Cigna/Evernorth GLP-1 Coverage

Step therapy may be required — you may need to try a lower-cost medication first.

• •Formulary varies by plan; check your specific Cigna plan details.
• •Step therapy is required for most GLP-1s unless medically justified.
• •Foundayo is not currently covered but may be added in future updates.
• •Copays depend on tier placement and whether you use an in-network pharmacy.

1. 1.Use the Evernorth PA portal to submit requests and upload supporting documents.
2. 2.Confirm your medication is on the formulary using the Cigna Pharmacy Finder.
3. 3.Ask your doctor to specify the exact indication (e.g., obesity, type 2 diabetes) in the PA request.

1. 1.Appeal within 180 days with updated clinical notes and lab results.
2. 2.Request a peer-to-peer review with a Cigna medical director.
3. 3.Include a letter from a specialist if your condition is complex.

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