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Semaglutide salt forms — Versions of semaglutide such as semaglutide sodium and semaglutide acetate, which the FDA says are different active ingredients from the semaglutide base used in approved drugs, with no known lawful basis for compounding.
Open enrollment — The annual window when you can enroll in or change your health plan, and the time to compare GLP-1 coverage across the plans available to you.
P&T committee (Pharmacy and Therapeutics committee) — The panel of physicians, pharmacists, and other clinicians that reviews the clinical evidence behind a plan's formulary: which drugs are acceptable, which are interchangeable, and what restrictions apply.
API (active pharmaceutical ingredient) — The raw drug substance in a medication that produces its effect — for example, semaglutide itself, before it is formulated into a pen or vial.
Certificate of analysis (CoA) — A document reporting the lab test results for a specific batch of a drug ingredient or product, such as identity, purity, and contaminants.
USP <797> — The United States Pharmacopeia standard for sterile compounding that traditional 503A pharmacies must follow when preparing injectable medications.
Enforcement discretion — The FDA's decision to temporarily not take action against conduct that technically violates the rules, such as the grace periods it gave compounders after the GLP-1 shortages ended.
Formulary exception — A request asking your plan to cover a drug that isn't on its formulary, or to cover it at a lower tier, based on medical need.
Letter of medical necessity — A prescriber's written statement explaining why a specific medication is medically required for a patient, used to support prior authorization and appeals.
External review — An independent, outside review of an insurer's denial after internal appeals are exhausted, with a decision the plan must follow.
ERISA (Employee Retirement Income Security Act) — The federal law governing most employer-sponsored health plans, which largely exempts self-funded plans from state insurance mandates and sets the rules for claims and appeals.
Self-funded (self-insured) plan — An employer health plan where the employer pays claims from its own funds instead of buying insurance, giving it direct control over what's covered.
Endotoxin — A toxin from the outer wall of certain bacteria that can contaminate poorly made injectable products and trigger fever, chills, and serious reactions.
503B outsourcing facility — An FDA-registered compounding facility that can make larger batches under CGMP standards and FDA inspection — a step above 503A, but still not an FDA-approved manufactured drug.
503A compounding — A section of federal law that lets a licensed pharmacy compound a medication for an individual patient's prescription, outside the FDA approval process.
NovoCare — Novo Nordisk's patient support platform offering savings programs, insurance guidance, and prescription access for its medications, including Ozempic and Wegovy.
LillyDirect — Eli Lilly's direct-to-patient platform offering telehealth access, home delivery, and savings programs for its medications, including Mounjaro and Zepbound.
GMP (Good Manufacturing Practice) — A regulatory standard ensuring medications are consistently produced and controlled to quality standards — a key marker of legitimacy for compounded or manufactured drugs.
Grey market — The unauthorized sale of medications outside official manufacturer and pharmacy supply chains — not necessarily counterfeit, but unregulated, risky, and for GLP-1s sold without a prescription, against U.S. drug law.
Compounding pharmacy — A pharmacy licensed to prepare customized medications, including compounded versions of GLP-1 drugs, outside of standard manufacturer production.
Telemedicine — The delivery of clinical medical services remotely, such as virtual doctor visits and prescribing — a subset of telehealth.
Telehealth — The broad use of digital communication technology to deliver healthcare services and information remotely.
Off-label use — Prescribing a medication for a condition or in a manner not officially FDA-approved.
Savings card — A manufacturer-provided coupon that reduces out-of-pocket cost for insured patients, typically not usable with government insurance.
Patient assistance program — A manufacturer- or nonprofit-run program that provides free or discounted medication to eligible patients who can't afford it.
Biosimilar — A biologic medication highly similar to an already-approved reference drug, often available at lower cost once patents expire.
PBM (Pharmacy Benefits Manager) — A third-party company that manages prescription drug benefits on behalf of insurers or employers, including which drugs are covered.
Appeal — A formal request asking your insurer to reconsider a denied claim or prior authorization.
Medical necessity — The insurer's determination that a treatment is required to diagnose or treat a condition, often required for coverage approval.
Out-of-pocket maximum — The most you'll have to pay for covered services in a plan year before insurance covers 100% of costs.
Deductible — The amount you must pay out-of-pocket before your insurance starts covering costs.
Coinsurance — The percentage of a drug's cost you're responsible for paying, after any deductible is met.
Copay — A fixed dollar amount you pay out-of-pocket for a prescription or visit, set by your insurance plan.
Compounded semaglutide — A version of semaglutide made by a compounding pharmacy rather than the original manufacturer — not FDA-approved as a standalone product.
Step therapy — A rule requiring you to try lower-cost options before a plan covers another.
Formulary — The list of medications your plan covers, organized into cost tiers.
Prior authorization — Approval your insurer requires before it will cover a medication.

Resources

NovoCare — Novo Nordisk's official patient support platform — savings programs, pharmacy delivery, and cost assistance for Ozempic, Wegovy, and other Novo Nordisk medications.
NAIC state insurance department directory — Find contact information for your state's insurance department or commissioner, locate an agent, or file a complaint against an insurer.