News + Insights

For many employees, health plan coverage has helped make glucagon-like peptide-1 (GLP-1) medications more accessible for managing diabetes, supporting weight loss and improving overall health. These medications have become an important part of treatment plans for millions of Americans. A 2026 Gallup survey found that approximately 11% of U.S. adults currently use a GLP-1 medication for weight loss.

The growing use of GLP-1 medications has prompted many employers and health plans to evaluate how these prescriptions are covered. Rising healthcare costs and increased demand have prompted some plans to adjust coverage requirements or medication eligibility to balance the needs of the broader employee population. Employees who are currently using a GLP-1 medication or considering future treatment may benefit from preparing for potential coverage changes before they occur.

This article explains factors contributing to changes in GLP-1 coverage, outlines options that may still be available and highlights resources that can help individuals prepare for potential disruptions to treatment.

Reviewing Plan Details

Coverage changes are not always obvious at first glance. A notice from a health plan, an open enrollment update or a change in prescription costs at the pharmacy may be the first indication that GLP-1 coverage has been modified. Taking time to review the details of the change can help clarify what has changed, when the change takes effect and how it may affect future access to medication. For individuals evaluating future coverage options, plan documents and prescription drug formularies can also provide insight into how specific medications may be covered before enrolling in a health plan.

A few areas for closer review include:

• Coverage status—Review whether GLP-1 medications remain covered under the plan and whether coverage applies to diabetes management, weight loss or both.
• Coverage requirements—Prior authorization, step therapy, quantity limits and other utilization management programs may affect access to covered medications.
• Formulary placement—Changes to a medication’s formulary status can affect coverage, out-of-pocket costs or the availability of alternative medications.
• Effective dates—Notices and plan communications typically identify when coverage changes take effect, allowing for evaluation of available options and preparation for potential treatment disruptions.

Reviewing the details of a coverage change can also provide helpful context for the factors contributing to those decisions.

Why GLP-1 Coverage May Change

GLP-1 medications have attracted significant attention in recent years due to their effectiveness in treating diabetes and supporting weight loss. As more individuals begin using these medications and remain on treatment for longer periods of time, employer-sponsored health plans have experienced a corresponding increase in prescription drug spending. According to a 2026 survey from the International Foundation of Employee Benefit Plans, employers that cover GLP-1 medications for weight loss reported that those medications accounted for an average of  11.4% of annual health plan claims.

Employer-sponsored health plans are designed to support the healthcare needs of an entire employee population. As prescription drug spending increases, employers and health plans often evaluate benefit strategies that help maintain affordable, sustainable coverage while continuing to provide access to a broad range of healthcare services. Coverage changes involving GLP-1 medications may be one component of those efforts.

Changes in coverage can create new questions about cost, access and continuity of care. Exploring available options can help provide greater clarity on what comes next.

Options for Continuing Care

Experiencing a potential disruption to an existing GLP-1 treatment plan can be concerning. A reduction or removal of GLP-1 coverage does not necessarily mean an immediate halt to care. Several options may still be worth exploring, particularly for individuals who are actively using a medication or considering future treatment.

One place to start is with the health plan itself. Some plans offer appeals, coverage exceptions or other review processes that allow additional information to be considered when evaluating a coverage decision. In certain situations, coverage may continue when a medication is being used for an approved medical condition or when supporting clinical documentation is available. A healthcare provider can help determine whether these opportunities exist and provide information that may support the review process.

Treatment discussions can also extend beyond the current prescription. If coverage is no longer available for a specific medication, a healthcare provider may discuss alternative medications, changes to an existing care strategy, or other approaches that align with an individual’s health goals and medical needs.

Additional resources may also help offset costs or support ongoing progress. Manufacturer savings programs and patient assistance programs sometimes provide financial assistance for eligible individuals. Health savings accounts and flexible spending accounts may help pay for qualified healthcare expenses. Some employers and health plans also offer wellness programs, nutrition counseling, weight management support and disease management resources that can complement other healthcare services.

Taking time to evaluate available coverage opportunities, alternative approaches and support resources can help create a clearer path forward if coverage changes occur.