Adipex Insurance Coverage

adipex medicaid

Adipex has become one of the most highly sough-after, and one of the most often prescribed, diet pills on the market today. To ensure that you are the right type of person for this prescription, your doctor will need to see you in his or her office to evaluate your health and your weight. If you are obese, or you are overweight and your health is suffering as a result, your doctor might tell you that taking Adipex for a short span of time is the way to get on track towards a slimmer body and improved physical well-being.

But, if you are given a prescription for these top diet pills, how much will it cost you? Will you need to pay for it all yourself, or is there Adipex insurance coverage that can make it easier on your wallet? Check out the information below to learn more.

Considering the Cost of an Adipex Prescription

Many dieters who receive a prescription would like to know if there is Adipex insurance coverage when it comes time to fill it, or will the whole cost have to be made out of pocket.

Though this medication is not meant for the long term, and will be used only over a period of several weeks, it is still not considered to be inexpensive and would therefore be prohibitive for many people if it is not included among the covered items on their policies.

Will Insurance Cover the Cost of Adipex Prescriptions?

Though there are some insurers who do include diet pills on their drug plans, Adipex insurance coverage is often restricted.

This brand name version of Phentermine is an appetite suppressant meant for obesity treatment. As some weight-related treatments are covered by health policies – such as for morbid obesity, diabetes, high cholesterol, or a risk of hypertension – there is a chance that the pills could be covered.

Before actually making the purchase, contact your insurer to discuss your plan and find out precisely what it covers. If the brand name is not included, then the generic alternative might be.

What About Medicaid?

If you have Medicaid, then it will depend on your state and the specific plan you have. Though no state requires this plan to cover weight loss medications, some of them have opted to provide it for certain patients who have specific health needs.

27 American states do not have any Adipex insurance coverage through Medicaid. These include:

  • Massachusetts
  • Colorado
  • Arizona
  • Mississippi
  • North Carolina
  • Pennsylvania
  • Maryland
  • Washington
  • Tennessee
  • Delaware
  • Arkansas
  • Texas
  • Connecticut
  • Ohio
  • Nevada
  • Utah
  • Montana
  • West Virginia
  • Illinois
  • Wyoming
  • Kentucky
  • Indiana
  • New Mexico
  • Oklahoma
  • Maine
  • Alaska
  • Washington D.C.

Some states that may include some Adipex insurance coverage on their Medicaid in certain specific conditions include:

  • Michigan
  • Missouri
  • Idaho
  • Oregon
  • Nebraska
  • Minnesota
  • New York

There are many conditions that need to be met in order to qualify for coverage within those states. For example, in Minnesota, Type II diabetes must also be present in the obese individual. In Missouri, dyslipidemia is a requirement along with obesity, which may cause the pills to be covered.

In Oregon, there is Adipex insurance coverage through Medicaid for obesity threatening the health of the patient.

The remaining 18 states have Medicaid Adipex insurance coverage as long as certain basic criteria are met in order to diagnose the individual as obese and to ensure that the drug can be used safely by them.

What About Medicare for Adipex Insurance Coverage?

Perhaps Medicare will help you pay for your Adipex prescription? Don’t get your hopes up. As you know, Medicare Part A and Medicare Part B do not cover prescriptions, so you need to get Part D to receive that type of coverage.

According to The Hill, Medicare Part D actually prohibits coverage of diet pills, even if they are FDA-approved. Also, according to the Medicare.org website, Part D Prescription Drug Plans, also known as PDPs, will not typically provide any coverage for medications that are used for weight loss.

It is important to keep in mind, though, that Part D coverage may come from a third-party insurance provider that might be willing to provide some level of help to cover the cost of these types of prescriptions, so check for yourself if you have this type of plan in place.

Adipex Insurance Coverage Might Be Disappointing

Before opting to get a prescription for Adipex, determine how much it will cost you out-of-pocket. You might be better off going with a more affordable diet pill that you can purchase over-the-counter instead. A great example is FENFAST 375, but you can talk to your doctor about what your best options would be. You might be surprised by how many other options are available for you to consider when Adipex is unaffordable because it isn’t covered by insurance.

{ 2 comments… read them below or add one }

brock August 24, 2014 at 8:10 AM

How much is adipex with michigan medicaid insurance coverage.

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Jennifer hampton April 25, 2017 at 3:25 PM

How much does it cost with michigan medicaid insurance?

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