Insurance stopped covering your GLP-1 in 2027? Your options

What changed in 2026, and what's coming in 2027

Employer coverage of GLP-1 medications for weight loss is shrinking, and 2027 continues the trend. Business Group on Health's survey of large employers found that the share covering GLP-1 weight-loss drugs fell from 72% in 2025 to 60% in 2026, as Reuters reported on August 25, 2026. SHRM reported on September 1, 2026 that 14% of employers in the same survey, which covered 127 employers and 8.7 million lives, have already dropped or plan to drop GLP-1 coverage for weight management by 2027, up from 10% earlier in the year.

Several large employers have made their changes public. In each case below, the change applies to GLP-1s used for weight loss; PwC and PepsiCo said diabetes coverage continues. As reported:

• Starbucks: starting in October 2026, no longer covers GLP-1 medications prescribed for weight loss for benefits-eligible employees, a change a company spokesperson confirmed (Business Insider, August 7, 2026).
• PwC (US): ends weight-management coverage starting July 2026 and continues to cover diabetes (Financial Times, via The Irish Times, May 1, 2026).
• Cigna, as an employer: stopped covering GLP-1s for weight loss through its own employee health plan on July 1, 2026 (ABC News, August 29, 2026).
• PepsiCo: cut weight-loss coverage while keeping diabetes coverage, according to an employee letter ABC News reviewed (ABC News, August 29, 2026).
• Massachusetts state employees (GIC): weight-loss GLP-1s are not covered starting July 1, 2026; some members still qualify through cardiovascular disease, sleep apnea or MASH (Mass.gov, June 8, 2026).

CVS Caremark adds Zepbound back on October 1, 2026, but your employer still decides

On May 28, 2026, CVS Health announced that CVS Caremark "will add Zepbound back to our commercial formularies as an additional preferred option October 1, 2026," for "plan sponsors who elect to provide coverage of those medications for their members." The same release says plan sponsors that adopt CVS Caremark's template formularies "retain discretion to customize coverage for their members."

In plain terms, a drug being on a formulary does not mean your plan covers it for weight loss. If your employer has excluded weight-loss GLP-1s, the October 1 change does not restore your coverage. If your employer does cover them, ask your plan which GLP-1s are preferred on your 2027 formulary, and talk to your prescriber before any switch.

Medicaid: states that stopped covering GLP-1s for weight loss

State Medicaid coverage is contracting too. KFF counted 13 state Medicaid programs covering GLP-1s for obesity under fee-for-service as of January 2026, down from 16 in October 2025 (KFF, January 16, 2026). California, New Hampshire, Pennsylvania and South Carolina stopped covering adult GLP-1 prescriptions for obesity on January 1, 2026 (KFF Health News, January 13, 2026). MassHealth in Massachusetts ended coverage for weight loss on July 3, 2026, after KFF's count.

Some programs still cover GLP-1s in narrower cases. MassHealth continues coverage, with prior authorization, for certain members with cardiovascular disease, MASH or obstructive sleep apnea (MassHealth Pharmacy Facts #271). Pennsylvania kept a pathway for members under 21 (Pennsylvania Bulletin, Vol. 55, No. 52).

The federal BALANCE model let states apply to add coverage: applications closed July 31, 2026, with state start dates between May 1, 2026 and January 1, 2027. CMS says the model "will not guarantee coverage for any individual," and participating states are not publicly listed (CMS, updated August 14, 2026). If you have Medicaid, ask your plan directly what it will cover in 2027.

Manufacturer offers with a December 31, 2026 date

Three Lilly and Novo Nordisk programs have a December 31, 2026 date. LillyDirect's vial prices do not.

Lilly's Zepbound Savings Card expires December 31, 2026. Its terms say: "Card expires and savings end on 12/31/2026." If your commercial insurance covers Zepbound, the card lets you pay as little as $25 for a one-, two- or three-month prescription of the single-dose pen, up to $1,300 in savings a year. If you have commercial insurance that does not cover Zepbound, it offers the single-dose pen from $499 a month. The card excludes people with government coverage, including Medicare, Medicaid, TRICARE and the VA (Lilly Zepbound Savings Card terms, checked September 24, 2026).

Lilly's KwikPen self-pay prices also end December 31, 2026. LillyDirect's Zepbound KwikPen prices ($299 for 2.5 mg, $399 for 5 mg, and $449 for 7.5 mg to 15 mg, with the same 45-day refill rule) run through Lilly's Zepbound KwikPen Self-Pay Savings Program, which allows up to 11 fills a year and whose terms say "Card expires and savings end on 12/31/2026" (Lilly, checked September 24, 2026).

NovoCare's introductory Wegovy price ends December 31, 2026. New patients pay $199 a month for the first two monthly fills of the 0.25 mg or 0.5 mg pen, then $349 a month, and NovoCare says its pricing is "to be updated after December 31, 2026" (NovoCare, checked September 24, 2026). Wegovy self-pay prices for 2027 have not been published.

