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To qualify, a person must be enrolled in a Medicare Part D plan and meet one of three clinical criteriaassessed at the time you first started GLP-1 therapy, not at the time you apply: BMI of 35 or higher (no additional diagnosis required) BMI of 30 or higher, plus a diagnosis of heart failure with preserved ejection fraction, uncontrolled hypertension on two or more blood pressure medications, or chronic kidney disease stage 3a or higher BMI of 27 or higher, plus a diagnosis of pre-diabetes, previous heart attack, previous stroke, or symptomatic peripheral artery disease Your provider submits a prior authorization request attesting you meet the criteriayou dont need to opt in or take any action yourself

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