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Formulary Changes Can Move Drugs to Higher Tiers or Remove Them Tier movements (especially to non-preferred or specialty tiers) significantly change member out-of-pocket cost

L-carnitines proven ability to facilitate fatty acid oxidation has driven its use in weight management and metabolism-boosting supplements

Pregnancy and breastfeeding increase B12 requirements, and pregnant women with B12 deficiency may need more frequent monitoring and potentially adjusted treatment schedules

That prior authorization almost always requires: a BMI of 30+ (or 27+ with a condition like Type 2 diabetes, high blood pressure, or high cholesterol), proof you're in a structured weight-management program, and, at the 6-month renewal, documented weight loss of at least 5%