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the provider does not need to be Medicare-enrolled) Receive prior authorization from your Part D plan, which is the standard pre-approval process Medicare uses for covered medications Patients who initiated GLP-1 therapy before the Bridge Program launched can still qualify if they met the BMI criteria at the time therapy was initiated, even if their current BMI is now lower (a common situation for patients who have already achieved meaningful weight loss)
This is why a benefits representative may tell you the drug is "covered" and the claim still rejects
How Long Should You Take Tirzepatide
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