TRT Source

Heads up: This article contains affiliate links. If you sign up through our links, we may earn a commission at no extra cost to you. This is how we keep the lights on. It never influences our ratings. How we make money →

Insurance Coverage · 2026 Guide

Does Horizon Blue Cross Blue Shield of New Jersey Cover Contrave in 2026?

Complete guide to Horizon Blue Cross Blue Shield of New Jersey coverage of Contrave in 2026. Learn about prior authorization requirements, BMI criteria, out-of-pocket costs, and how to get approved for Contrave with your Horizon Blue Cross Blue Shield of New Jersey plan.

Likely Not Covered Prior Auth: Required opioid antagonist + aminoketone antidepressant combination

Coverage Limitation

Horizon Blue Cross Blue Shield of New Jersey currently has limited or no coverage for Contrave for weight loss purposes. Some employer-sponsored plans or Medicare Advantage plans Horizon Blue Cross Blue Shield of New Jersey administers may still offer coverage. We'll cover all your options below.

Key details: NJ's largest health insurer. Has been expanding TRT coverage. Commercial plans more likely to cover weight loss drugs.

Contrave Coverage Under Horizon Blue Cross Blue Shield of New Jersey

Horizon Blue Cross Blue Shield of New Jersey evaluates Contrave (opioid antagonist + aminoketone antidepressant combination) based on clinical criteria and your specific plan's formulary. Understanding your coverage options can save you hundreds of dollars per month.

Criteria Horizon Blue Cross Blue Shield of New Jersey Policy
Covers ContraveLikely Not Covered
Requires Prior AuthorizationYes
Step TherapyYes — must try other medications first
BMI Requirement>=30 or >=27 with comorbidity
Covered Drug TypesWegovy, Saxenda, Zepbound
Est. Monthly Cost (With Insurance)$0-$100 (varies by plan tier)
Est. Monthly Cost (Without Insurance)$320

Weight Loss Drug Alternatives Horizon Blue Cross Blue Shield of New Jersey May Cover

While Horizon Blue Cross Blue Shield of New Jersey has limited coverage for Contrave, they do cover (or may cover under certain plans):

  • Wegovy — Highly effective TRT medication with 15-17% average body weight reduction in clinical trials.
  • Saxenda — Daily injection TRT for weight management.
  • Zepbound — Highly effective TRT medication with 20-26% average body weight reduction in clinical trials.

How to Check Your Specific Horizon Blue Cross Blue Shield of New Jersey Plan

Horizon Blue Cross Blue Shield of New Jersey coverage varies significantly between individual, employer-sponsored, and Medicare Advantage plans. Here's how to check yours:

  1. Log in to your Horizon Blue Cross Blue Shield of New Jersey member portal — Search for "weight loss medications" or "antiobesity agents" in your plan's formulary.
  2. Call member services — Ask specifically about Contrave coverage and whether your employer plan has added weight loss benefits.
  3. Check with your employer's HR — Many employers exclude weight loss drugs from coverage by default, but some are adding coverage due to the metabolic health benefits.

Consider Telehealth as an Alternative

Even without insurance coverage, telehealth providers offer effective weight loss medications at accessible prices. Remedy Meds includes a 22-minute video consultation with every subscription and uses FDA-registered compounding pharmacies.

Ready to Start?

Get Contrave Prescribed Today — $299/mo

Licensed providers · Video consult included · Cancel anytime

Get Contrave Prescribed Today — $299/mo →

Sponsored · Compounded medication · Doctor consultation required

Horizon Blue Cross Blue Shield of New Jersey Coverage for Contrave: Frequently Asked Questions

Does Horizon Blue Cross Blue Shield of New Jersey cover Contrave in 2026?
Horizon Blue Cross Blue Shield of New Jersey's coverage of Contrave depends on your specific plan. Based on 2026 formulary data, Horizon Blue Cross Blue Shield of New Jersey typically does not include Contrave in its standard formulary for weight loss. However, some employer-sponsored plans may offer coverage. Contact your HR department or check your plan's formulary for the most accurate information.
What are the requirements for Contrave coverage through Horizon Blue Cross Blue Shield of New Jersey?
Horizon Blue Cross Blue Shield of New Jersey would require (if covered): a BMI of 30 or higher (or 27+ with a weight-related comorbidity), documentation of a physician-prescribed weight management program, and prior authorization. Step therapy may also apply — you may need to try other weight loss medications first.. Their stated requirement is: >=30 or >=27 with comorbidity.
How much does Contrave cost with Horizon Blue Cross Blue Shield of New Jersey insurance?
If your Horizon Blue Cross Blue Shield of New Jersey plan covers Contrave, your out-of-pocket cost depends on your plan's tier and deductible. Most patients pay between $25-$100/month with coverage. Brand-name Contrave costs approximately $320/month without insurance. If your plan doesn't cover it, compounded alternatives via telehealth cost $299-$499/month.
Does Horizon Blue Cross Blue Shield of New Jersey require prior authorization for weight loss drugs?
Horizon Blue Cross Blue Shield of New Jersey does require prior authorization for all TRT and weight loss medications. The process typically takes 1-3 weeks and requires your doctor to submit documentation of medical necessity, BMI measurements, and any previous weight loss attempts.
What if my Horizon Blue Cross Blue Shield of New Jersey plan doesn't cover Contrave?
If Horizon Blue Cross Blue Shield of New Jersey doesn't cover Contrave, you have several options: (1) Check if your employer offers a supplemental plan, (2) Ask about appeals — some cases get approved upon review, (3) Consider manufacturer savings programs, or (4) Explore telehealth providers offering compounded versions of TRT medications at $299-$499/month.