Is your GLP-1 still covered in 2027? What changed and what to do

Fewer employer plans cover GLP-1 medicines for weight in 2027, and many that do add conditions such as a lifestyle program. Medicare Part D still can't cover them for weight loss, but a CMS program, the Medicare GLP-1 Bridge, runs through December 31, 2027. Check your 2027 drug list, ask about prior authorization, and remember that a denial can be appealed.

Reviewed by Darshan Patel, MD, Obesity medicine physician, on 2026-11-12. Next review 2027-01-31.

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If your benefits changed this year, you're not alone

Maybe you opened your 2027 benefits guide and your weight medicine was gone, or your plan added new rules you've never heard of. That's frustrating, especially when the medicine has been helping. The good news: a change in coverage is a reason to make a plan, not a reason to give up.

What changed for 2027

Employer plans are pulling back. In KFF's 2026 employer survey, published October 22, 2026, about 1 in 5 firms with 200 or more workers (18%) covered GLP-1 medicines specifically for weight loss. Many of those add conditions, such as joining a lifestyle program or meeting with a clinician. In a Business Group on Health survey of 105 large employers that cover these medicines for weight, 72% said they were likely to keep covering them in 2027 and 10% said they likely would not.

Coverage often comes with conditions. Employers that keep coverage told the Business Group on Health they may require a weight management program, confirm eligibility with objective health measurements, limit who can prescribe, or leave some medicines off the drug list.

Medicare has a short-term program. By law, Medicare Part D can't cover medicines used specifically for weight loss. CMS runs the Medicare GLP-1 Bridge for eligible Part D members from July 1, 2026 to December 31, 2027. It works outside the Part D benefit, and a central processor handles prior authorization. In April 2026, CMS said it would not start its BALANCE model in Medicare in 2027. See the Medicare GLP-1 Bridge explained.

Medicaid depends on your state. Covering GLP-1s for obesity is optional for state Medicaid programs. KFF counted 13 states covering them for obesity as of January 2026, after California, New Hampshire, Pennsylvania and South Carolina ended coverage. Medicaid must still cover GLP-1s approved for diabetes, and Wegovy and Zepbound for their heart and sleep apnea uses.

Savings programs reset each year. Lilly's current Zepbound Savings Card terms end on December 31, 2026, and Novo Nordisk's introductory Wegovy pricing runs through the same date. Look for the 2027 terms in January before you plan around them.

What to do now

1. Find your 2027 drug list. Your plan's formulary is the list of medicines it covers. Your Summary of Benefits and Coverage gives the overview, and you can ask your plan or HR for both.
2. Call the number on your insurance card. Ask whether Wegovy, Zepbound or another GLP-1 is covered for weight management, whether prior authorization is needed, and what the criteria are. Our guide to checking your GLP-1 coverage has the full list of questions.
3. Ask about other approved uses. Wegovy is also approved to lower the risk of heart attack and stroke in some adults, and Zepbound to treat moderate to severe sleep apnea in adults with obesity. If one applies to you, your coverage may look different.
4. Choosing a plan? Employers set their own enrollment windows. On HealthCare.gov, open enrollment runs November 1 to January 15, and you need to pick a plan by December 15 for it to start January 1.
5. If you're denied, appeal. A denial isn't always the last word. Here's what to do after a Wegovy denial and how to appeal a Zepbound denial.
6. If you end up without coverage, compare the makers' direct options in our GLP-1 cash price guide.

How Aayu Well helps

We start with your insurance. We check your coverage before your video consultation, your visit is billed to your plan, and we collect any copay at check-in. Your obesity medicine physician reviews your health history first, and together you decide whether medicine is right for you.

If it is, we submit the prior authorization for brand-name medicine, and our team runs it as a concierge service: the paperwork, the follow-up, and the appeal if your plan says no. We also help you apply for manufacturer copay assistance. Most major insurance is accepted. Book my consultation

Good to know

• Your plan makes the final coverage decision. We can't promise an approval, but we build the strongest case your health record supports.
• Medicine is prescribed when it's right for you after a consultation, and your physician talks you through every option, with or without medicine.
• Survey numbers describe employers overall. Your own plan documents are what count for you.

Questions people ask

Why are employers dropping GLP-1 coverage for weight loss?

Employers point to cost. In KFF's 2026 employer survey, 29% of large firms that cover these medicines for weight loss said it had a significant impact on their prescription drug spending, and few firms that don't cover them plan to start.

Does Medicare cover Wegovy or Zepbound for weight loss in 2027?

Not through Part D, which by law can't cover medicines used specifically for weight loss. Part D can cover them for other approved uses, such as heart risk reduction or sleep apnea. Separately, CMS runs the Medicare GLP-1 Bridge for eligible Part D members from July 1, 2026 through December 31, 2027, with prior authorization.

My employer dropped coverage. Can I still use a manufacturer savings card?

If you have commercial insurance, you may be able to. Lilly's Zepbound Savings Card and Novo Nordisk's Wegovy offer both have options for people whose plan doesn't cover the medicine. People with Medicare, Medicaid or other government coverage can't use them through their insurance. Check the 2027 terms, because current terms are written through the end of 2026.

When can I switch to a plan that covers GLP-1s?

At your employer's open enrollment, or on HealthCare.gov from November 1 to January 15. To have a new HealthCare.gov plan start January 1, choose it by December 15.

Can Aayu Well help if my plan says no?

Yes. If medicine is right for you, we submit the prior authorization and our team runs it as a concierge service, including the appeal if your plan says no. We also help you apply for manufacturer copay assistance. If it's still denied, we talk through every alternative with you.

Sources

1. KFF: 2026 Employer Health Benefits Survey news release (October 22, 2026)
2. SHRM: 1 in 10 employers likely will stop GLP-1 coverage in 2027, on the Business Group on Health survey (May 25, 2026)
3. CMS: Medicare GLP-1 Bridge (page modified July 13, 2026)
4. KFF: What to know about the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge (updated May 11, 2026)
5. KFF: Medicaid coverage of and spending on GLP-1s (January 16, 2026)
6. Lilly: Zepbound coverage and savings
7. NovoCare: Wegovy savings offer
8. DailyMed: Wegovy (semaglutide) injection and tablets, prescribing information (revised 6/2026)
9. DailyMed: Zepbound (tirzepatide) prescribing information (revised 8/2026)
10. HealthCare.gov: Dates and deadlines for 2027 health insurance
11. HealthCare.gov glossary: Summary of Benefits and Coverage