Coverage
3 pages in this section, most recently updated September 4, 2026.
- 01
Medicare and GLP-1s in 2026: the Part D exclusion, the $50 Bridge, and the 2027 prices
Why Medicare Part D could not cover Wegovy or Zepbound for weight loss, which indications it does cover, how the Medicare GLP-1 Bridge works from July 1, 2026 to December 31, 2027 ($50 a month, Wegovy, Zepbound KwikPen, Foundayo, CMS criteria), the indefinitely postponed BALANCE model, the $245 manufacturer price and the $274 negotiated semaglutide price for 2027.
Updated September 4, 2026
- 02
Medicaid and GLP-1s in 2026: 13 states cover obesity, 4 dropped out, and the $245 price
What state Medicaid programs cover as of KFF's January 2026 count: GLP-1s for diabetes everywhere by federal rule, obesity coverage optional and offered by 13 states under fee-for-service, four states that dropped it since October 2025, the utilization controls every state applies, and the $245 per month manufacturer price available to states from the November 2025 agreement.
Updated September 4, 2026
- 03
Employer coverage of GLP-1s for weight loss: the IFEBP 2026 survey numbers
What the International Foundation of Employee Benefit Plans found in its GLP-1 Drugs: 2026 Pulse Survey (U.S.): 36 percent of corporate plans cover GLP-1s for both diabetes and weight loss, flat on 2025; 60 percent cover diabetes only; 45 percent cover other approved conditions; 90 percent impose a BMI minimum; and GLP-1s reached 11.4 percent of corporate claims. With the 2023 to 2026 trend and what it means for what you pay.
Updated September 4, 2026