Omada is required for individuals seeking coverage of weight‑loss medications under the MTM Select EPO plan.

To qualify for medication coverage, the following must be met each month:

Clinical Eligibility

You must meet one of the following criteria:

• BMI of 35 or higher, or
• BMI of 27-34 with two or more weight‑related comorbidities
  (Examples include hypertension, Type 2 diabetes, hyperlipidemia, sleep apnea, etc.)

Monthly Omada Engagement Requirements

To maintain medication coverage, you must:

• Engage 4 times with the smart device provided by Omada (e.g., weigh‑ins)
• Complete 4 interactions in the Omada app (lessons, coach messages, group engagement, etc.)
  
  

Your provider must also complete prior authorization for the medication to confirm all criteria are met.

Eligibility for Omada

Omada is available to:

• Employees and dependents enrolled in the MTM Select EPO medical plan
• Individuals meeting BMI‑based criteria (listed above)
• Participants pursuing weight‑loss medication coverage under the plan

Omada itself is always $0 cost to eligible members.