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Why Doesn’t Insurance Cover Semaglutide for Weight Loss? Ozempic is approved by the U.S. Food and Drug Administration (FDA) to: Help people with type 2 diabetes manage blood sugar levels
In 2021, House lawmakers introduced The Treat and Reduce Obesity Act, which would have allowed the federal government to expand Medicare Part D coverage to include weight loss medications.
Medicare Part D is prohibited to cover “agents when used for anorexia, weight loss, or weight gain (even if used for a non-cosmetic purpose.” Medicaid is another government insurance program ...
Without insurance coverage, the drugs can cost as much as $1,000 a month. ... plans to require Medicare and Medicaid to offer coverage for weight-loss medications, a move that could cost $36 ...
But research suggests far more people might qualify, with the Centers for Medicare and Medicaid Services estimating roughly 28 million people on Medicaid are considered obese. Medicare has been barred from offering the drugs under a decades-old law that prohibits the government-backed insurance program from covering weight-loss products.
Depending on the company and coverage plan, some medications, like Wegovy, are now covered for weight loss, but for people on Medicare, a 2003 law actually prevents weight loss medication coverage.
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