Zepbound for OSA Medicare primary
I’m a retired civil servant in NY, I’m on Medicare since I’m on SSDI and have NYSHIP as secondary. Caremark/CVS manages both prescription plans. I was denied Zepbound for weight loss and denied 4 more times on appeals. When I found out Medicare started covering Zepbound, I talked to my PP and referred to a Pulmonologist. I’m almost done with testing and waiting on sleep test. My question is if I’m diagnosed with OSA and Dr prescribes Zepbound to treat this that is covered by Medicare, can Caremark/CVS still deny and push Wegovy which isn’t authorized by FDA for OSA. Thanks for your thoughts on this.
Posted May 5, 2025, 2:01 AM UTC
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