INSURANCE & GLP MEDICATIONS
GLP medications such as Ozempic, Mounjaro, Wegovy and Zepbound are part of a group of drugs that have been prescribed for over two decades to help people with Type 2 Diabetes better manage their blood sugar. They can also be prescribed to reduce cardiovascular disease risk (cardiovascular risk means a history of heart disease, such as a prior heart attack or stroke).
In recent years, these medications have become popular due to their ability to aid with weight loss. However, insurance coverage for these medications is inconsistent. Virtually all insurance companies will cover GLPs for diabetes management, and most will cover for cardiovascular risk reduction. However, not all will cover for weight loss and their coverage may be limited. Here is a list of NYC area insurance plans and what they cover.
AETNA: Covers GLPs for diabetes and cardiovascular risk. Coverage for weight loses varies by plan type but would cover individuals with a BMI 30 and above, or a BMI 27 and above with at least one other medical condition.
BLUE CROSS BLUE SHIELD: Covers GLPs for diabetes and cardiovascular risk. Coverage for weight loses varies by plan type but would cover individuals with a BMI 30 and above, or a BMI 27 and above with at least one other medical condition.
CIGNA: Covers GLPs for diabetes and cardiovascular risk. Coverage for weight loses varies by plan type but would cover individuals with a BMI 30 and above, or a BMI 27 and above with at least one other medical condition.
FIDELIS: Covers GLPs for diabetes and cardiovascular risk only. Coverage only for weight loss is excluded.
MEDICAID: Covers GLPs for diabetes and cardiovascular risk only. Coverage only for weight loss is excluded.
MEDICARE & MEDICARE ADVANTAGE PLANS: Covers GLPs for diabetes and cardiovascular risk only. Coverage only for weight loss is excluded.
METROPLUS: Covers GLPs for diabetes and cardiovascular risk only. Coverage only for weight loss is excluded.
MOLINA: Covers GLPs for diabetes and cardiovascular risk only. Coverage only for weight loss is excluded.
UNITED HEALTHCARE: Covers GLPs for diabetes and cardiovascular risk. Coverage for weight loses varies by plan type but would cover individuals with a BMI 30 and above, or a BMI 27 and above with at least one other medical condition.