Coverage and new Special Authorization requirements for Chronic Weight Management products

Wegovy, a prescription drug that contains the same active ingredient as Ozempic (semaglutide), recently became available in Canada, prompting inquiries regarding coverage. While these drugs have the same active ingredient, Ozempic has been approved by Health Canada for treatment of Type II diabetes, while Wegovy has been approved for treatment of chronic weight management.

Personal health plans will not cover Wegovy. However, effective June 1, 2024, it will be added with Special Authorization (SA) requirements to some Group plans depending on an employer’s coverage. To check your drug coverage, visit the Group member portal or SK Blue Cross: Group app on or after June 1, 2024.

In addition to Wegovy, SA requirements will be added for three existing chronic weight management drugs: Xenical, Contrave and Saxenda. If a Group plan includes coverage for these products, new claimants will need to submit an SA request for approval. If a member is already receiving coverage for any these three drugs, they will not have to fill out a form and will not have any interruption in benefits.

To submit an SA request, new claimants will need to complete the Chronic Weight Management Prescription Drug Special Authorization Form and submit to our office using one of the following options:

Email: providerrelations@sk.bluecross.ca

In-person: 516 2nd Avenue North, Saskatoon or 100-1870 Albert Street, Regina

Fax: 306.667.5860

Mail: Attn: Claims Department
Saskatchewan Blue Cross
516 2nd Avenue North, PO Box 4030
Saskatoon SK S7K 3T2

Once a request is received and reviewed, members will receive confirmation of coverage or denial via letter, issued within five business days of our receipt of confirmation.