For Humana commercial plans, the 2026 PA criteria require five elements: BMI of 30 or higher, or BMI 27 to 29.9 with at least one weight-related comorbidity (type 2 diabetes, hypertension, dyslipidemia, OSA, CVD), documentation of a structured weight management program for at least 6 months in the past 24 months, prescriber attestation that lifestyle changes alone have been inadequate, age 18 or older, and concurrent reduced-calorie diet and physical activity
GLP-1 receptor agonists have already proven their ability to suppress appetite and promote weight loss by targeting hormonal imbalances in the brain and gut
Jeni-susan Shergold | Southampton | April 2025 Good value and helping with M.E
I was eating a lot of bread
Do not use GLP-1 if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) Do not use GLP-1 if you have had a serious allergic reaction to semaglutide or tirzepatide or any of the ingredients in GLP-1
