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Patients should monitor the injection site for any immediate reactions

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Requirements: Apnea-Hypopnea Index (AHI) 15 (moderate to severe OSA) May require sleep study documentation Could become FDA-approved OSA treatment Insurance Eligibility: Beyond Medical Criteria Expected Prior Authorization Requirements Even if medically eligible, insurance may require: Step 1: Lifestyle Modification Documentation 612 months of documented diet and exercise attempts Food logs, gym records, nutritionist visits Weight tracking showing unsuccessful attempts Step 2: Trial and Failure of Less Expensive Options Try semaglutide (Wegovy) first inadequate response Try tirzepatide (Mounjaro/Zepbound) inadequate response Document why each failed (side effects, insufficient weight loss) Step 3: Medical Necessity Documentation Letter from doctor explaining why retatrutide specifically needed Documentation of obesity complications Photos, medical records, comorbidity lab values Step 4: BMI Documentation Two BMI measurements separated by 30+ days Both meeting 30 (or 27 with comorbidity) threshold Predicted Insurance Coverage (Based on Wegovy/Mounjaro Patterns) Commercial Insurance: Coverage: 4050% of plans initially Cost-sharing: $25100/month with coverage, $1,2001,500/month without Prior authorization: Required by 90%+ of plans Medicare: The GLP-1 Bridge program (July 1, 2026 December 31, 2027) covers FDA-approved obesity drugs at $50/month but retatrutide won't be approved in time

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