Weight loss care with insurance or a cash membership: which fits you?
With insurance-billed obesity care, your visits are billed to your health plan: you pay your share, such as a copay, and what you pay for covered, in-network care counts toward your out-of-pocket limit. A cash membership charges a fee the program sets, outside your plan. It may not include medicine, and spending on care your plan doesn't cover doesn't count toward that limit. The right fit depends on your coverage.
Reviewed by Darshan Patel, MD, Obesity medicine physician, on 2026-11-12. Next review 2027-05-11.
Book my consultation Video consultations with an obesity medicine physician. Most major insurance accepted, plus convenient cash pay options.
If you're looking for help with your weight, you'll see two very different ways to pay. Some practices bill your visits to your insurance, like any other doctor's office. Others charge a membership fee instead. Neither is right for everyone. Here's how they compare, so you can choose the one that fits your coverage, your budget and the kind of care you want.
Side by side
| Insurance-billed care | Cash membership | |
|---|---|---|
| What you pay for visits | Your plan's share: a copay, coinsurance or your deductible | A fee the program sets, per visit or per month |
| Counts toward your deductible and out-of-pocket limit | Yes, for covered, in-network care | No, when your plan doesn't cover it |
| Medicine | Billed to your plan if it's covered, or bought at a cash price if it isn't | Ask whether the fee includes it |
| Prior authorization for medicine | Ask whether the practice submits it and appeals a denial | Ask whether the program helps with it |
| Fits best when | Your plan covers visits with an in-network physician | You don't have coverage for this care, or you'd rather pay a set fee |
When insurance-billed care is the better fit
- Your plan covers the visits. You pay your share, and HealthCare.gov counts deductibles, copays and coinsurance for covered, in-network care toward your out-of-pocket limit.
- Your plan might cover the medicine. Coverage for weight loss varies. In KFF's 2026 survey, 18% of firms with 200 or more workers covered GLP-1s for weight loss, and 40% of those required people to meet with a dietitian, case manager or therapist, or to join a lifestyle program, for the drug to be covered. A physician who bills your plan can document your care and submit the prior authorization.
- You can use the makers' copay savings. If your commercial plan covers the medicine, the makers' savings cards can lower what you pay at the pharmacy. People with government coverage, such as Medicare, can't use these cards.
When a cash membership can make sense
- You don't have insurance, or your plan doesn't cover visits for this care.
- You want one set fee you can plan around each month.
- You'll pay cash for medicine anyway. The makers sell brand-name medicine at cash prices with a prescription (see GLP-1 cash prices). Add that to the program's fee: in Lilly's directory of independent virtual care options, the rates providers report don't include any medication costs.
- You'd like to use pre-tax money. The IRS counts weight-loss program fees, including membership, as a medical expense when the program treats a disease a physician has diagnosed, such as obesity. Ask your HSA or FSA administrator what qualifies.
Questions to ask any program, including us
- Who is my clinician, and what is their training in obesity care?
- Is the fee per visit or per month, and is the medicine included or extra?
- Is the medicine a brand-name product from the maker, or compounded? Compounded drugs are not FDA-approved, and FDA does not review them for safety, effectiveness or quality before they're sold.
- If my plan covers the medicine, will you submit the prior authorization and appeal a denial?
- Does anything I pay count toward my deductible?
- How do I cancel, and what happens to my care if I do?
- Who answers my questions between visits?
How we do it at Aayu Well
We built our care around your insurance. You see an obesity medicine physician by video. Your visits are billed to your insurance, and you pay your plan's copay. Before your first consultation, we check your coverage. If brand-name medicine is right for you, we submit the prior authorization and run it as a concierge service: the paperwork, the follow-up, and the appeal if your plan says no. We also help you apply for the maker's copay savings. And if your plan still won't cover it, we talk through every alternative with you. Book my consultation
Good to know
- Coverage differs from plan to plan and from year to year. Your plan's member services line, or a practice that checks for you before your first visit, can give you a clear answer.
- Whichever program you choose, FDA advises getting a prescription from your doctor and filling it at a state-licensed pharmacy.
- We don't name or price other programs here. Their fees change, so check each program's own site.
Questions people ask
Is insurance-billed weight care cheaper than a membership?
It depends on your plan. If your plan covers the visits, you pay your share, and that money counts toward your out-of-pocket limit. If you have no coverage for this care, a set membership fee may be easier to plan around. Either way, add the cost of medicine before you compare.
Does a weight-loss membership count toward my deductible?
Not when your plan doesn't cover it. HealthCare.gov describes the deductible and the out-of-pocket limit in terms of covered services, and spending on services your plan doesn't cover doesn't count toward the out-of-pocket limit.
Will my insurance cover GLP-1 medicine for weight loss?
Some plans do. In KFF's 2026 employer survey, 18% of firms with 200 or more workers covered GLP-1s for weight loss. A practice that checks your coverage can tell you what your plan asks for.
Can I use my HSA or FSA for a weight-loss program?
The IRS counts weight-loss program fees, including membership, as a medical expense when the program treats a disease a physician has diagnosed, such as obesity. Ask your HSA or FSA administrator what they accept.
How does Aayu Well bill for visits?
Your visits with an obesity medicine physician are billed to your insurance, and you pay your plan's copay. We check your coverage before your consultation.
See what your insurance can do for you
Book a video consultation with an obesity medicine physician. Your visit is billed to your plan, we check your coverage before you meet, and if brand-name medicine is right for you, our team handles the prior authorization.
Sources
- HealthCare.gov glossary: Out-of-pocket maximum/limit
- HealthCare.gov glossary: Deductible
- KFF: 2026 Employer Health Benefits Survey (October 22, 2026)
- LillyDirect: Telehealth options for obesity (independent providers and their reported rates)
- NovoCare: Price your Wegovy, self-pay and savings offer terms
- LillyDirect: Foundayo self-pay and savings card terms
- FDA: FDA's concerns with unapproved GLP-1 drugs used for weight loss (current as of October 1, 2026)
- IRS Publication 502, Medical and Dental Expenses (for 2025 returns): Weight-loss program
