fda pulls semaglutide Ban on Compounded GLP-1 Drugs: What to Know FDA Approves Oral Semaglutide as

"Not medically necessary" or "step therapy required" (must try other treatments first) = PA denial (you can appeal) "Excluded benefit" or "not covered" = plan exclusion (different strategy needed) WHAT'S COMING Cigna Coverage Outlook for 2026 Generally Stable Coverage for 2026 Unlike some BCBS affiliates that are reducing GLP-1 coverage, Cigna and Express Scripts appear to be maintaining Wegovy on their 2026 formularies for plans that already cover obesity medications

Each area responds differently to non-surgical versus surgical options, so assessment by a clinician should be region-specific

doi: 10.2337/diabetes.53.suppl_3.S16 106 EdelmanSVArgentoNBPettusJHirschIB

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