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Pharmacy benefit manager

Optum Rx

UnitedHealth Group, through Optum · 6 documents cited · Read September 2026

Its 2027 lists add Foundayo, drop Saxenda to excluded, and still exclude the Zepbound KwikPen and vials.

American GLP, Publisher · Who writes this site

Optum Rx runs the drug benefit for UnitedHealthcare and for many other plans, and it publishes two main template lists, Premium and Select. The January 2027 editions are already posted, and they're the clearest look at where these drugs are heading.

On the 2027 Premium list Foundayo, Wegovy, Wegovy HD and the Zepbound auto-injector sit on tier 2 with prior authorization and a quantity limit. Saxenda, the Zepbound KwikPen and the Zepbound vials are on tier E, which the list's own legend calls excluded.

Every one of those weight-loss rows carries a "++" mark, and the legend says what it means: coverage is determined by your plan's benefit. The list tells you where a drug sits if the benefit exists. It doesn't tell you that it does.

What changes between July 2026 and January 2027?

The July 2026 Premium list carried Saxenda on tier 2 and had no Foundayo row. The January 2027 edition adds Foundayo on tier 2 and moves Saxenda to excluded, with generic liraglutide on tier 1.

The Select list for 2027 lists Foundayo, Wegovy, Wegovy HD and the Zepbound auto-injector, and doesn't list Saxenda at all.

How much will a prior authorization let you fill?

Optum's January 2027 prior-authorization list for Premium sets the limits: one tablet a day for Foundayo and the Wegovy pill, four syringes per 28 days for Wegovy, Wegovy HD and Zepbound, and five syringes per 30 days for liraglutide.

What is Weight Engage?

Weight Engage is Optum's program for employers and health plans, announced in April 2026, built with Calibrate, Omada and Virta. Optum's own product page says plans can choose to cover only the highest-risk members. If your plan uses it, the rules you meet are the plan's, not Optum's.

Every claim above, with the document behind it

These are the policies we opened and the month we opened them. Each one carries its own policy number and effective date on its face, and those are printed here as the document shows them.

The 2027 Premium Standard Formulary, "Effective January 1, 2027", lists "FOUNDAYO 2 PA; ++; QL", "WEGOVY 2 PA; ++; QL", "WEGOVY HD 2 PA; ++; QL" and the Zepbound auto-injector on tier 2, with "ZEPBOUND KWIKPEN E", the Zepbound vial solution and "SAXENDA E" on tier E, and liraglutide on tier 1.

Optum Rx, 2027 Premium Standard Formulary, effective January 2027 · source

The same list's legend: "Tier E Excluded May not be covered or need prior authorization. Lower-cost options are available and covered." and "++ Benefit design options – Coverage is determined by your prescription medication benefit plan."

Optum Rx, 2027 Premium Standard Formulary, effective January 2027 · source

The July 1, 2026 Premium Standard list carries Saxenda on tier 2 with prior authorization and has no Foundayo row.

Optum Rx, Premium Standard Formulary, July 1, 2026, effective July 2026 · source

The 2027 Select Standard Formulary, "Effective January 1, 2027", lists Foundayo, Wegovy, Wegovy HD and the Zepbound auto-injector on tier 2 with "PA; ++; QL", and liraglutide on tier 1. Saxenda isn't listed.

Optum Rx, 2027 Select Standard Formulary, effective January 2027 · source

Optum's January 2027 Premium prior-authorization list, under Weight Loss, sets quantity limits of "1 tablet per day" for Foundayo and the Wegovy tablet, "4 syringes per 28 days" for Wegovy, Wegovy HD and Zepbound, and "5 syringes per 30 days" for liraglutide.

Optum Rx, Prior Authorization – Premium Formulary Utilization Management, effective January 2027 · source

"Through partnerships with Calibrate, Omada Health and Virta Health, Weight Engage brings together benefit navigation, behavioral coaching and access to clinically appropriate care," and it "gives employers and health plans flexibility to design programs that align with the needs of their members, whether that means prioritizing high-risk individuals."

Optum newsroom, "Supporting better health through sustainable weight management", effective April 2026 · source

Optum Rx's Weight Engage page tells plan sponsors: "Plans have the option to cover the most at-risk obesity populations only."

Optum Rx, Weight Engage · source

What these documents cannot tell you

Everything above is what Optum Rx publishes as a template. The "++" on every weight-loss row is Optum saying the same thing: your plan's benefit decides.

  • Optum Rx doesn't publish its commercial prior-authorization criteria for these drugs, so the BMI and program rules your plan applies can't be read from outside it.
  • Tier and copay depend on the plan. A tier-2 listing says nothing about what you'll pay.
  • The 2027 lists take effect January 1, 2027. Until then the July 2026 editions are the ones in force, and a plan can adopt a different list entirely.
  • Weight Engage is set up by the plan, and Optum says plans can limit it to the highest-risk members.

Where this comes from

  1. Optum Rx, 2027 Premium Standard Formulary, effective January 2027 — Open the document
  2. Optum Rx, Premium Standard Formulary, July 1, 2026, effective July 2026 — Open the document
  3. Optum Rx, 2027 Select Standard Formulary, effective January 2027 — Open the document
  4. Optum Rx, Prior Authorization – Premium Formulary Utilization Management, effective January 2027 — Open the document
  5. Optum newsroom, "Supporting better health through sustainable weight management", effective April 2026 — Open the document
  6. Optum Rx, Weight Engage — Open the document

Where to go next

American GLP is not a law firm, an insurer, a government office or a clinician, and nothing here is legal or medical advice. This page describes what Optum Rx publishes. It is not affiliated with UnitedHealth Group, through Optum, and your own plan documents and your own notice govern your case. Policies carry effective dates and change — read the sources before you act.