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What to Know About MA Plans Formularies vary: Not all MA plans have added Wegovy for CV risk reduction to their formulary (the plan's list of covered drugs) Prior authorization required: Nearly all plans require prior authorization (pre-approval from your insurer before filling the prescription) with cardiology documentation Cost sharing varies: Plans have different tiers, copays (fixed dollar amounts), and coinsurance (percentage of drug cost) 2025 out-of-pocket limits: In-network maximum is $9,350