Fewer employers cover GLP-1 weight-loss drugs than a year ago, and more are weighing cuts for 2027. WTW’s 2026 Best Practices in Healthcare Survey found that coverage for weight loss fell for the first time in three years, from 57% of employers to 53%, and 30% of the employers that still cover the drugs are considering dropping them. Whether your own plan covers them is set in your 2027 plan documents, so this guide shows you what to check during open enrollment.
How many employers still cover GLP-1s for weight loss?
WTW’s 2026 survey press release says the survey covered 471 US employers with at least 100 employees, together employing 7 million people, fielded June 22 to August 7, 2026. Among employers that have dropped coverage or are weighing dropping it, 91% cite cost. Bloomberg Law’s report from October 30, 2026 says fewer workers will find their employers cover these drugs as they enroll this fall.
A second survey points the same way. Ethos Benefits’ 2027 coverage analysis cites the Business Group on Health: 72% of large employers that cover GLP-1s for weight management expect to keep that coverage in 2027, 10% expect to drop it, and 18% have not decided.
Why are employers dropping GLP-1 coverage?
Cost is the main reason. Pharmacy is the pressure point. WTW says pharmacy costs were expected to rise 11.5% in 2026, after 9% in 2025, and pharmacy is about 36% of total claims, including drugs paid through medical benefits. CNBC’s October 27 report says covering these drugs for weight loss typically costs employers in the mid-$500s to mid-$600s per user each month.
Use is climbing too. CNBC, citing Gallup, reports that 11% of US adults took GLP-1s for weight loss in 2026, up from 3% in 2024. Marsh expects health insurance cost per employee to rise 8.2% in 2027, and CNBC reports that GLP-1 use accounts for a full percentage point of that increase.
Do employers have to cover GLP-1s?
Ethos Benefits writes that there is no federal mandate requiring employer-sponsored plans to cover GLP-1s for weight management, and that anti-obesity medications are commonly excluded. Some state insurance mandates do apply to fully insured plans, so ask HR whether your plan is fully insured and confirm the details in your plan documents. For a different category of drug, a 2001 Employee benefits journal article on the Pregnancy Discrimination Act reports the EEOC’s position that employer health plans must, in many instances, cover prescription contraceptives.
Will Zepbound prices drop in 2027?
Plan around today’s self-pay price for Zepbound, and confirm the 2027 figure with the manufacturer before you budget. Prices and bundles change, so check today’s price directly with the company. CNBC’s October 27, 2026 report lists these starting self-pay prices, and pepglp1.com lists its own figures for the same products.
| Product | Self-pay price reported | Source |
|---|---|---|
| Wegovy pill, lowest dose | From $149 a month | CNBC |
| Wegovy shot, lowest dose | From $199 a month | CNBC |
| Wegovy pen | $199 a month for the first two starter fills through December 31, 2026, then about $349 a month for most doses | pepglp1.com |
| Wegovy pill, by dose | Roughly $149 to $299 a month | pepglp1.com |
| Zepbound vial or KwikPen | From $299 a month | CNBC |
| Zepbound vials, by dose | About $299 a month at the lowest dose, up to $449 a month at higher doses when refilled within 45 days | pepglp1.com |
Novo Nordisk says its current promotional pricing may be modified or canceled, and CNBC notes that Wegovy self-pay prices are subject to change in 2027. Ethos Benefits reports that Novo’s unified US list price for Wegovy, Ozempic and Rybelsus starts at $675 a month on January 1, 2027. List price is not the same as what you pay out of pocket.
What else is coming for premiums and out-of-pocket costs?
WTW says employers project healthcare costs rising 11.1% in 2027 before plan changes and 9.7% after, the highest rate since the early 2000s. By 2028, 85% of employers are planning or considering shifting costs through employee premiums (44% today), and 71% through out-of-pocket costs (30% today). 22% are planning or considering restricting eligibility by 2028 (13% today), and 41% are planning or considering eliminating some generous coverage provisions (11% today). These are general health-cost moves across benefits, not GLP-1 decisions, but they can arrive alongside any GLP-1 change.
What should I check in my 2027 plan documents?
pepglp1.com advises starting with the Summary of Benefits and Coverage and the drug formulary that HR posts for each plan before open enrollment. Search for “GLP-1,” “weight management,” “anti-obesity” and the brand names you use. Then check these five things.
- Formulary. Is the drug still on it? pepglp1.com notes that if Zepbound or Wegovy is missing, coverage for weight loss is likely gone, and that GLP-1s prescribed for type 2 diabetes are usually still covered.
- Tier. A move from tier 2 to tier 4 can raise your copay sharply. pepglp1.com gives the example of a copay rising from $25 to hundreds of dollars.
