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Prior authorization criteria in detail Cigna's Zepbound PA criteria via Express Scripts (current as of May 2026): BMI ≥ 30, or BMI ≥ 27 with at least one obesity-related comorbidity Age ≥ 18 Documented prior weight-management intervention (typically 6 months of lifestyle modification) Step therapy completed or exception granted Prescriber attestation of intent to combine with continued lifestyle counseling No concurrent use of another GLP-1 receptor agonist Reauthorization at 6 months requires documented weight loss of at least 5% from baseline The 5% reauthorization threshold is plan-specific
