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Note: GLP-1 solutions may be available to members enrolled in a Condition Management program based on the benefits offering provided by your employer, health plan or care provider. For questions on your benefits offering, please contact your benefits administrator.

Livongo care providers can prescribe GLP-1s for members enrolled in condition care through their Condition Management program when clinically appropriate.

Our approach is to offer these medications in addition to providing guidance on lifestyle modifications. Members can expect support from nutritionists, expert coaching and other licensed professionals.

It depends on many factors:

• You must be enrolled in our programs on Diabetes Management, Hypertension Management or Weight Management, or our Diabetes Prevention Program. Your employer or plan sponsor must also have opted in to offer the condition care service.
• If you clinically qualify, you’ll receive an invitation to enroll in condition care.
• Once enrolled in condition care, your Livongo care provider will assess whether a GLP-1 medication is right for you. Typically, these medications are available to members who meet additional clinical criteria. Members must also have already shown a strong attempt at lifestyle modifications and were unsuccessful.

You’ll meet with a Livongo care provider for an initial visit. During this visit, the provider will review your medical history. They’ll also review your current and previous medications. If you meet certain criteria, the provider may suggest starting a weight loss medication. Together, you can decide if it’s right for you. Your provider will also educate you on how to use it, the expected impact, side effects and how to monitor it.

After your provider submits the prescription, it may take several weeks to get it filled. You can expect some administrative follow-up to get the medication approved. You or your provider may need to submit more documentation, prior authorizations or appeal letters if the medication is denied. You’ll be informed if the medication is denied. And your provider may suggest a different one.

You can also expect regular clinical follow-ups after the initial visit:

• Eight to 12 weeks to check early response and predict final response to medications.
• Every two to four weeks in the beginning and every two to three months thereafter for certain members and medications. The goal is to assess side effects, evaluate weight loss and adjust doses if necessary.
• Six to 12 months to evaluate weight maintenance, prevent weight gain and keep focus on diet and physical activity. For most weight-loss medications, doctors recommend ongoing use if the medication is helping you lose weight. If you stop taking a medication that’s working, you can expect to regain the weight.

Your care provider may recommend additional clinical support. An expert coach will be available to support your weight loss journey. You may also meet with a registered dietitian for personalized nutritional guidance or a behavioral health specialist.

Out-of-pocket costs for these medications are quite high. Your insurance may or may not cover the cost of certain GLP-1s. If they don’t, there are patient assistance programs that may help with costs. However, many programs expire after some time.