Blue Cross Blue Shield of Michigan GLP-1 Coverage Changes Explained
Understanding the New Coverage Changes
As of August 1, 2024, Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) are altering their coverage for GLP-1 receptor agonists, which include popular weight loss medications like Saxenda® (liraglutide), Wegovy® (semaglutide), and Zepbound® (tirzepatide). These changes will affect fully insured large group commercial members, with a significant shift coming on January 1, 2025, when coverage for these medications will be discontinued altogether.
What This Means for Patients
Prior Authorization Changes (August 1, 2024 - December 31, 2024):
New prior authorization requests will be required.
Members must be 18+ with a BMI of 35 or higher.
The prescriber must have an established, in-person relationship with the member.
Participation in a documented lifestyle modification program for at least six months is required.
Enrollment in the Teladoc® Health weight management program is mandatory.
Coverage Termination (Starting January 1, 2025):
Coverage for Saxenda, Wegovy, and Zepbound will end.
Affected members will need to bear the full cost of these medications if they choose to continue using them.
Our Solution: Affordable Compounded Medications
At Restorative Compounding Pharmacy + Wellness, we understand the impact these changes may have on your health journey. That's why we offer affordable, high-quality compounded semaglutide and tirzepatide. These medications are compounded to provide the same active ingredients as the brand names, ensuring effective treatment without the high costs.
Why Choose Us?
Cost-Effective Solutions: Our compounded medications are priced competitively to ensure they remain accessible.
Personalized Care: We tailor each prescription to your specific needs, maintaining the highest standards of quality and safety.
Expert Support: Our team is here to answer any questions and help you navigate your options.
Get Started Today
If you have any questions or need more information, please give our team a call at (248) 266-5276. We are here to help you find the best solution for your weight loss needs during this transition.
By addressing these changes and offering affordable alternatives, we aim to support our community's health and wellness. Stay informed, stay healthy, and let us help you achieve your weight loss goals.
For more detailed information, refer to the official announcements from BCBSM and BCN (Link).
