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Do you need assistance? Please visit our Contact Provider Relations page to find your designated Provider Relations Specialist.
Fidelis Care has noted many recent requests for GLP-1 agonists (particularly Ozempic and Mounjaro) that appear to be intended for use outside of the FDA-approved indications for the product. GLP-1 agonists are primarily approved for the treatment of type II diabetes. Inappropriate prescribing of medications like Ozempic and Mounjaro for treatment of obesity has contributed to shortages of these medications for patients with type II diabetes. Fidelis Care will actively monitor and review prior authorization (PA) requests to ensure these medications are used only per their FDA-approved indications. Requests for documentation to substantiate attestations made in the PA request process may be required. Coverage of the products with weight loss indications are not covered by all plans.
For more information, please visit our Pharmacy Services webpage here.
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Volume 10, Issue 1
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To submit prior authorization request types, use the Fidelis Care provider portal.
Members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.
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