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CVS Health subsidiary with ~22M members + integrated pharmacy benefits
Aetna is a CVS Health subsidiary covering ~22M members. Integration with CVS Caremark PBM allows tighter formulary management. GLP-1 coverage is moderate — typically covered with PA for both diabetes and weight loss indications.
Aetna covers most major GLP-1s with prior auth. CVS Caremark formulary lists Wegovy and Zepbound at tier 3 with BMI ≥30 + comorbidity PA criteria. Aetna excluded Mounjaro for weight-loss off-label use in 2025 — only diabetes indication covered.
Sample copays based on a representative Aetna plan. Your specific plan may differ.
| Product | Status | Sample copay |
|---|---|---|
| Hims & Hers Weight Loss | Not covered | — |
| Mounjaro T2D only — off-label weight-loss explicitly excluded as of 2025 | Diabetes only | $30/mo |
| Ozempic T2D diagnosis | Covered | $30/mo |
| Zepbound BMI ≥30, 3-month lifestyle program | PA required | $60/mo |
| Wegovy BMI ≥30 + comorbidity, 3-month lifestyle, age 18+ | PA required | $60/mo |
Look up your specific plan ID for plan-level accuracy. Open formulary tool
Coverage shown is a sample plan and not a guarantee for your specific Aetna plan. Always verify with member services or your benefits administrator. We update this page when formulary changes are detected — last verified May 16, 2026.
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