CommercialPrior AuthMedium impact
Coverage Reminders for Glucagon-like Peptide-1 (GLP-1) Receptor Agonists
CareFirst BlueCross BlueShield·Endocrinology, Family Medicine, Internal Medicine·Provider News
Effective date
Jul 20, 2023
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is reminding providers that GLP-1 receptor agonists (OZEMPIC, TRULICITY, RYBELSUS, VICTOZA) are only covered for type 2 diabetes treatment and may require prior authorization with provider attestation. For weight loss coverage, only FDA-approved obesity medications are covered under specific prior authorization criteria.
Action Required
Immediately: Billing team must verify prior authorization requirements for GLP-1 medications (OZEMPIC, TRULICITY, RYBELSUS, VICTOZA) before prescribing. Providers must attest medication is for type 2 diabetes treatment. Update encounter forms to remind providers of coverage restrictions. Contact CareFirst Pharmacy Services at (800) 241-3371 for prior authorization assistance.