Is Plenity Covered by Insurance?
Is Plenity Covered by Insurance?

Is Plenity Covered by Insurance?

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Plenity is a prescription weight loss medication that was approved by the FDA in 2019. The drug is designed to help adults with a BMI of 25 to 40 lose weight in conjunction with a diet and exercise program. While Plenity is gaining popularity as an effective weight loss treatment, many patients are wondering if it is covered by insurance.

What is Plenity?

Plenity is a non-stimulant, non-systemic weight loss medication that is taken orally before meals. The medication is made up of two ingredients: cellulose and citric acid. When ingested, the pill releases hydrogel particles in the stomach, which absorb water and expand, creating a feeling of fullness. This helps patients eat less and lose weight over time. Plenity is only available with a prescription from a healthcare provider.

Is Plenity Covered by Insurance?

The answer to this question varies depending on the individual’s insurance plan. Plenity is a relatively new medication and not all insurance plans may cover it. However, some insurance plans may cover the cost of Plenity, subject to certain conditions such as prior authorization and medical necessity.

If you are interested in taking Plenity and have health insurance, the best course of action is to check your insurance policy or contact your insurance provider directly to determine if the medication is covered under your plan. You may also want to speak with your healthcare provider to discuss alternative treatment options and to see if they can provide medical documentation or evidence to support the need for Plenity.

How Much Does Plenity Cost?

The cost of Plenity can vary depending on a variety of factors, including the individual’s insurance plan, the pharmacy where the medication is purchased, and any available discounts or coupons. Without insurance, the average cost of Plenity can range from $80 to $100 per month. However, some patients may be eligible for cost-saving programs that can significantly reduce the cost of the medication.

What Are the Side Effects of Plenity?

Common Side Effects of Plenity

Plenity is a non-stimulant, non-systemic weight loss medication that is made up of two ingredients: cellulose and citric acid. The medication works by creating a feeling of fullness in the stomach, which can lead to reduced food intake and weight loss. While Plenity is generally well-tolerated, some individuals may experience side effects while taking the medication. Common side effects of Plenity may include:

  • Abdominal pain or discomfort
  • Bloating
  • Constipation
  • Diarrhea
  • Gas
  • Nausea
  • Vomiting

If you experience any of these side effects while taking Plenity, it is important to speak with your healthcare provider. They may be able to recommend treatment options or suggest changes to your medication regimen to help alleviate your symptoms.

Less Common Side Effects of Plenity

In rare cases, Plenity may cause more serious side effects. While these side effects are not common, it is important to be aware of them and seek medical attention if they occur. Less common side effects of Plenity may include:

  • Difficulty breathing
  • Hives or rash
  • Swelling of the face, lips, tongue, or throat

If you experience any of these less common side effects while taking Plenity, seek medical attention immediately. These symptoms may be indicative of a serious allergic reaction or other medical emergency.

Precautions and Considerations

Before taking Plenity, it is important to discuss your medical history and any current medications you are taking with your healthcare provider. Plenity may interact with other medications or medical conditions, so it is important to disclose this information to ensure the medication is safe for you to take.

It is also important to note that Plenity may not be appropriate for everyone. The medication is only available with a prescription from a licensed healthcare provider and should only be taken under their supervision. Plenity is not recommended for individuals under the age of 18 or for individuals with a BMI under 25.

What Should I Do If Plenity is Not Covered by My Insurance?

If Plenity is not covered by your insurance plan, there are several options that may be available to help make the medication more affordable:

  • Talk to your healthcare provider about alternative weight loss treatments that may be covered by your insurance plan.
  • Look into cost-saving programs offered by the manufacturer of Plenity or through third-party organizations.
  • Consider using a discount card or coupon to lower the cost of Plenity.
  • Discuss the possibility of appealing the decision with your insurance provider, particularly if you believe that Plenity is medically necessary for your weight loss treatment.

It is important to note that even if your insurance plan does not cover Plenity, you should not attempt to obtain the medication from sources other than a licensed healthcare provider. This can be dangerous and potentially harmful to your health.

Conclusion

Plenity is a relatively new weight loss medication that can help individuals lose weight in conjunction with a diet and exercise program. While the medication may not be covered by all insurance plans, some plans may cover the cost of Plenity subject to certain conditions. Patients interested in taking Plenity should speak with their healthcare provider and insurance provider to determine if the medication is covered under their plan and to discuss alternative treatment options