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BMI of 30 or Higher With a Qualifying Medical Condition You may also qualify with a BMI of at least 30 if you have one or more of the following: Heart failure with preserved ejection fraction Uncontrolled high blood pressure despite treatment with two antihypertensive medications Chronic kidney disease stage 3a or higher BMI of 27 or Higher With Certain Cardiometabolic Conditions Adults with a BMI of at least 27 may qualify if they have one or more of these conditions: Prediabetes Previous heart attack Previous stroke Symptomatic peripheral artery disease If you’re wondering who qualifies for Medicare GLP-1 , these BMI pathways are one of the most important parts of the eligibility review
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(More info on appeals here: If you need assistance navigating a Part D appeal, you can contact our free, national helpline at 800-333-4114
