IU Human Resources is sharing an important update from CVS Caremark, the pharmacy benefit manager for IU’s medical plans, about changes to the coverage of weight loss medications.

Zepbound formulary change

CVS Caremark reviews and updates its list of covered medications — called the formulary — each quarter. Following a recent review, the following change was implemented:

• The brand name weight loss medication Zepbound will be removed from the formulary and no longer covered effective July 1, 2025.

Existing prior authorizations for Zepbound will be automatically transferred to Wegovy, keeping the original expiration date. CVS Caremark is also reaching out to providers on behalf of each member to request a new prescription for Wegovy or another preferred alternative.

If a provider believes that Zepbound is medically necessary, they can request a new prior authorization for continued coverage, which will be reviewed by CVS Caremark. If coverage is denied, there are self-pay options that would allow members to continue taking Zepbound, such as LillyDirect.

Coverage for weight loss medications

The removal of Zepbound reflects an update to CVS Caremark’s formulary, not the removal of coverage for all weight loss medications. The following alternatives will continue to be covered:

• Orlistat
• Qsymia
• Saxenda
• Wegovy

As a reminder to members currently taking these medications: Weight loss medications are no longer included on the high-deductible health plan preventive drug list. This means members pay the full cost of their medication until their annual deductible is met, similar to other non-preventive drugs on the formulary.

While CVS Caremark has already notified impacted members directly, IU Human Resources is sharing this update to ensure that IU medical plan members understand how these changes may affect their coverage. All employees are encouraged to review the formulary and their prescription drug coverage during Open Enrollment and throughout the year.

For questions or assistance with IU prescription drug benefits, log in to caremark.com or call CVS Caremark at 866-234-6952.

IU resources for weight management

Along with prescription drug coverage, IU offers comprehensive support and benefit coverage for weight management, including:

• Dietary counseling through your primary care provider.
• Bariatric surgery coverage.
• Health coaching, counseling and primary care through Marathon Health.
• Access to wellness programs, resources and nutritional counseling through Healthy IU.
• Discounts on wellness products and services through Anthem.

For questions about your IU benefits, contact AskHR at askhr@iu.edu or 812-856-1234.