Innovative Weight Loss Coverage: MyWeighForward Offers a New Path

For individuals who have struggled with weight loss and sought solutions, the wait is over. The new MyWeighForward plans from Avera Health Plans offer innovative coverage for weight loss medications, including options that may have been out of reach in the past.

Your health is your greatest asset, and you can help protect it by losing weight.

It’s no secret that carrying extra weight can affect more than just how you feel day to day. Being overweight or obese can lead to a host of health problems, including heart disease and diabetes. Studies have shown that even moderate weight loss can lead to significant reductions in the risks associated with chronic conditions like type 2 diabetes and cardiovascular disease.

But for many people, losing weight is about more than the physical—it’s about reclaiming their lives. Weight loss is linked to improvements in energy, mood and overall quality of life.

Tailored Health Coaching

Losing weight can be difficult to navigate alone, which is why MyWeighForward provides multiple coaching programs to provide support and guidance:

• LiveNOW: A wellness program offered through Avera Health Plans
• Virta: A specialized program for individuals with obesity, pre-diabetes or type 2 diabetes

Having a coach who understands your goals and can guide you with practical, effective strategies is key to long-term success. Staying engaged is important, so participants in MyWeighForward are required to complete at least one coaching session per month. These programs aren’t about quick fixes—they’re about creating lasting change through accountable, measurable progress.

Why Medication Coverage Matters

Medications such as GLP-1 agonists have become a game-changer in the world of weight management. These drugs work by regulating appetite, helping individuals feel full longer and controlling cravings. Research has found possible benefits to these drugs including decreased risk of heart disease, stroke and kidney disease. However, they can be expensive, which makes insurance coverage critical for many people.

MyWeighForward offers coverage for weight loss medications for those who meet specific clinical criteria, are prescribed them by a provider and are willing to participate in health coaching.

Enrollees may be prescribed weight loss medications, but coverage of GLP-1 prescriptions is not guaranteed. If other weight loss medications are unsuccessful, GLP-1 medications will be considered, but only for patients who meet clinical criteria.

Who Can Enroll in MyWeighForward?

MyWeighForward may be an option to you if you are purchasing individual or family coverage (during open enrollment or a special enrollment period) or if your employer offers it to you as an option through Avera Health Plans group coverage. MyWeighForward plans are available to residents of Brown, Minnehaha and Lincoln counties in South Dakota. To qualify for weight loss drug coverage under MyWeighForward, you must:

• Be 18 years or older
• Be willing to enroll in an Avera Health Plans-approved weight loss program
• Have a body mass index (BMI) of 30 or higher
• Or, have a BMI of 27 or greater with at least one of the following health conditions:
  • Hypertension (high blood pressure)
  • Hyperlipidemia (high cholesterol)
  • Obstructive sleep apnea
  • Cardiovascular disease
  • Type 2 diabetes

These conditions, coupled with a high BMI, often contribute to greater health risks. 

A Broad Range of Benefits

In addition to weight loss features, MyWeighForward offers a full suite of health services for members and their dependents, including:

• Preventive, specialty and emergent care
• Fitness center membership incentives
• Access to the Avera Health network of providers and specialists
• Prescription drug coverage through Avera Health Plans’ Rx network and cost transparency tools

By the LiveNOW Health and Wellness team