FAQs for Anti Obesity Medication (AOM)

Vida’s prescribing services offer anti-obesity medications (AOMs), such as Glucagon-Like Peptide 1s (GLP-1s), to eligible members in the Medical Weight Loss program. For some members, Vida also acts as Prior Authorization (PA) for coverage of AOMs by their insurance. GLP-1s are well-known not only for their effectiveness in weight loss, but with diabetes management as well. 

FAQs

Am I eligible to receive AOMs?

Eligibility is based on a combination of the following:

• Your employer or health plan’s criteria for coverage
• Program
• BMI
• Health Conditions
• Whether you are already prescribed a GLP-1
• Ethnicity

In addition to the above, Vida’s care team will determine the clinical appropriateness of prescribing AOMs on a patient by patient basis.

What is the Medical Weight Loss (MWL) program?

The Medical Weight Loss program is Vida’s science-backed treatment for obesity. Vida has created an integrated, digital program that combines behavior change and medicine to address obesity effectively. For more details, visit this article.

Why do I need to meet with a health coach or dietitian?

Vida’s MWL program, provided by your organization/health plan, is designed to offer coaching and support in managing eating habits, exercise routines, and mental health for effective weight loss and maintenance. This support is beneficial whether you're trying to lose weight without the use of medications, actively using weight loss medications or considering discontinuation of medications. If you are prescribed weight loss drugs, combining these with dietary and exercise adjustments optimizes their effectiveness. Vida's coaching aims to facilitate safe weight loss, maintain energy levels, and safeguard against excessive muscle loss. It's important to note that weight loss medications are intended for use alongside recommended dietary and exercise changes, as advised by the FDA.

Why can’t I see my regular doctor for a GLP-1 prescription?

If you are required to enroll in Vida in order to obtain prior authorization for AOM prescription coverage through your insurance, you'll keep working with your regular doctor to get your weight loss medicine and any other medicines you take.

For some members, the only way to receive GLP-1s covered by insurance is to enroll in Vida’s MWL program and receive a prescription from a Vida provider. GLP-1 medicines for weight loss are injected and may not be right for everyone. Your regular doctor may not offer a one-stop place to get medical nutrition therapy, an eating plan made for you, health coaching, a smart scale, trackers to show your progress, and treatment updates—all in one handy app. Your organization asks the obesity specialists at Vida to visit with you about your health status, weight history, desire to use a medicine, and finally, to determine you meet criteria to have the medicine covered by your health plan. Then you and the provider decide if any medicine, including a GLP-1, is the best way to start or continue your weight loss journey.

I’m in Medical Weight Loss but I'm not getting a GLP-1. I'm only getting counseling on eating, exercise, and stress management.

Vida’s Medical Weight Loss service is designed to find the best obesity treatment plan for you. Your clinician wants to see what results you start to get from eating and exercise changes, using your dietitian-designed eating plan for weight loss. You may find you don't need weight loss medicine or you can use a less-expensive medicine to safely and successfully lose weight—and keep it off.

I’m enrolled in Vida but I can’t get a GLP-1 from my doctor/pharmacy

If you are required to enroll in Vida in order to obtain prior authorization for AOM prescription coverage, Vida does not directly prescribe your weight loss medication.

Upon completing your enrollment, it may take up to 6 days to communicate this to your pharmacy in order to release your prescription. If you’ve already completed this requirement and need your medication sooner, please contact your medical doctor to re-process the prior authorization. If further proof of enrollment is needed for their process, contact support@vida.com and we’ll provide an attestation document.

Please note: Vida enrollment is only part of the criteria for prior authorization. It does not guarantee approval. If you’ve completed the steps above and are still experiencing PA rejection, please contact your healthcare provider.

If you’re part of our Medical Weight Loss program...

your Vida medical provider will assess you and suggest a personalized obesity treatment/prevention plan, which may or may not include medicine. The provider looks at your medical history, labs, conditions that make it dangerous to use certain medicines, and other factors to decide if a GLP-1 or other weight loss medicine is right for your safe and steady weight loss. They are guided by national obesity treatment clinical guidelines, FDA drug labeling, your budget, and how much you want to commit to following your personalized weight loss plan.

For some members, Vida is the only medical clinic that can prescribe GLP-1s covered by insurance. If members do not meet insurance criteria to have GLP-1s covered, but have clinical indications for a GLP-1, our providers will work with these members on whether an external referral to a doctor who can prescribe a GLP-1 would be beneficial. In these cases, the member would pay out of pocket for the medicine. Please speak to your provider for more information.

Where do I get the medicine Vida prescribes?

Fill out the form in the app asking about your preferred pharmacy or let your Vida medical provider know which pharmacy you want to use, such as your local retail pharmacy or a mail-order pharmacy. Vida electronically sends the prescription to the pharmacy of your choice. The pharmacy will let you know about any coinsurance, co-pay, or out-of-pocket costs that you’ll need to pay.

Do I get a discount on the meds because I’m enrolled with Vida?

If you are required to enroll in Vida in order to obtain prior authorization for AOM prescription coverage, enrollment in Vida is required for you to get coverage for weight loss medicine, based on your health plan rules.

Generally, enrollment in Vida does not affect medicine prices or discounts at this time.

Does Vida send me the medicine?

Vida does not send medicine. You’ll fill prescriptions at your retail or mail-order pharmacy. See your health plan card or portal for pharmacy help.

I can’t afford the med prescribed by Vida. What should I do?

Vida considers which medicines are on your insurance's drug formulary at the lowest cost to you. If Vida prescribes a drug you can’t afford, please let your Vida team know. We can connect you with patient assistant programs.

You hear about nausea, diarrhea, vomiting, muscle loss, and more with these weight loss drugs. How does Vida keep me safe?

If you have side effects while taking a medicine prescribed by your regular doctor, please reach out to your doctor.

If you’re working with our Vida Care team, you and your Vida provider will talk about possible side effects before you get a prescription, so you know what to expect. You will fill out a weekly side effects form and let your provider know during check-in calls about any problems. Vida dietitians will suggest eating tips that help people avoid or reduce side effects when using weight loss medicine. Please do not stop taking any medicine without talking to your medical provider. 

Your safety. Vida does not address medical emergencies via telehealth. If you need medical help right away, please call 911. Or go to the nearest hospital emergency room. If you are having a mental health crisis, call or text the free 988 Suicide & Crisis Lifeline at 988 or 800-273-8255.

Why is Vida making changes to my meds, such as the dose or type, or tapering me off?

Safety first! If you have side effects or your body doesn't respond to a weight loss medicine, your Vida medical provider will help you safely stop or reduce the dose. Do not stop taking the medicine without speaking with your Vida medical provider. 

If you are on a weight-loss medicine prescribed by Vida that can be safely reduced as a result of your progress, Vida will adjust it. Vida may prescribe a lower dose of the medicine or help you taper off. You’ll have ongoing behavior change support to maintain your weight.