Understanding Your Options for Weight Loss Medications
Moda Health offers a Preferred Drug Program that includes coverage for weight loss medications in Oregon. Here’s what you need to know about your options:
Tiered Coverage
Moda Health uses a tiered system for weight loss medications. The copay you pay will vary depending on the tier of medication you choose:
- Generic Medications: Most affordable
- Preferred Medications: More expensive than generic, but cheaper than brand-name
- Brand-Name Medications: Most expensive
What Medications Are Covered?
The specific medications covered by Moda Health can vary. Check your CCO’s member handbook or the Moda Health website for the most current list.
Generic vs. Brand-Name Medications
You can choose to take a brand-name medication, but you will likely pay a higher copay. Generic medications are typically just as effective and may cost less.
Coverage Details
Not all Moda Health plans cover weight loss medications. Additionally, some medications may require prior authorization or step therapy protocols. It’s important to check your plan details for specific coverage information.
Eligibility Requirements for Coverage
To be eligible for weight loss medication coverage, you may need to meet certain criteria, such as:
- Having a BMI of 30 or higher
- Having a weight-related health condition
- Demonstrating past efforts at weight loss
- Receiving approval from your doctor
Making a Decision
The best way to understand your options for weight loss medication coverage is to speak with your healthcare provider and review your Moda Health plan documents. Together, you can make informed decisions about the best treatment plan for your needs.
Additional Resources
- Moda Health Mail-Order Pharmacy: Get a 90-day supply of your medication and save money.
- Moda Health Customer Service: Ask questions about coverage, eligibility, and other issues.
- National Weight Control Registry: Find support and resources for weight loss management.