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What You Will Pay If Anthem approves your prior authorization, your cost depends on your plan: Anthem Plans in Virginia Employer-sponsored plans: Coverage determined by your employer's plan design Individual/ACA marketplace plans: Coverage varies by metal tier and plan Medicare Advantage: Anthem Medicare plans have their own formularies (PEAK does not accept these plans) Medicaid (Anthem HealthKeepers): Weight loss medication coverage is limited (PEAK does not accept these plans) How We Help Anthem Members Benefits verification — We contact Anthem to verify your specific coverage before your first visit Prior authorization submission — We complete and submit PA requests with required documentation Step therapy navigation — We help document previous treatments to satisfy requirements Appeals when appropriate — We file appeals if we believe a denial was incorrect Alternative pathway exploration — We explore cardiovascular or sleep apnea indications if standard coverage is unavailable What If Anthem Denies Coverage
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The regulation of peripheral metabolism by gut-derived hormones
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