GLP-1 drugs have transformed the conversation around weight loss, diabetes management, and chronic care in America. Their popularity has surged, but so has confusion around cost and coverage—especially as policymakers and employers grapple with rising healthcare premiums and major shifts in drug pricing policy.
Employers, specifically, face mounting pressure in the face of GLP-1 demand. According to KFF’s 2025 Employer Health Benefits Survey, only 19% of companies cover GLP-1 for weight loss in 2025—yet many require wellness programs or strict clinical documentation. Meanwhile the majority of health plans still don’t cover these drugs, creating a major gap in access and affordability.
Looking to learn more about GLP-1 coverage and payment options?
Here, we’ll break down what GLP-1 drugs are, how coverage for GLP-1s works, what GLP-1s cost with and without insurance, and actionable ways to better access these medications—now and in the future.
What Are GLP-1 Drugs?
GLP-1 drugs are a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. Developed originally to treat Type 2 diabetes, these injectable therapies mimic a hormone that helps regulate blood sugar, appetite, and digestion. By delaying stomach emptying and enhancing feelings of fullness, they can result in significant weight loss alongside improved metabolic health.
Common GLP-1 medications include:
Ozempic: Approved for diabetes and often prescribed off-label for weight loss
Wegovy: FDA-approved for weight loss
Mounjaro: Approved for diabetes
Zepbound: Approved for weight management and sleep apnea
Use Cases for GLP-1 Drugs
GLP-1s’ unique ability to combine glucose regulation with appetite suppression makes them a valuable tool for chronic metabolic disorders beyond traditional diabetes care.
Going further, GLP-1s can now be used for:
Type 2 diabetes management: GLP-1s can improve glycemic control by enhancing insulin secretion and lowering blood glucose levels.
Obesity and weight management: These medications can help reduce appetite and body weight.
Cardiovascular disease risk reduction: Some GLP-1s have demonstrated reduced risk of major cardiovascular events in diabetic patients.
Are GLP-1 Drugs Covered by Insurance?
The short answer is: Yes, GLP-1 drugs are covered by insurance but it depends on the plan. Most health insurers—including employer-sponsored plans—cover GLP-1s if prescribed for Type 2 diabetes, but weight loss coverage is less predictable and varies widely depending on plan design, medical necessity criteria, and federal/state guidance.
Coverage can also hinge on plan rules around “lifestyle drugs,” with some insurers categorizing obesity treatments as non-essential, while others are expanding benefits in response to employee requests and projected savings on future healthcare costs.
Here’s a closer look at current insurance coverage trends for GLP-1s:
Most plans cover GLP-1s for Type 2 diabetes: These medications are typically covered with standard copays or coinsurance.
Weight loss coverage remains spotty: Most insurers require prior authorization and evidence of medical necessity, and may limit duration or frequency of use.
Employer health plans are changing: Employers are increasingly reviewing whether to add or restrict GLP-1 coverage for weight loss due to rising costs.
Which GLP-1 Drugs Are Covered for Weight Loss?
Certain GLP-1 drugs like Wegovy and Zepbound are approved for weight loss. However, eligibility for coverage often comes with strict parameters, like:
Medical necessity: Many plans require BMI ≥ 30 or BMI ≥ 27 with obesity-related comorbidity.
Documentation: Patients must submit physician notes, health history, and failed previous weight loss attempts.
Health program participation: As KFF found, about 34% of firms that cover GLP-1s for weight loss require employees to meet with a dietician or participate in a structured wellness or lifestyle program.
Prior authorization: Insurers may mandate approval upfront and renewals every 6-12 months.
Quantity/dose limits: Some cover only initial treatment periods, not long-term use.
How Much Are GLP-1 Drugs With Insurance?
Costs for GLP-1s under insurance vary dramatically:
Typical copay: GLP-1 drug costs under insurance typically range from $25 to $150 per month for diabetes treatment, but costs are often higher when prescribed for weight loss. Also, until the patient has met their deductible, they have to pay the full cost of the drug.
Deductibles and coinsurance: Many insurance plans require patients to meet deductibles, apply out-of-pocket maximums, or pay higher coinsurance rates for medications like GLP-1s.
