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Providers can complete a non-formulary drug form on the members behalf if they believe there is medical reason for continuance of the removed drug
The most critical contraindications include: Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2): Ozempic carries a black box warning for MTC risk
When switching might not be the right move The switch from semaglutide to tirzepatide is not automatically the right decision for everyone
Last Published 06.01.2026 Effective Date: 01.01.2026 This policy addresses the use of cranial orthotic devices for treating infants following craniosynostosis surgery or for nonsynostotic (nonfusion) deformational or positional plagiocephaly
US$ 21.44
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US$ 26.40
US$ 24.13
