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Zepbound (tirzepatide) for chronic weight management, OSA with obesity. Covered with PA under UnitedHealthcare.
UnitedHealthcare (largest US insurer) uses OptumRx for pharmacy benefits. PA pathways are clearly documented and well-staffed.
BMI ≥ 30 or comorbidity-based BMI ≥ 27. OSA pathway.
LillyDirect $349-499/mo.
UHC approval rate for Zepbound runs ~70-80% with thorough BMI/comorbidity documentation.
Editorial summary, not legal or medical advice. Insurance formularies change quarterly. Verify with your specific plan member services before relying on any single source. Copay ranges reflect typical commercial plans; your plan may differ.