Does Aetna Cover Contrave?
The verdict
Conditional on most plans
Whether Aetna covers Contrave depends on your plan's weight-loss drug benefit, administered by CVS Caremark. Contrave is FDA-approved only for chronic weight management; Aetna plans with an anti-obesity carve-out exclude it, and standard Medicare Part D excludes it by statute. Where covered, CVS Caremark's BMI-based prior authorization template applies: BMI ≥30, or ≥27 with a qualifying comorbidity, plus a documented behavioral program. CurAccess at approximately $99/month is the realistic cash route.
Coverage is set by your specific plan and formulary. This is a research summary — always confirm with Aetna using your member ID.
Key facts
CVS Caremark's AOM prior auth template for Contrave requires BMI ≥30 (or ≥27 with comorbidity) plus a documented diet or behavioral program — but only applies if the employer plan has a weight-loss benefit.
CVS Caremark formulary management guidelines
Standard Medicare Part D excludes weight-loss agents including Contrave by federal statute. No plan-specific exception exists; the Bridge covers only injectable weight-loss GLP-1s.
CMS.gov, Medicare Part D statutory exclusions
CurAccess (Currax) offers Contrave at approximately $99/month with free shipping, open to cash-paying patients including government-insured who do not bill their plan.
Currax Pharmaceuticals CurAccess program
Medicare vs. commercial coverage
Whether Aetna covers Contrave depends heavily on which kind of plan you hold. They follow completely different rules — here's each one, side by side.
Medicare
Part D & Advantage plans
Standard Medicare Part D statutorily excludes Contrave as a weight-loss agent — this applies to Aetna Medicare plans as well. The 2026 GLP-1 Bridge does not cover Contrave (Bridge covers Wegovy, Foundayo, and Zepbound KwikPen only — injectable weight-loss GLP-1s, not oral AOMs). The manufacturer copay coupon excludes Medicare members. CurAccess (~$99/month cash) is available to government-insured patients who do not bill their plan.
Commercial / Employer
Group & marketplace plans
Aetna commercial/employer plans cover Contrave only where the employer has purchased a weight-loss benefit; many have not. ACA/individual Aetna plans often exclude anti-obesity medications. Where covered, CVS Caremark's Contrave/AOM prior authorization requires BMI ≥30 (or ≥27 with a qualifying comorbidity) plus a documented behavioral modification or diet program. Aetna Better Health (Medicaid, state-dependent) may cover Contrave where the state PDL allows, but AOM coverage is often excluded at the state level. Verify on CVS Caremark or Aetna's drug search.
The 5 boxes you must tick to get approved
Commercial plans that will consider Contrave require prior authorization. Check off what applies to you to see how close you are — this is a guide, not a guarantee of approval.
0 of 5 requirements selected. Meet all 5 and you have a documented case for approval. Missing any one is the most common reason requests are denied.
Your cost, three ways
What Contrave actually costs you swings enormously depending on how it's covered. Here's the realistic range.
Paying cash
Retail approximately $619 (Drugs.com) to $753 (SingleCare) per month.
List price with no coverage — before any manufacturer savings card.
With coverage
Commercial copay coupon: as low as $0, maximum $199/month without coverage. Excludes Medicare, Medicaid, TRICARE.
Typical monthly copay once prior authorization is approved.
Bridge program
CurAccess (Currax): approximately $99/month with free shipping. Open to cash-paying patients including government-insured who do not bill their plan. No generic for Contrave.
Reduced copay through the assistance program, where eligible.
Estimates only. Confirm with CVS Caremark or Aetna's drug pricing tool.
Check YOUR exact coverage in 3 steps
General answers only get you so far. Here's how to confirm your own plan's decision in a few minutes.
- 1
Confirm your Aetna plan covers weight-loss medications
Search for 'naltrexone/bupropion' or 'Contrave' on Aetna.com or CVS Caremark's formulary tool. If the plan has an anti-obesity exclusion, the drug will not be covered — skip to CurAccess.
- 2
Document BMI and qualifying comorbidity
Have your BMI documented (≥30, or ≥27 with hypertension, T2D, dyslipidemia, OSA, or CVD) and confirm enrollment in a behavioral modification or diet program — both required for CVS Caremark's AOM prior auth template.
- 3
Have your prescriber submit the PA to CVS Caremark
Your doctor submits Aetna's BMI-based PA through CVS Caremark. Initial approval is typically 4 months; reauth requires ≥5% weight loss. If denied due to exclusion, ask about CurAccess or alternative weight-loss options.
Options if Aetna won't cover Contrave
A denial isn't the end of the road. These are the paths people commonly explore next — discuss any of them with your prescriber.
CurAccess (Currax direct program)
Approximately $99/month cash with free shipping — the most reliable route for patients without weight-loss coverage, including Medicare members.
