What insurance plans cover weight loss medication?

In this article:

• What insurance plans cover weight loss medications?
• Examples of coverage
• Weight loss meds and their coverage status
• What if you don't have coverage?
• How to save
• Future of weight loss coverage
• Bottom line

In this article

• What insurance plans cover weight loss medications?
• Examples of coverage
• Weight loss meds and their coverage status
• What if you don't have coverage?
• How to save
• Future of weight loss coverage
• Bottom line

Weight loss drugs have been available since the 1930s, but their popularity surged recently after the Food and Drug Administration (FDA) approved three GLP-1 receptor agonists for weight loss: Wegovy (semaglutide), Saxenda (liraglutide), and Ozempic (tirzepatide). For some individuals, these medications may be more tolerable, effective, and convenient than other weight loss drugs, such as Qsymia (phentermine-topiramate), Contrave (naltrexone-bupropion), or Alli (orlistat). 

Despite the health benefits of weight loss and the efficacy of GLP-1 agonists like Wegovy, some health insurance plans don’t cover them. Sometimes coverage is available for other FDA-approved uses, such as Zepbound for obstructive sleep apnea or Wegovy for cardiovascular protection. Since coverage for weight loss medications is often subject to change, it’s best to review your plan regularly.

If you’re interested in weight loss medications but don’t want to pay out of pocket, this guide will help you understand your insurance options. 

What insurance plans cover weight loss medications?

Insurance coverage for any medication varies depending on the plan. After reviewing more than a dozen formularies, we noticed the following trends:

• Employer-sponsored benefit plans are the most likely to cover weight loss drugs, with a 2025 study showing that 19% of large firms and 43% of firms with 5,000 or more employees cover GLP-1 agonists. 
• Marketplace (Affordable Care Act) plans typically don’t cover weight loss drugs.

Gail Clifford, MD, an internal medicine hospitalist practicing in Orlando, Florida, says, “Older medications like phentermine are often covered because they have been around a long time and are relatively inexpensive. Some plans will also cover Contrave or Qsymia, which are FDA-approved for weight loss and can be effective for the right person.” She’s also started to see better coverage for Wegovy.

“In my experience, either all weight loss medications are covered under a specific insurance plan, or none are,” says Jennifer Brown, MD, a board-certified physician specializing in obesity and family medicine. “I haven’t found that one class of weight loss medication is covered more often than another. Of course, we all want our patients on GLP-1s because they are so much more effective than the other alternatives.”

Most insurance plans do cover GLP-1 agonists—just not for weight loss. You might look at a sample drug list and see that semaglutide is covered as Ozempic, tirzepatide is covered as Mounjaro, and liraglutide is covered as Victoza. These are the brand names that are FDA-approved to treat Type 2 diabetes. 

Why do insurance companies not cover weight loss drugs?

So, why won’t insurance companies pay for weight loss drugs when being overweight or having obesity is linked to many other health conditions? For starters, GLP-1 agonists can be pricey. Insurance companies like to keep costs low, and there are over 100 million adults who are overweight or have obesity in the U.S. who might want to use these products. 

“Let’s face it: GLP1s are the medications that doctors want to prescribe, and patients want to take,” Dr. Brown says. “They are far superior to the other weight loss medications. Universal GLP-1 coverage for obesity treatment could bankrupt a lot of insurance plans.”

However, inexpensive weight loss drugs like Alli (orlistat), Adipex-P (phentermine), and Qsymia (phentermine-topiramate) are not always covered by insurance. This could be due to a controversial belief that obesity isn’t a disease, despite the American Medical Association’s 2023 statement recognizing it as such.

“Obesity is still thought of as a cosmetic issue that’s due to a lack of willpower by many. Even among other doctors, I still frequently hear, ‘If only the patient would eat less or exercise more.’ Of course, this outdated thinking is not the case at all,” Dr. Brown says. “Obesity is a chronic metabolic disease that needs lifelong treatment.” 

