GLP-1 medications for weight loss: clinical criteria, coverage and costs
GLP-1 medications have become more popular for treating obesity and weight loss. So, if you are thinking about trying it, you’re not alone. Let’s break down what you need to know about clinical eligibility, insurance coverage and cost.
Note: This guide is for people without diabetes. If you have diabetes, please consult your care provider to discuss the medications and treatment plans that are right for you.
Before your visit, confirm your insurance coverage to understand your potential costs
Coverage for GLP-1 medications varies by insurance plan. Some plans may not cover these medications for weight loss. Some plans may cover them if you meet additional requirements.
Before you meet with your care provider, check with your insurance provider to find out:
- If GLP-1 medications for weight loss are covered
- What your copay will be
- If there are any steps you need to take to qualify for coverage
- If you have full or partial coverage
During your visit, your care provider will determine if you’re clinically eligible
Your care provider will determine if a GLP-1 medication is right for you using the following FDA criteria:
- If you have obesity (BMI of at least 30)
- If you are overweight (BMI of at least 27) and you also have a weight-related health issue like high blood pressure or sleep apnea
If your care provider determines that one of these medications will support your health journey, they will prescribe the medication. If you don’t qualify, your care provider will work with you to build a care plan that best suits your needs.
Concerned about costs? Explore our discounted self-payment option.