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Anthem commercial plans (employer-sponsored): Prior authorization required for Ozempic across all commercial plans Formulary tier: mostly Tier 4 (specialty), some Tier 3 (non-preferred brand) Obesity coverage: denied unless employer purchased obesity rider (8% of employer groups as of 2025) Copay card eligibility: yes, if plan allows (most do) Appeal rights: internal appeal to Anthem, external appeal to independent review organization Anthem Medicaid (varies by state): California (Medi-Cal): Ozempic covered for diabetes with PA, obesity excluded, generic metformin required first Colorado (Health First Colorado): Ozempic covered for diabetes, requires step therapy (metformin, then sulfonylurea, then GLP-1) Nevada (Nevada Medicaid): Ozempic covered for diabetes, BMI ≥30 required, A1C ≥8.0% required Copay: $0 to $3 per prescription (state-dependent) Copay card eligibility: no (federal anti-kickback statute prohibits manufacturer copay assistance for Medicaid patients) Anthem Medicare Advantage: Ozempic coverage: yes, with prior authorization Formulary tier: Tier 4 or Tier 5 (specialty) on most plans Step therapy: required (metformin, then sulfonylurea or DPP-4 inhibitor, then GLP-1) Copay: 25% to 33% coinsurance during coverage gap (donut hole), $0 to $100 copay before gap Copay card eligibility: no (federal law prohibits for Medicare patients) The Medicaid and Medicare Advantage restrictions are statutory, not Anthem-specific