Dr. Clifford agrees. “A big part of it comes down to outdated thinking. For a long time, obesity was not treated as a medical condition—it was seen more as a personal choice or lifestyle issue. Even though we now know it is a complex, chronic disease with hormonal and genetic drivers, many insurance companies still exclude treatment, especially medications, from their coverage.” 

Does Medicare cover weight loss medication?

Medicare doesn’t currently cover weight loss medication. This puts it in the same boat as a handful of other medications Medicare never covers, including cosmetic hair loss treatments, fertility drugs, and erectile dysfunction treatments.

Medicare also doesn’t cover medications for off-label use except when treating cancer. 

Starting in 2026, Medicare will begin covering select GLP-1 medications for obesity under a new policy that expands access to these medications. Under the White House agreement, these drugs will be available to Medicare beneficiaries at reduced costs, with monthly copays expected to be around $50.

Does Medicaid cover weight loss medication?

Medicaid coverage for weight loss medications varies by state. As of October 2025, 13 Medicaid state plans cover at least one GLP‑1 receptor agonist. Coverage for other types of FDA‑approved weight loss drugs (like phentermine) is less frequently reported.

Does the VA cover weight loss medication?

Yes, the VA covers some weight loss medications, including Contrave, Xenical, and Qsymia. 

The VA considers GLP-1s for weight loss “non-formulary” medications, meaning healthcare providers must submit exception requests in order for the drug to be dispensed for the purpose of weight loss.

Examples of insurance plans that cover weight loss medication

We found several insurance plans that cover weight loss and obesity medications:

• The Blue Cross Blue Shield Federal Employee Program covers name-brand Wegovy, Saxenda, Contrave, Xenical, Qsymia, and Lomaira, and generic benzphetamine, diethylpropion, orlistat, phendimetrazine, and phentermine. Wegovy isn’t covered in the Blue Focus plan.
• The Aetna Standard Plan covers name-brand Wegovy, Saxenda, Zepbound, and Qsymia, and generic diethylpropion. Adipex-P is available as a non-preferred brand, which means Aetna is willing to cover it if you try at least two of the other listed medications first and they don’t work. 
• Cigna’s employer-sponsored plans cover name-brand Wegovy and Saxenda, plus generic benzphetamine, diethylpropion, phendimetrazine, and phentermine. Contrave, Qsymia, and Zepbound are non-preferred brands.

Coverage often requires prior authorization. Your healthcare provider may need to share your body mass index (BMI) and other documentation to show that you’re following a weight loss diet and exercise plan. 

Common weight loss medications and their coverage status

Various medications are approved for weight loss. Generally, newer medications, such as GLP-1 agonists, are the least likely to be covered, while older drugs are commonly found on formularies.

GLP-1 receptor agonists

Some plans may cover GLP-1s for weight loss, but they often require prior authorization. They’ll generally base eligibility on whether you meet the BMI threshold, whether you’ve tried other medications, and whether you’re on an exercise and diet program. Although some plans may exclude GLP-1s for weight loss, they might approve them for diabetes or sleep apnea. 

Combination drugs

Medications like Qsymia and Contrave are more likely to be on formularies since they’re older and less expensive than GLP-1s. As with GLP-1s, coverage may also require prior authorization, a specific BMI, and consideration of other treatments first. Plans may also have limits on refills or require frequent follow-ups to continue coverage.

Appetite suppressants 

Drugs like phentermine, diethylpropion, and benzphetamine may be covered by some plans as older medications. However, they’re often only approved for short-term use, not chronic weight management. In many cases, plans may also need documentation that the drug is being used alongside a supervised weight-loss program. 

Lipase inhibitors

This drug class mainly refers to orlistat, known under the brand names Xenical and Alli. Plans may cover it since it’s an older, less costly medication. Alli is the brand-name version that can be found over-the-counter (OTC) and is not usually covered by insurance. As an OTC drug, it usually has lower out-of-pocket costs than newer GLP-1 drugs.

