Does Oscar Health Cover Contrave?
The verdict
Conditional on most plans
Oscar Health often does not cover Contrave. Oscar is an ACA-marketplace-focused insurer, and individual marketplace plans frequently exclude anti-obesity medications — more so than employer-sponsored plans. Contrave is FDA-approved only for chronic weight management, so an Oscar plan that carves out AOM covers it at nothing. Where Oscar does include a weight-loss benefit, BMI-based prior authorization applies. CurAccess at approximately $99/month is the practical cash route.
Coverage is set by your specific plan and formulary. This is a research summary — always confirm with Oscar Health using your member ID.
Key facts
ACA/individual marketplace plans are the most restrictive on anti-obesity drug coverage. Oscar, as primarily an ACA insurer, frequently excludes Contrave.
KFF 2025 Employer Health Benefits Survey; ACA plan benefit design guidance
There is no generic for Contrave. The CurAccess cash program at approximately $99/month is the operative cost-reduction option for uninsured or excluded patients.
Currax Pharmaceuticals CurAccess program
Contrave carries an FDA boxed warning for suicidality and neuropsychiatric events via the bupropion component — a clinical consideration regardless of coverage.
FDA Prescribing Information, naltrexone/bupropion (Contrave)
Medicare vs. commercial coverage
Whether Oscar Health 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
Oscar Health has a limited Medicare footprint. Standard Medicare Part D excludes Contrave by statute — this applies wherever Oscar offers Medicare plans. The manufacturer copay coupon also excludes Medicare members. CurAccess (~$99/month cash) is open to government-insured patients who do not bill their plan.
Commercial / Employer
Group & marketplace plans
Oscar's dominant line is the ACA/individual marketplace, where plans frequently exclude anti-obesity medications — individual plans are generally more restrictive than large employer-sponsored plans on AOM coverage. Where an Oscar ACA plan includes a weight-loss benefit, Contrave requires BMI-based prior authorization (BMI ≥30, or ≥27 with a qualifying comorbidity) plus documentation of a behavioral modification or reduced-calorie diet program. Oscar's commercial/employer footprint is limited. Medicaid coverage is not part of Oscar's business (n/a). Cells are representative composites; verify on Oscar'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.
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 coupon: as low as $0, maximum $199/month without coverage. Usable for Oscar ACA/commercial members; excludes Medicare and Medicaid.
Typical monthly copay once prior authorization is approved.
Bridge program
CurAccess (Currax): approximately $99/month with free shipping. Open to cash-paying patients. No generic for Contrave.
Reduced copay through the assistance program, where eligible.
All figures are estimates. Confirm with Oscar'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 Oscar's drug search for AOM coverage status
Go to hioscar.com and use the drug pricing/search tool to look up 'naltrexone/bupropion' or 'Contrave.' If your plan has an AOM exclusion, it will not appear as covered. Oscar ACA plans are frequently more restrictive than employer plans on weight-loss drugs.
- 2
Confirm BMI and comorbidity documentation if covered
If your Oscar plan does include a weight-loss benefit, your BMI (≥30, or ≥27 with a qualifying comorbidity) and enrollment in a behavioral/diet program must be documented before your prescriber can file the PA.
- 3
Plan for CurAccess if excluded
If Oscar's plan carves out weight-loss drugs, the Currax CurAccess program at approximately $99/month with free shipping is the most accessible option. The commercial coupon (usable for Oscar ACA/commercial members) provides up to $199/month maximum savings — CurAccess is often cheaper.
Options if Oscar Health 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 — typically the most practical route for Oscar marketplace members whose plan excludes Contrave.
Generic phentermine
DEA Schedule IV, FDA-approved for short-term (~12 weeks) weight management. Cash price approximately $40 retail (~$10 with coupon) — far cheaper than Contrave and sometimes covered where Contrave is excluded.
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
Individual ACA marketplace plans operate on tighter benefit designs than large employer-sponsored plans. Employers can negotiate or add AOM benefits as a group; individual marketplace plans set benefits for a broader pool and often exclude anti-obesity medications to manage premium costs. Oscar, as a primarily marketplace insurer, reflects this pattern. Assume Contrave is excluded on an Oscar ACA plan unless you verify otherwise.
No. There is no generic for Contrave (naltrexone/bupropion extended-release combination). The individual components — generic naltrexone and generic bupropion — exist separately but are not therapeutically equivalent to the Contrave formulation for weight management. The CurAccess cash program at approximately $99/month with free shipping is the main cost-reduction option.
Yes, for Oscar commercial and ACA members the manufacturer coupon is usable: as low as $0, maximum $199/month without coverage. It excludes Medicare and Medicaid members. However, CurAccess at approximately $99/month is often the lower out-of-pocket option — compare before filling.
Medicaid plans are not part of Oscar Health's business model. Oscar operates primarily in the ACA marketplace and limited commercial segments. If you are on Medicaid, contact your state Medicaid program directly for Contrave coverage information — state preferred drug lists vary, and some states exclude AOM entirely while others allow select agents.
Where Oscar includes a weight-loss benefit, prior authorization typically requires: BMI ≥30, or ≥27 with at least one qualifying comorbidity (hypertension, T2D, dyslipidemia, OSA, CVD), plus documentation of a behavioral modification or reduced-calorie diet program. Initial approval is typically 4 months; reauthorization at 4 months requires ≥5% body weight loss. Figures are composites; confirm on your specific Oscar plan.
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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 Oscar Health 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.