Does Anthem Cover Contrave?
The verdict
Conditional on most plans
Whether Anthem covers Contrave depends on whether your specific plan includes a weight-loss drug benefit. Contrave is FDA-approved only for chronic weight management; Anthem plans (and employer groups) that carve out anti-obesity medications exclude it entirely, and standard Medicare Part D excludes it by statute. Where Anthem does cover it, expect BMI-based prior authorization (BMI ≥30, or ≥27 with comorbidity, plus a documented behavioral program). For most cash-paying readers, CurAccess at approximately $99/month is the practical answer.
Coverage is set by your specific plan and formulary. This is a research summary — always confirm with Anthem using your member ID.
Key facts
Contrave is FDA-approved only for chronic weight management — not diabetes. Any plan that excludes anti-obesity medications will not cover it regardless of clinical need.
FDA Prescribing Information, naltrexone/bupropion (Contrave)
Standard Medicare Part D excludes weight-loss agents by statute (Medicare Modernization Act). The 2026 GLP-1 Bridge covers only specified injectable weight-loss GLP-1s — not Contrave.
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 Anthem 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 is written into law (Medicare Modernization Act) and is not plan-specific. The 2026 Medicare GLP-1 Bridge ($50/month, July 1 – Dec 31, 2027) does NOT cover Contrave; the Bridge covers only specified weight-loss injectable GLP-1s (Wegovy, Foundayo, Zepbound KwikPen), not oral anti-obesity drugs. The manufacturer copay coupon explicitly excludes Medicare members. CurAccess (~$99/month cash) is open to government-insured patients who do not bill their plan.
Commercial / Employer
Group & marketplace plans
Anthem commercial/employer plans cover Contrave only where the employer group has purchased a weight-loss drug benefit — many have not. ACA/individual Anthem plans often exclude anti-obesity medications. Where covered, Anthem requires BMI-based prior authorization (BMI ≥30, or ≥27 with at least one comorbidity such as hypertension, T2D, dyslipidemia, OSA, or CVD), plus a documented concurrent behavioral modification and reduced-calorie diet program. Anthem Medicaid (Elevance multi-state) is state-dependent — some states exclude anti-obesity drugs, others cover less expensive oral agents. Coverage varies widely; verify on Anthem's member drug-search tool.
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.
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, no more than $199/month without coverage. Excludes Medicare, Medicaid, and TRICARE. Where Anthem covers Contrave, copay depends on plan tier.
Typical monthly copay once prior authorization is approved.
Bridge program
CurAccess (Currax): approximately $99/month with free shipping — open to cash-paying patients including those with government insurance who do not bill their plan. No generic for Contrave.
Reduced copay through the assistance program, where eligible.
All figures are estimates. Actual cost varies by plan tier, pharmacy, and deductible status. Confirm with Anthem'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
Check whether your Anthem plan covers weight-loss drugs at all
Log in at Anthem.com and search your drug list for 'naltrexone/bupropion' or 'Contrave.' If the plan has an anti-obesity exclusion, Contrave will not appear as covered regardless of BMI or clinical criteria. This step comes before any PA documentation.
- 2
Verify BMI and comorbidity documentation with your provider
If your plan does cover weight-loss drugs, confirm your BMI (≥30, or ≥27 with a qualifying comorbidity) is documented and that you are enrolled in or can document a behavioral modification program. These are the PA gating criteria.
- 3
Have your prescriber submit the prior authorization to Anthem
Your doctor submits the BMI-based PA to Anthem. Initial approval is typically 4 months; reauthorization at the 4-month mark requires at least 5% weight loss. If denied due to a plan-level exclusion, ask about the CurAccess cash program or alternative weight-loss medications.
Options if Anthem 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 with free shipping — the most practical cash route for patients without coverage, including Medicare/Medicaid members who cannot use the copay coupon.
Qsymia (phentermine/topiramate ER)
Another oral anti-obesity agent. Generic phentermine/topiramate ER launched 2025 (Teva). Follows the same AOM-exclusion logic but has REMS restrictions and a teratogenicity warning.
Compounded semaglutide or tirzepatide (via Curex)
An injectable GLP-1-based weight-management option that does not require insurance or prior authorization. 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
Only if your Anthem plan has a weight-loss drug benefit — many employer groups and ACA plans do not. Contrave is FDA-approved for chronic weight management, so any plan with an anti-obesity carve-out excludes it entirely. Standard Medicare Part D excludes Contrave by statute. The first step is confirming your plan covers weight-loss medications at all before pursuing a prior authorization.
Yes. Medicare Part D statutorily excludes weight-loss agents, including Contrave — this is federal law, not a plan-by-plan decision. The 2026 Medicare GLP-1 Bridge does not change this; the Bridge covers only specified injectable weight-loss GLP-1s. For Anthem Medicare members, CurAccess at approximately $99/month is the operative cash option since the manufacturer coupon also excludes Medicare.
Where Anthem's plan includes a weight-loss benefit, prior authorization typically requires BMI ≥30, or BMI ≥27 with at least one qualifying comorbidity (hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, or cardiovascular disease). Documentation of a behavioral modification or reduced-calorie diet program is also required. Figures are composites; verify exact requirements on your Anthem plan.
Anthem administers Medicaid plans in multiple states under Elevance Health. Anti-obesity drug coverage on Medicaid is state-determined; some states exclude AOM entirely, while others may cover lower-cost oral agents. There is no uniform answer across Elevance's multi-state Medicaid footprint — check your specific state's Medicaid preferred drug list or contact your Anthem Medicaid plan directly.
CurAccess is Currax Pharmaceuticals' direct cash program for Contrave: approximately $99/month with free shipping. It is open to cash-paying patients, including those with government insurance (Medicare, Medicaid) who do not bill their plan. The manufacturer copay coupon is separate and excludes government-insured patients. CurAccess is available regardless of whether insurance covers Contrave.
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Read moreA weight-loss alternative that skips insurance and prior auth
Curex offers compounded semaglutide from $49/month and compounded tirzepatide from $149/month at getcurex.com/cl/glp — no insurance and no prior authorization required. This is compounded semaglutide/tirzepatide and is not the same medication as Contrave. Compounded medications have not been approved by the FDA and the FDA has not evaluated their safety or efficacy. 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 Anthem 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.