Does Insurance Cover Zepbound or Wegovy for Weight Loss?

There is no single answer. Most employer plans do not cover these drugs for weight loss, Medicare covers them for weight loss only through a temporary program, and Medicaid coverage depends on the state.

The fastest way to know is to call your plan and ask about each drug by name. The steps are at the bottom of this page.

• KFF's 2026 survey found 18% of firms with 200 or more workers cover GLP-1 drugs for weight loss, similar to 19% a year earlier. Coverage was 16% at firms with 200 to 999 workers and 33% at firms with 5,000 or more.
• Among firms that do cover them, 40% require a meeting with a dietitian, case manager or therapist, or enrollment in a lifestyle program. At the largest firms that share is 59%.
• 12% of firms that do not cover them said they stopped covering these drugs in the last year, and 79% of non-covering firms said they are not likely to start in the next year.

Your own plan can differ from these averages. Check your plan documents or call the number on your card.

Medicare Part D does not generally cover drugs for weight loss. The temporary Medicare GLP-1 Bridge is the exception, running July 1, 2026 through December 31, 2027.

• Cost: $50 copay for a one-month supply. It does not count toward the Part D deductible or the out-of-pocket cap.
• Drugs: Wegovy (injection and tablets), Foundayo, and the Zepbound KwikPen. Zepbound vials and single-dose pens are not covered, and pen needles are not covered.
• Who qualifies, age 18 or older: a BMI of 35 or higher; or a BMI of 30 or higher with heart failure with preserved ejection fraction, uncontrolled high blood pressure or chronic kidney disease stage 3a or higher; or a BMI of 27 or higher with prediabetes, a prior heart attack or stroke, or symptomatic peripheral artery disease.
• Process: your prescriber requests prior authorization and attests to the criteria. CMS says the Bridge has no appeals process, though a prescriber can resubmit. The help line is 855-273-0102.
• Not eligible for the Bridge: people with type 2 diabetes, moderate to severe sleep apnea or noncirrhotic MASH. Medicare.gov says their Part D plan might cover the drug, so ask your plan.

KFF estimated about 3.8 million Medicare beneficiaries met the criteria, using 2023 claims.

KFF counted 13 state Medicaid programs covering GLP-1s for obesity under fee-for-service as of January 2026, down from 16 in its October 2025 survey. California, New Hampshire, Pennsylvania and South Carolina ended coverage. North Carolina ended and then reinstated it in December 2025. Check your state Medicaid program for current rules, because they change.

• Zepbound card: as little as $25 for the single-dose pen with commercial coverage, capped at $100 per one-month fill. If your commercial plan does not cover Zepbound, the single-dose pen is as low as $499. The card ends 12/31/2026, and it excludes Medicare, Medicaid and other government programs.
• Zepbound self-pay: KwikPen from $299 (2.5 mg) and $399 (5 mg), and $449 for 7.5 mg and up with refill terms. See vials vs pens.
• Wegovy card: as little as $25 a month with commercial insurance, with maximum savings of $100 a month. Savings do not count toward deductibles.
• Wegovy self-pay: $199 a month for the first two fills of 0.25 and 0.5 mg for new patients through 12/31/2026, then $349 a month. Tablets are $149, $199 or $299 depending on dose. Patients with government coverage can use only the self-pay prices.

Prices and card terms reviewed November 3, 2026. The manufacturers can change or end them at any time.

Zepbound is also FDA approved to treat moderate to severe obstructive sleep apnea in adults with obesity. Wegovy is also approved to reduce the risk of major cardiovascular events in adults with established cardiovascular disease and either obesity or overweight. If you have one of these conditions, ask whether your plan covers the drug for that use, because the criteria can differ from weight loss.

1. Call the member services number on your insurance card.
2. Ask about Zepbound and Wegovy by name. Ask whether each is covered for weight management and whether your plan excludes weight-loss drugs.
3. Ask about prior authorization, BMI or health-condition requirements, lifestyle program requirements and quantity limits.
4. Ask separately about coverage for sleep apnea, cardiovascular disease and diabetes.
5. Write down the call reference number and ask for the answer in writing.

If your plan says no, see how to appeal a denial, or compare self-pay options below.