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Typical Plan Coverage Criteria for OSA While FDA approval doesn't specify strict eligibility criteria, Medicare plans that cover Zepbound for OSA typically require: Clinical Criteria Diagnosis of moderate-to-severe OSA confirmed by sleep study Apnea-Hypopnea Index (AHI) 15 events/hour BMI 30 kg/m (obese) [27] Inadequate response or intolerance to PAP therapy (CPAP/BiPAP) Concurrent reduced-calorie diet and increased physical activity Required Documentation Sleep study results (polysomnography or home sleep apnea test) AHI score documented by sleep specialist Current BMI (height and weight within last 30 days) CPAP/BiPAP trial documentation showing inadequate response or intolerance Letter of Medical Necessity from prescribing physician ICD-10 Codes for OSA vs

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This allows the solution to reach room temperature, reducing the thermal shock to tissue and decreasing the viscosity of the solution for smoother injection

Consult a healthcare provider if fatigue becomes problematic

If you experience severe and persistent fatigue that interferes with your daily activities, contact your healthcare provider

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