% weight loss
• Manufacturer savings card drops copay to $0–25/mo for commercially insured patients

Cash fallback — NovoCare Pharmacy: $149/mo (1.5 & 4 mg; 4 mg promo through 8/31/2026 then $199)

Commercial plan PA (employer opt-in)

• ?Typical PA: BMI ≥30, or ≥27 + comorbidity — enter BMI
• ?Document lifestyle program participation (plans commonly require 3–6 months)

• Weight-loss coverage is an employer opt-in — many plans exclude it entirely; check the member formulary or run a test claim
• If covered: renewal typically requires ≥5% weight loss
• Manufacturer savings card drops copay to $0–25/mo for commercially insured patients

Cash fallback — LillyDirect Self Pay Journey: $299/mo (2.5 mg), $399/mo (5 mg), $449/mo (7.5–15 mg)