Does Kaiser cover Ozempic for weight loss: Debunking Myths

Kaiser Permanente has a medical group of physicians, caregivers, and specialists that work collectively towards providing the best possible medical care to its members. It offers wide coverage to all the medical needs a member might require under their health insurance plan. There has been a lot of debate about whether Kaiser covers Ozempic (Injectable semaglutide) for weight loss; we shall discuss the same in this article. Let’s take a look.

Does Kaiser cover for Ozempic for weight loss

Does Kaiser Cover Ozempic For Weight Loss?

The answer is not straightforward and needs a clear understanding.

Kaiser does not cover Ozempic (Injectable semaglutide) for weight loss, as it has not been approved for weight loss in people without diabetes. However, Ozempic is covered under the prescription drug benefit for weight loss ONLY for Kaiser Northwest members, with coverage for medications used to treat weight loss. Others pay member cash price.

The Food and Drug Administration (FDA) has not approved Ozempic as a weight loss drug and has been only approved to treat Type 2 diabetes. The drug also reduces certain cardiovascular risks in people with Type 2 diabetes.

In case of questions, always seek help from your doctor or a healthcare provider well-versed with Kaiser. You may also seek help from the insurance group to get what you need.

When Does Kaiser Cover Ozempic?

Kaiser covers Ozempic as a prescription drug only under the below-mentioned criteria. Check them out:

  1. Diagnosis of Type 2 Diabetes Mellitus.
  2. No personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
  3. On metformin or allergy or intolerance* to metformin.

The patient is also required to meet one of the following categories:

  • Suffering from atherosclerotic cardiovascular disease (ASCVD) and intolerance or contraindication to an SGLT-2 inhibitor (for example, Jardiance)
  • Inadequate glycemic response on basal and bolus insulin despite high dose requirements (total daily insulin dose of 1.5 units per kilogram of body weight or more OR greater than 200 units).
  • Experienced recurrent nocturnal hypoglycemia with basal insulin defined as three or more episodes of nocturnal hypoglycemia (blood glucose less than 70 mg/dL) over the preceding 30 days that persists despite basal insulin dose reduction (including a decrease in NPH dose and subsequent switch to and dose adjustment of insulin glargine).

How Does Ozempic Work Towards Weight Loss?

The usage of Ozempic is directed towards helping regulate blood glucose levels, and weight loss is just a side effect. As you consume food, GLP-1 is released by intestinal cells, decreasing the rate at which food leaves your stomach and causing you to feel fuller. The brain controls your appetite, and some hunger hormones are also thought to be directly impacted by GLP-1.

Ozempic helps reduce calorie intake by simulating the effects of GLP-1 to help control appetite and make you feel full, eventually leading to weight loss.

Many celebrities and influencers have started to consume Ozempic as an aid to look thinner on the internet, which creates an unhealthy beauty standard for the millions of people around the world who follow them.

Similarity And Differences Between Ozempic and Wegovy

Many people have heard about Wegovy when discussing Ozempic. Famous people like Elon Musk have used Wegovy to reduce weight. Here are the similarities and differences between them:

OzempicWegovy
It is an Injectible Semiglutide.It is an Injectible Semiglutide.
It is not FDA-approved for weight loss. It is only FDA-approved for diabetes. It is FDA approved for weight loss.
It has less quantity of semaglutide than Wegovy.It has more quantity of semaglutide than Ozempic.

Conclusion

We hope this article helped our readers to understand the coverage of Ozempic for weight loss by Kaiser. If you are looking for more such informational content on Kaiser Permanente, stay connected with us.

Also, Read: Is Lapiplasty bunion surgery covered by insurance?

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