Qsymia (phentermine/topiramate ER)
Another oral AOM; same exclusion logic applies. Generic phentermine/topiramate ER available 2025 (Teva). REMS-restricted with teratogenicity warning.
Compounded semaglutide or tirzepatide (via Curex)
Injectable GLP-1-based weight-management option requiring no insurance or prior auth. Not the same medication as Contrave. From $49/month.
These options are listed for information only — your own clinician decides what is appropriate for you.
Frequently Asked Questions
CVS Caremark (Aetna's PBM) uses a standardized AOM prior authorization template for Contrave and Qsymia: BMI ≥30, or ≥27 with a comorbidity, plus a documented behavioral or diet program. This template is specific to CVS's AOM management pathway and differs from, for example, OptumRx's process. Before filing, confirm your employer plan includes a weight-loss benefit — CVS Caremark cannot approve what a plan has excluded.
No. Medicare Part D statutorily excludes weight-loss agents including Contrave — this applies to all Medicare plans, including Aetna's. The 2026 GLP-1 Bridge does not cover oral AOMs. The manufacturer copay coupon also excludes Medicare members. CurAccess at approximately $99/month cash is open to Medicare patients who choose not to bill their plan.
An anti-obesity medication carve-out is an employer-elected exclusion that removes weight-loss drugs from the plan's covered benefits. Because Contrave is FDA-approved only for weight management, any Aetna plan with this carve-out will not cover it — no PA, no appeal, and no clinical documentation will change a plan-level benefit exclusion. Checking this before filing a PA saves time.
The manufacturer commercial copay coupon (as low as $0, maximum $199/month without coverage) is usable for Aetna commercial and ACA members. It explicitly excludes Medicare, Medicaid, and TRICARE. CurAccess, the cash program at approximately $99/month, is separate from the coupon and is open to all cash-paying patients including government-insured members who do not bill their plan.
Aetna Better Health administers Medicaid in several states; AOM coverage on state Medicaid is state-determined. Some states exclude anti-obesity medications entirely; others may allow certain lower-cost oral agents. There is no uniform Aetna Medicaid answer — check your specific state's Medicaid preferred drug list or call Aetna Better Health for your state.
Related Articles
Does UnitedHealthcare Cover Dupixent? 2026 Guide
UnitedHealthcare covers Dupixent on the specialty tier with PA via OptumRx, but blocks concurrent JAK inhibitors or biologics. 2026 Part D cap: $2,100.
Read moreDoes Humana Cover Adderall? 2026 Medicare Part D Guide | Curex
Humana covers Adderall via Medicare Part D — generic preferred, brand may need PA. Age and CV review apply for older adults. Verify on Part D drug list.
Read moreDoes Regence Cover Ozempic? 2026 Coverage Guide | Curex
Regence covers Ozempic for T2D with PA — not weight loss. Serves OR, WA, ID, UT. NovoCare $25/mo for commercial T2D patients. Verify on Regence formulary.
Read moreDoes Medica Cover Ozempic? 2026 Coverage Guide | Curex
Medica covers Ozempic for type 2 diabetes with prior auth — not weight loss. MN nonprofit plan; MN Medicaid AOM context. Verify tier on Medica drug lookup.
Read moreDoes Anthem Cover Contrave (Naltrexone/Bupropion)? 2026 | Curex
Anthem often excludes Contrave via AOM carve-outs; Medicare bars it by law. Where covered, BMI prior auth applies. CurAccess ~$99/mo is the cash route.
Read moreDoes Anthem Cover Viagra? 2026 Honest Answer | Curex
Anthem does not cover Viagra for ED — CarelonRx lifestyle exclusion; Medicare Part D barred by statute. Covered path: sildenafil (Revatio) for PAH only.
Read moreA weight-loss alternative that skips insurance and prior auth
You just saw how tangled Contrave coverage can get — auto-rejections, prior authorization, and high cash prices. Curex compounded semaglutide: $199/month equivalent prepaid annually ($2,388 upfront), or $299/month paid monthly. Compounded tirzepatide: $299/month equivalent prepaid annually ($3,588 upfront), or $399/month paid monthly. Commercial rates as of 2026-10-12; compounded products are not FDA-approved and clinical eligibility must be assessed. Curex compounded medications are not the same as Contrave. No insurance or prior authorization required; prescription required, subject to provider review.
- Medication + free shipping
- 24/7 provider access
- Medical intake & prescription review
Compounded semaglutide and tirzepatide are not the same medications as Contrave and are not branded or FDA-approved products. Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy.
This content is for informational purposes only and does not constitute medical, financial, or insurance advice. Coverage rules, prior-authorization criteria, and copay amounts change frequently and vary by plan, formulary tier, and effective date — always verify current benefits directly with Aetna before making any decision. Consult a licensed healthcare provider and your plan administrator for guidance specific to your situation. Curex offers compounded semaglutide and tirzepatide, which are not the same medications as Contrave and are not branded or FDA-approved products; prescription required, subject to provider review. Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy.