Saxenda
Generic: liraglutide
18 MG — Pen Injector
Also known as:
liraglutide
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Coverage by Insurer
Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.
Ambetter (Centene)
29 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
Standard Gold with Atrium Health + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Silver with Atrium Health
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Gold with Atrium Health
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Complete Gold + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Everyday Bronze + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Elite Bronze + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Focused Silver with Atrium Health + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Complete Gold with Atrium Health + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Expanded Bronze + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Silver + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Gold + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Expanded Bronze with Atrium Health + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Silver with Atrium Health + Vision + Adult Dental
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Complete Gold
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Enhanced Asthma/COPD Care Silver with $0 Drug Options
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Everyday Bronze
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Elite Bronze
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Clear Silver with $0 Insulin Options
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Expanded Bronze
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Silver
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Standard Gold
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Everyday Bronze with Atrium Health
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Elite Bronze with Atrium Health
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Focused Silver with Atrium Health
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
|
Complete Gold with Atrium Health
via liraglutide |
Tier 2 - Generic | — | — | ✓ | QL |
Medicare Part D
12 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
PruittHealth Premier (HMO I-SNP)
via liraglutide |
Tier 1 - Preferred Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Liberty Medicare Dual Plan (HMO D-SNP)
via liraglutide |
Tier 1 - Preferred Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP)
via liraglutide |
Tier 1 - Preferred Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Longevity Health Plan (HMO I-SNP)
via liraglutide |
Tier 1 - Preferred Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
NHC Advantage (HMO I-SNP)
via liraglutide |
Tier 1 - Preferred Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Senior Care (HMO I-SNP)
via liraglutide |
Tier 2 - Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Liberty Medicare Advantage (HMO C-SNP)
via liraglutide |
Tier 2 - Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Troy Medicare (HMO)
via liraglutide |
Tier 2 - Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP)
via liraglutide |
Tier 2 - Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
AmeriHealth Caritas VIP Care (HMO D-SNP)
via liraglutide |
Tier 2 - Generic | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Wellcare Dual Reserve (HMO-POS D-SNP)
via liraglutide |
Tier 3 - Preferred Brand | ✓ | — | ✓ 9 per 30 days | PA | QL |
|
Wellcare Giveback Open (PPO)
via liraglutide |
Tier 3 - Preferred Brand | ✓ | — | ✓ 9 per 30 days | PA | QL |
NC Medicaid PDL
3 plans| Plan | Tier | Prior Auth | Step Therapy | Quantity Limit | Restrictions |
|---|---|---|---|---|---|
|
NC Medicaid Preferred Drug List 2026
via Victoza Victoza is the same molecule (liraglutide) but is indicated for type 2 diabetes, while Saxenda is for weight management. Coverage may differ by indication. |
Preferred | ✓ | ✓ | — | PA | ST |
| NC Medicaid Preferred Drug List 2026 | Non-Preferred | ✓ | — | — | PA |
|
NC Medicaid Preferred Drug List 2026
via liraglutide |
Non-Preferred | ✓ | ✓ | — | PA | ST |