Wegovy, an FDA-approved weight loss medication, has been a game-changer for many individuals struggling with obesity. However, recent changes in insurance policies have led to a growing number of patients discovering that Wegovy is no longer covered for weight loss under their health plans. This shift is raising concerns, questions, and frustrations among patients and providers alike.
In this article, we explore why Wegovy is being dropped by insurers, which plans still cover it, and what alternatives exist for patients.
Why Is My Insurance No Longer Covering Wegovy?
Many insurance providers are re-evaluating their coverage of GLP-1 medications like Wegovy due to rising costs and questions about long-term outcomes. While Wegovy is clinically proven to help with significant weight loss, some insurers consider obesity a lifestyle issue rather than a chronic condition, leading them to exclude coverage for anti-obesity medications.
Additionally, high demand and supply chain issues have also made insurers more selective. Employers that purchase group health plans may also opt out of obesity drug coverage to manage costs, leading to variability in coverage across plans.
Why Is BCBS Not Covering Wegovy?
Blue Cross Blue Shield (BCBS), like many insurers, often reviews medications based on clinical guidelines, cost-effectiveness, and employer plan design. If Wegovy is not listed in your BCBS plan’s formulary, it’s likely due to either:
- Employer-chosen plan exclusions,
- Limited medical policy on weight loss treatments,
- Or reclassification of Wegovy under “non-essential” drugs for weight loss.
It’s important to contact BCBS or check the drug formulary of your specific plan for current coverage status.
Can You Really Get Wegovy for $25?
In some cases, yes. Novo Nordisk, the manufacturer of Wegovy, offers a savings card program that allows eligible commercially insured patients to pay as little as $25 per 28-day prescription. However, this offer is not valid for patients on government-funded insurance like Medicare or Medicaid and depends on specific plan participation.
To access this, patients must:
- Have commercial insurance coverage,
- Download the savings card from the Wegovy website,
- Present it to their pharmacy along with the prescription.
What Insurance Plans Cover Wegovy for Weight Loss?
Coverage varies significantly by plan and state. As of mid-2025, some private insurance plans, employer-sponsored plans, and a few state Medicaid programs offer coverage for Wegovy, but it’s not guaranteed.
To determine if your plan covers Wegovy:
- Request the drug formulary from your insurer.
- Ask if anti-obesity medications are included in the plan.
- Confirm any prior authorization or step therapy requirements.
Medicare currently does not cover Wegovy or any other weight loss medications, though policy changes are under discussion at the federal level.
What To Do If Wegovy Is No Longer Covered
If you find that Wegovy is no longer covered for weight loss, consider the following steps:
- Appeal the decision: You or your doctor can submit a formal appeal with medical necessity documentation.
- Explore manufacturer savings programs: Novo Nordisk’s programs can ease the financial burden if you qualify.
- Consult your doctor about alternatives: Other GLP-1 medications or lifestyle programs may be available and effective.
- Switch plans during open enrollment: Some insurance plans offer better coverage for weight loss medications. Work with a broker to find one that includes Wegovy.
Final Thoughts
The growing number of insurers who have decided that Wegovy is no longer covered for weight loss leaves many patients at a crossroads. While the drug remains a promising tool in combating obesity, the battle for insurance coverage continues. Staying informed about your options, rights, and alternative treatments is key to maintaining your health and weight loss goals.