What to do if insurance won’t cover weight loss medication

If your insurance company won’t cover your weight loss medication, your doctor can write an appeal or exception letter to explain why the drug is medically necessary. Such letters may also be required if your insurance company includes weight loss medications in its formulary but denies you coverage.

Prior authorization is often required before insurance companies will cover weight loss medications. Dr. Brown says the prior authorization process requires healthcare providers to answer pages of questions and submit medical records for review. For example, some insurance companies require patients to have already tried a specific diet and exercise routine for a certain period or to have tried a different type of weight loss medication first.

If the insurance company denies your claim, your healthcare provider can send an appeal letter further explaining why the drug is medically necessary and why alternatives aren’t appropriate. 

“I have seen appeals succeed, especially when a healthcare provider explains why the medication is needed,” Dr. Clifford says. “For example, if a patient has a high BMI and other health problems like diabetes or high blood pressure, and they have already tried diet and exercise without enough success, that makes a strong case.” She says it’s important to work with a healthcare provider who is willing to advocate for you and go through several rounds of appeals if needed. 

Dr. Brown warns that, in her experience, the prior authorization and appeals process is rarely successful for weight loss drugs. Your final options are to pay out of pocket for the prescription medication or explore other savings options, which we’ll discuss below.

What to do if insurance stops covering weight loss medications

After the insurance company initially approves your weight loss prescription, your healthcare provider may need to submit updated medical records periodically to maintain approval. Michaela Robbins, a healthcare provider of nursing practice in New York City, says insurance companies may drop coverage for weight loss medications if they don’t seem to be working, or if they’ve worked and you’re no longer considered to have overweight or obesity.

This can be challenging because many people need to stay on weight loss medications to maintain a lower body weight, and some medications take weeks to work. If your insurance company stops covering your medication, contact your healthcare provider immediately so they can initiate the appeals process. Dr. Robbins says it can sometimes take days to hear back. 

How to save on weight loss medication

If insurance won’t cover weight loss medication and you need to pay out of pocket, there are several ways to save:

• SingleCare prescription discount card: This free, reusable card may lower the cost of weight loss medications at participating pharmacies. Sign up for a free SingleCare account, compare pharmacy prices, and show your discount card to the pharmacist when you pick up your prescription drug.

• Patient assistance programs (PAPs): Manufacturers sometimes offer free or discounted medications to people with lower incomes. These programs aren’t typically available for GLP-1s prescribed for weight loss, but may be available for other options, such as Rybelsus and Ozempic, which are indicated for Type 2 diabetes.

• Manufacturer savings cards: A manufacturer savings card allows you to get your prescription at a discounted price from virtually any pharmacy. Sometimes these cards can only be used once or must be used by people with insurance other than Medicare. Lilly, the manufacturer of Zepbound, offers a self-pay option that allows patients to purchase the medication directly from Lilly Direct at a discount. However, this offer only applies to vials of the drug, not the autoinjector pens. And the price increases the higher the dose.

The future of weight loss medication coverage

Coverage for weight loss treatments is expected to change, particularly as studies demonstrate that treating obesity can result in lower long-term healthcare costs. The federal government is also likely to expand Medicare and Medicaid coverage for GLP-1s in 2026. Additionally, if the pricing changes are implemented, those currently paying high cash prices may see lower out-of-pocket costs. 

New medications are also in the pipeline, which could increase competition and lower prices. These include next-generation GLP-1s, such as retatrutide, as well as GLP-1 combination drugs, like cagrilintide with semaglutide.

Bottom line

Insurance coverage for weight loss medication is changing, and the number of states offering Medicaid coverage for weight loss drugs has grown over the past few years. If you have obesity or are overweight, you’re more likely to get insurance coverage for weight loss medications if you have a weight-related health condition, such as Type 2 diabetes, cardiovascular disease, or obstructive sleep apnea. Discuss your options with your healthcare provider. They can prescribe a weight loss plan tailored to your budget and lifestyle.