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Medical Necessity Checklist for Formulary Exception If you're requesting a formulary exception, gather this documentation first: Required Documentation for Exception Request Current BMI documentation (30 or 27 with comorbidity) Documented comorbidities with ICD-10 codes (medical diagnosis codes): Obesity Class I/II/III (E66.811, E66.812, E66.813) Hypertension (I10) Type 2 Diabetes (E11) Dyslipidemia/high cholesterol (E78.5) Obstructive Sleep Apnea (G47.33) Failed alternative treatments documented trials of: Phentermine or diethylpropion Qsymia or Contrave Semaglutide (Wegovy/Ozempic) for 6+ months Lifestyle modification records (diet/exercise program participation) Weight history showing chronic obesity (past 1-2 years) Letter of Medical Necessity from your Kaiser provider For more on prior auth documentation, see our Wegovy prior authorization guide EXCEPTION PATHWAYS How Some Members Get Coverage While standard coverage is limited, some Kaiser members do get Wegovy covered
Curbing your appetite and increasing feelings of fullness can significantly enhance your weight loss efforts and contribute to your journey toward a healthier, more confident you
The Aging Process: Natural production typically begins to decline after age 20, often dropping by about 10% per decade
SLU-PP-332 is an investigational small-molecule pan-agonist of the estrogen-related receptors (ERR//) developed at Saint Louis University
They also promote weight loss by suppressing appetite and slowing gastric emptying, making patients feel fuller longer
