Are Weight Loss Drugs Covered by Insurance?

Weight loss medications can help you lose weight and improve your overall health. So, are weight loss drugs covered by insurance? It’s a tricky question. 

Most of the time, weight loss drugs aren’t covered by insurance unless you’re using them to treat type 2 diabetes. Some insurance providers cover weight loss medications, but you’ll need to meet specific eligibility criteria.

In this article, we’ll discuss insurance coverage for weight loss drugs in more detail, including when you can get coverage, which drugs may be covered, and how to reduce the cost of weight loss medications when paying out of pocket.

Most of the time, weight loss drugs aren’t covered by insurance.

This is a different story if you have type 2 diabetes. With a diabetes diagnosis, you may be able to get drugs like Ozempic^® and Mounjaro^® covered. These drugs are actually approved by the Food and Drug Administration (FDA) to treat diabetes, and they have weight loss as a side effect.

Ozempic^® and Mounjaro^® are sometimes prescribed off-label for weight loss. An off-label prescription is when a healthcare provider prescribes a drug for something it isn’t FDA-approved to treat. Insurance providers don’t usually cover off-label prescriptions, though.

And while drugs like Wegovy^® and Zepbound^® are FDA-approved to treat overweight and obesity, they’re not usually covered, either.

Research found that only 18 percent of large companies offering health benefits covered GLP-1 medications for weight loss in 2024. GLP-1s (glucagon-like peptide-1 receptor agonists) are a class of medication that includes Ozempic^® and Wegovy^®.

If your plan covers weight loss drugs, you’ll still need to meet eligibility criteria. These can include:

• Having a body mass index (BMI) above a specific number

• Having a weight-related health condition like type 2 diabetes, high blood pressure (hypertension), sleep apnea, heart disease, or high cholesterol

A healthcare provider will review your medical profile, health history, and BMI before determining whether to prescribe weight loss drugs.

Does Medicare Cover Weight Loss Medications?

By law, Medicare doesn’t cover medications when they’re used for weight loss alone.

The 2003 Medicare Prescription Drug, Improvement, and Modernization Act (MMA) states that weight loss medications can’t be covered.

Does Medicaid Cover Weight Loss Medications?

You might be able to get coverage for weight loss medications through Medicaid. It depends on the medication and the state you live in. Check your state’s Medicaid website to learn more.

Does Hims Take Insurance?

You don’t need insurance to access weight loss medications through Hims. If you’re eligible for medication, you can pay out of pocket. You can also save on Hims weight loss subscriptions using your health savings account (HSA) or flexible spending account (FSA).

The weight loss drugs you could get covered by insurance depends on your insurance provider and health status — like if you have a BMI above a certain threshold or a health condition like type 2 diabetes.

In general, these are some of the FDA-approved weight loss drugs that insurance providers could cover:

• Wegovy^®

• Zepbound^®

• Saxenda^®

• Contrave^®

These medications are FDA-approved for type 2 diabetes, so insurance may cover them if you have that diagnosis:

• Ozempic^®

• Mounjaro^®

• Victoza^®

• Metformin

If you have diabetes, a healthcare provider may prescribe one of these medications, in which case your insurance may cover it.

Is Semaglutide Covered by Insurance?

Semaglutide — the active ingredient in Ozempic^® and Wegovy^®, from the pharmaceutical company Novo Nordisk — isn’t always covered by insurance for weight loss.

Will My Insurance Cover Ozempic^®?

Ozempic^® is FDA-approved for people with type 2 diabetes. If you have a diabetes diagnosis, you may be able to get Ozempic^® covered. If you’re prescribed Ozempic^® off-label for weight loss, you’ll probably have to pay out of pocket.

Will My Insurance Cover Wegovy^®? 

Wegovy^® is FDA-approved for weight loss in people with a BMI of 30 or more or 27 or more with at least one weight-related health condition. Some health insurance plans may offer coverage if you’re eligible, but not all of them.

Check your insurance policy to see if you could get weight loss medication covered. Don’t forget to look at the fine print to see if there are any restrictions or steps you need to take, like getting prior authorization from a medical provider.

Weight loss drugs not being covered by insurance is a complex topic. Some American insurance companies consider weight loss and other obesity treatments a cosmetic choice, rather than something that can dramatically improve your health.

Weight loss medications are also expensive, so providers may wait for costs to come down before offering coverage.

Will Weight Loss Drugs Ever Be Covered by Insurance?

Just because weight loss medications aren’t typically covered now doesn’t mean they won’t be in the future.

There’s pressure on insurance providers and employers to offer coverage, and obesity is increasingly being seen as the medical condition it is. So, insurance providers could cover weight loss medications in the future.

Here’s how you can try to get weight loss medication covered by insurance:

• Find out if your insurance provider offers coverage. Check your plan to see if it covers weight loss medications. Look out for eligibility criteria and restrictions.

• Talk to your healthcare provider about your needs. You may need a prior authorization note or a confirmed diagnosis of a weight-related health condition. Your provider can also talk you through the different types of weight loss medications you could be eligible for.

• Appeal. Denied coverage? You can appeal the decision. This may increase your odds of getting medication approved.

Without health insurance coverage, you’ll need to pay for weight loss medications out of pocket — meaning the full list price rather than just a co-pay for a prescription. And since you often take weight loss drugs for long-term weight management, costs can add up.

The price depends on which medication you get, of course. But here’s what GLP-1 injections cost without insurance (at the time of publishing):

• Ozempic^® can cost $1,800 a month.

• Wegovy^® can cost $2,000 a month.

• Mounjaro^® can cost $1,900 per month.

• Zepbound^® can cost $1,900 per month.

→ Read: The Cost of Weight Loss Drugs With and Without Insurance 

You can save money on weight loss medications by paying upfront in full, going for more affordable medications, or using coupons, savings programs, or your HSA or FSA. 

Here’s more on those options:

• Pay upfront in full. Some telehealth providers, like Hims, offer weight loss subscriptions that include medication. If you pay upfront in full, you can save on the overall cost of your treatment.

• Consider oral medications for weight loss. Weight loss pills are often more affordable than injections. Options include pills like bupropion, metformin, topiramate, and naltrexone.

• Look into coupons and manufacturer savings programs. Manufacturers often offer coupons, discounts, and payment-assistance programs to help reduce the high cost of obesity drugs. They don’t last forever, but they might help lower the expense.

• Use your HSA or FSA. Use pretax dollars for eligible medical expenses. You can use your HSA or FSA to pay for your Hims weight loss subscription. Check your plan for details.

*Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the FDA. Prescription required.

**Actual price depends on product and plan purchased.

Here’s what to keep in mind about what weight loss drugs are covered by insurance:

• Insurance providers don’t usually cover weight loss drugs, even if you meet the eligibility criteria for medication.

• Check your plan just in case, but know that you may need to pay for treatment out of pocket.

• Luckily, you can reduce your costs with coupons, an FSA or HSA, or by paying upfront in full for subscriptions.

Hims offers access to weight loss medications for those who are eligible. Through our men’s health platform, you can connect with a licensed healthcare provider. They can assess your health history, needs, and goals, then — if suitable — recommend a treatment plan.