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[9] To get Wegovy approved, you must meet all of: A 6-month weight-management program first — documented behavioral modification, reduced-calorie diet, and increased physical activity with continuing follow-up (this is the real hurdle, not another drug) BMI ≥30 , or ≥27 with a weight-related condition (hypertension, type 2 diabetes, or dyslipidemia) Age 18+ (ages 12–17 require the injection plus the comprehensive program) No drug step therapy: CVS Caremark's standard Wegovy policy does not require trying and failing another weight-loss drug first (some individual employer plans add it — check yours) Wegovy also has separate coverage pathways for cardiovascular risk reduction (established heart disease + BMI ≥27, if you don't have type 2 diabetes) and MASH liver disease