Coverage checklist: ask about your exact plan.

Work through the question

Keep the answers with your notes.

• Start with the medicine list.

  Ask whether the named product is on your plan’s covered medicine list. That list is often called a formulary. Ask about the proposed form too.

• Ask what approval the insurer needs.

  Prior authorization is the plan’s advance agreement to pay before it handles a prescription under that approval. Ask who submits the request and how you will hear the answer.

• Keep the reason for treatment in view.

  Medicare’s regular drug benefit, as of September 26, 2026, leaves out medicine used for weight loss; another accepted medical use may qualify for coverage.

  Eligibility for coverage is no promise of payment; the medicine list and prior authorization rules of the plan still matter.

  Use the Medicare checklist if that is your coverage.

• Ask about each bill separately.

  Ask whether the visit, medicine, tests and follow-up are handled through insurance. Then ask your expected share for each part.

• Ask your state health plan directly.

  As of September 26, 2026, Medicaid coverage of weight-loss medicines varies by state and often requires prior authorization where it is offered.

  Medicaid is public health coverage with state rules. Ask your own plan about its present policy. Keep the reply with your cost notes.