Prior authorization and step therapy: Insurers often require prior authorization or step therapy protocols, which can delay access by requiring patients to try lower-cost medications first.
Average out-of-pocket costs: After meeting their deductible, the average insured patient paying for GLP-1s like Wegovy or Zepbound typically pays between $25 and $250 per prescription, depending on the plan’s design; some encounter even higher costs due to restrictions or exclusions.
How Much Are GLP-1 Drugs Without Insurance?
Without insurance, GLP-1 drugs are expensive, commonly reaching $1,000 to $1,320 per month. While discounts and copay cards can bring costs down for some drugs, GLP-1s currently remain financially inaccessible for millions of uninsured or underinsured Americans.
Pharmaceutical companies like LillyDirect and NovoCare are also offering direct-to-patient pricing that significantly undercuts traditional list prices for uninsured individuals. Through LillyDirect, Eli Lilly now sells Zepbound vials at lower monthly prices. And Novo Nordisk’s NovoCare programs similarly offer Wegovy and Ozempic savings for self-pay patients. These programs can cut GLP-1 costs roughly in half, but eligibility rules and time-limited promotions mean many patients may still struggle to afford long-term therapy.
How to Get GLP-1s for Weight Loss Without Insurance
For those lacking GLP-1 coverage for weight loss, you’re not out of options. Innovative and cost-saving solutions continue to emerge, including:
Manufacturer patient assistance programs: Eligibility varies, but some pharmaceutical manufacturers provide assistance programs to help those without insurance afford GLP-1 medications.
Coupons and discount cards: Pharmacies and bundle providers offer discount programs and copay cards that can reduce out-of-pocket expenses.
Weight loss clinics and telehealth platforms: Many clinics and digital health platforms offer bundled pricing or subscription plans for GLP-1 treatments, driving up costs even further.
Always consult with a licensed physician before starting any GLP-1 therapy for weight loss, especially when purchasing outside traditional insurance channels.
Introducing Andel: A New Solution for GLP-1 Access
Andel is revolutionizing drug affordability and access, starting with GLP-1s for weight loss. Andel leverages the buying power of aggregated members to directly source from manufacturers, unlocking lower prices and guaranteed supply for brand-name medications—including GLP-1s. That means no prepaying, rebate chasing, or complex claim setups.
Here’s a quick breakdown of how Andel works:
Andel buys direct: Andel leverages the combined buying power of our members to go direct to manufacturers for better prices and a guaranteed supply.
Employers contribute: Employers choose a contribution to make medications even more affordable for their employees.
Employees benefit: Andel’s app delivers a best-in-class pharmacy experience for members.
Andel’s solution is designed for employees who need GLP-1s and similar treatments, but whose employers can’t afford traditional coverage or want a smarter way to manage costs. By going straight to manufacturers and combining demand, Andel provides sustainable, scalable drug affordability.
Solving for GLP-1 Access—Today
GLP-1 drugs offer promise for treating diabetes and obesity, but their cost and coverage hurdles can be daunting. The good news is, Americans now have innovative options like Andel, which reimagines affordability and access for employees and employers alike.
By combining buying power and going directly to manufacturers, Andel unlocks affordable GLP-1s and other key drugs for more people—without breaking the bank, raising premiums, or exposing employees to unsafe buying channels. For HR leaders and plan sponsors, this is the next evolution in affordable access models: practical, sustainable, and centered on member impact.
Ready to learn more about how to save big on GLP-1s? Get in touch.
GLP-1 Drugs FAQs
Are GLP-1 drugs covered for weight loss?
Yes, certain GLP-1 drugs are covered for weight loss, but it depends on the insurance plan. Coverage also comes with steep eligibility rules. For example, employer plans may cover certain drugs like Wegovy or Zepbound for weight loss if certain clinical criteria are met.
What is the average monthly cost of GLP-1s with insurance?
Most insured patients pay between $25 and $250 per month after they have met their deductible, although coverage limits and exclusions may raise costs. Cash-pay discounts may reduce out-of-pocket for uninsured patients, but not always to insured levels.
Can employers contribute to GLP-1 costs directly?
Yes, Andel allows employers to choose a contribution that’s applied to member purchases, driving down costs and improving access.
