What health conditions help qualify a patient for GLP-1 agonist coverage through insurance?
Semaglutide is approved by the FDA for treatment of obesity in patients with a body mass index(BMI) of 30 or higher or people with a BMI above 27 and at least one serious health complication because of their weight.
Health complications include but are not limited to type 2 diabetes, hypertension, CAD, GERD, sleep apnea and osteoarthritis.
Additionally, these health conditions are sometimes taken into consideration:
Use of certain antipsychotic medications for depression, bipolar disorder and psychotic disorders that result in weight gain.
Chronic arthritis due to things other thean osteoarthritis such as rheumatoid and psoriatic when joint damage from disease makes weight gain and obesity more damaging.
Chronic orthopedic issues limiting mobility such as hip or knee replacement or injuries with permanent partial impairment of function.
Chronic back or neck issues limiting mobility.
COPD/Emphysema
Coronary heart disease, Congestive heart failure, and Blood clots of the lung or legs (PE or DVT).
Prediabetes and metabolic syndrome.
Endometrial hyperplasia.
Hypothyroid disease.
History of Stroke or TIA.