Wegovy semaglutide injection pens. Credit: K KStock/Adobe Stock
A significant percentage of private health plan enrollees do not know if their plan covers weight loss medications at a time when many are turning to glucagon-like peptide 1 drugs to help with weight loss, according to a study by the Employee Benefits Research Institute (EBRI).
GLP-1 is a naturally occurring hormone that regulates blood sugar and appetite. Typically given as an injection, these drugs have proven effective in promoting weight loss and appear to have additional cardiovascular benefits for some individuals. About half of enrollees said they were unsure whether their plan covered GLP-1s, while one-quarter said they did and one-fifth said they didn't.
However, most employees said health plans should cover GLP-1 medications, with 64% saying they should and 12% saying they should not. About one-quarter were unsure.
Only about 18% of employers with 200 or more employees cover GLP-1s for weight loss and many of those impose conditions or requirements for approval, a KFF study recently found. Requirements include meeting with a dietitian, psychologist, case worker or therapist before approving a prescription.
Without health plan coverage, GLP-1s are expensive, with list prices ranging from $900 to $1,300 per month. According to KFF, about half of all adults who have taken GLP-1 drugs say it was difficult to afford the cost, including 22% who say it was “very difficult.”
The 2024 Consumer Engagement in Health Care Survey, conducted with Greenwald Research, polled 2,011 Americans between the ages of 21 and 64 with private health insurance coverage. The online survey was fielded between October and November 2024.
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