- Prior authorization, step therapy and program rules. Look for prior authorization, step therapy, required participation in a weight-management program, or a BMI threshold. Among employers that set a minimum BMI, IFEBP found 38% set it at exactly 30, 37% use a threshold below 30 and 25% require above 30, according to Ethos Benefits.
- Which plan. If your employer offers more than one plan, GLP-1 coverage can differ between them.
- Mid-year changes. pepglp1.com says most changes take effect at renewal, typically January 1, and that plans must give advance notice of mid-year changes. Watch for letters from your pharmacy benefit manager.
What should I ask HR or my insurer?
Call the pharmacy benefit manager at the number on the back of your card. pepglp1.com suggests asking: “Will [drug] be covered for weight management on January 1, 2027, and what do I need to do to qualify?” Write down the date, the representative’s name and the answer. Then ask HR:
- Is my plan fully insured? Some state mandates apply only to fully insured plans.
- What documentation do I need to qualify, and where is the prior authorization form?
- Does the employer offer a weight-management program in place of drug coverage?
- Is coverage for diabetes written separately from coverage for weight loss? Ethos Benefits notes that a plan can cover GLP-1s for diabetes and exclude them for weight loss, which it calls the most common structure in the market.
- Can my FSA or HSA pay for this? CNBC reports that GLP-1s are eligible when prescribed by a licensed provider to treat a diagnosed medical condition, such as obesity.
What are my options if my employer drops coverage?
CNBC describes the routes employers are using. None of them is the same as full coverage, so compare them with your own costs.
| Option | How it works | What to check |
|---|---|---|
| Plan with clinical requirements | Coverage stays, with prior authorization, BMI rules or program participation. Ethos Benefits calls this clinical gating. | The written criteria and the documents you need |
| Self-pay through manufacturer programs | The employer drops coverage and you buy directly through NovoCare or LillyDirect. WTW’s survey showed 8% of employers have gone this route, and 28% were planning or considering it. | Current prices in the table above, and refill terms |
| Employer-paid weight-management program | Third-party programs such as CVS Weight Management, Noom, Omada Health, UnitedHealthcare, Vida and Virta offer coaching on diet, exercise and behavior. CNBC reports these cost about $65 to $100 per employee per month. | Whether your employer offers one, and what it includes |
| FSA or HSA reimbursement | Pre-tax money can pay for GLP-1s prescribed by a licensed provider for a diagnosed medical condition, such as obesity, per CNBC. | Your account administrator’s rules |
| Medicare, if you are on it | The Medicare GLP-1 Bridge charges $50 a month for eligible beneficiaries through December 31, 2027, according to Ethos Benefits. | Eligibility rules. Ethos Benefits notes the Bridge does not change commercial employer plans. |
Program vendors report their own results. CNBC cites Omada Health data showing that 63% of members evaluated at 12 months after stopping a GLP-1 maintained or continued to lose weight. For the Mounjaro side of the cost picture, the mounjaro cost guide covers prices, coverage and alternatives.
What if my coverage ends while I’m on treatment?
Start with your prescriber. Ask whether a different medication in the same class would be covered or cost less, and what the self-pay route would cost for the dose you take. pepglp1.com suggests raising this in November or December so you have a plan before the switch.
If you have a medical need, ask about a formulary exception or an appeal, with documentation of your diagnosis and progress, as pepglp1.com describes. Plans often still cover GLP-1s for type 2 diabetes, cardiovascular risk reduction or obstructive sleep apnea. IFEBP found 45% of employers cover GLP-1s for other approved indications such as obstructive sleep apnea and cardiovascular risk reduction, according to Ethos Benefits.
Ask HR for notice in writing. Ethos Benefits describes the rule: under ERISA, a material reduction in covered services generally requires a Summary of Material Modifications within 60 days of the employer adopting the change.
What should I know about compounded GLP-1s?
Some offers are for compounded versions. The FDA’s alert on unapproved GLP-1 drugs used for weight loss says: “compounded drugs are not FDA approved. This means the agency does not review compounded drugs for safety, effectiveness or quality before they are marketed.” The same alert says a compounded drug might be appropriate if a patient’s medical need cannot be met by an FDA-approved drug, or the FDA-approved drug is not commercially available. It also states that “FDA is aware of fraudulent compounded semaglutide and tirzepatide with false label information.” Before you use any telehealth service, run through the telehealth weight loss company legit checklist.
Your next step
This week, open your 2027 plan’s formulary, search for GLP-1, and call the pharmacy benefit manager with the question above. pepglp1.com says open enrollment usually runs from mid-October through November, so the call is worth making before the window closes.
By HealthDataConsortium.org Research Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.
