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Common Prior Authorization Criteria BMI documentation: Most states require a documented BMI of 30 or greater, or 27 or greater with at least one weight-related comorbidity (hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea) Failed lifestyle modification: Typically 3 to 6 months of documented dietary counseling and physical activity recommendations that did not produce adequate weight loss Step therapy: Some states require patients to try and fail less expensive medications (phentermine, orlistat) before approving GLP-1 coverage Provider qualification: Some Medicaid plans require the prescriber to have completed training in obesity medicine

Patients often eat 30 to 50 percent fewer calories than before treatment

So, consult with your doctor if you are at high risk or have any of the symptoms

Some studies suggest HCG can help move body fat around, but the proof is not solid

Your safety is worth the small additional cost of fresh supplies

This distinction matters enormously for practices that dispense tirzepatide directly