Only LillyDirect's vial self-pay prices have no published end date. The Zepbound vial prices ($299 for 2.5 mg, $399 for 5 mg, and $449 for 7.5 mg to 15 mg on the first fill and on refills within 45 days) show no expiration on the LillyDirect page as of September 24, 2026. Lilly can still change them, so confirm the price before each refill.

Medicare: the GLP-1 Bridge runs through December 31, 2027

If you have Medicare Part D, 2027 looks different. CMS delayed the Part D portion of its BALANCE model for calendar year 2027 and extended Medicare's GLP-1 Bridge, which started July 1, 2026, through December 31, 2027 (CMS memo, April 21, 2026). Eligible beneficiaries pay a $50 copayment for a one-month supply of Wegovy, Foundayo or the Zepbound KwikPen. With a $50 copayment for a one-month supply, the Bridge is likely to cost less than any cash-pay price on this page, including Cora's plans for compounded medication, which is not FDA-approved and is not therapeutically equivalent to FDA-approved products. It is not automatic: you need Part D, you must meet BMI and health criteria, and your provider must submit a prior authorization. The full eligibility rules are in our coverage-changed guide.

Open enrollment dates for 2027 coverage

Open enrollment is your chance to pick a plan that covers your medication, if one is available to you. Check the formulary of every plan you are considering, including a spouse's plan, before you enroll. Dates checked September 24, 2026:

• Medicare Open Enrollment: October 15 to December 7, 2026, with coverage starting January 1 (Medicare.gov).
• HealthCare.gov Marketplace: November 1, 2026 to January 15, 2027. Enroll by December 15 for coverage that starts January 1. State-run marketplaces can set different dates (HealthCare.gov).
• Employer plans: your employer sets its own open enrollment window. Ask HR for the dates and the 2027 prescription formulary.

What paying out of pocket costs, side by side

If your coverage ends, these are the published monthly prices to compare. Brand-name prices are per LillyDirect and NovoCare, checked September 24, 2026, and require a valid prescription from your prescriber. Cora's prices are from its published plans. The Cora rows are compounded medications, which are not FDA-approved and are not therapeutically equivalent to FDA-approved products; this table compares prices, not products. Brand names are trademarks of their respective owners.

Before your coverage ends: a checklist

Work through these in order, ideally as soon as you get the notice:

• Ask HR or your plan for the 2027 prescription formulary, the exact date weight-loss coverage ends, and whether GLP-1s stay covered for other conditions.
• Ask your prescriber whether your medical history meets any criteria the plan will still cover, and whether a prior authorization or appeal is worth filing. If a renewal was already denied, see what to do after a prior authorization denial.
• If you have Medicare Part D, ask your provider whether you meet the GLP-1 Bridge criteria. Your provider submits the prior authorization.
• Compare plans during open enrollment, including a spouse's plan, and check each plan's formulary.
• Compare self-pay prices, including LillyDirect's 45-day refill rule and the offers that end December 31, 2026.
• Don't stop, switch or change your dose on your own; any change to your medication is a decision for your prescriber.
• For a situation-by-situation guide (lost job, turning 65, restarting after a break, switching providers), see Your GLP-1 coverage changed: what to do next.

Where Cora fits

Cora Health is one cash-pay option among several on this page. Check the appeal route and any Medicare benefit you qualify for first. Cora connects patients with licensed providers at Wasef Health, PC, who may prescribe compounded semaglutide or compounded tirzepatide when appropriate; a US-licensed 503A compounding pharmacy prepares and dispenses the medication. Cora does not prescribe or compound medication. Compounded medications are not FDA-approved. They are prepared by state-licensed pharmacies based on a valid prescription from a licensed provider. Compounded medications are not therapeutically equivalent to FDA-approved products. Brand-name and compounded doses are not interchangeable, and there is no dose conversion between them; your provider determines the right dose based on your history. Plans start at $99/month for compounded semaglutide and $135/month for compounded tirzepatide on the annual plan ($1,188 and $1,620 billed every 12 months), renew automatically until you cancel, and accept HSA and FSA cards. Prices may change. Every tier is on the plans page.

FAQ: GLP-1 coverage in 2027

Will CVS Caremark plans cover Zepbound in 2027? Zepbound returns to CVS Caremark's commercial formularies as an additional preferred option on October 1, 2026, but only for plan sponsors that elect to cover these medications. Ask your plan whether it covers Zepbound for weight loss in 2027.

Will the Zepbound Savings Card work in 2027? Not under its current terms: the card expires and savings end on December 31, 2026, and the same date applies to Lilly's KwikPen self-pay program. Only LillyDirect's vial self-pay prices show no end date.

My state Medicaid program stopped covering GLP-1s for weight loss. What else is there? Ask your Medicaid plan whether any of your health conditions still qualify, since some states cover narrower uses. Lilly's Zepbound Savings Card excludes people in government programs, including Medicaid, and Novo Nordisk says government-insured patients can use its Wegovy self-pay pricing only if they pay outside their insurance. Ask LillyDirect directly whether its self-pay pricing is available to you.

Sources

Last verified: September 24, 2026. Prices, formularies and program terms change; confirm with the source before you decide. This article is general information, not medical, legal or insurance advice. Wegovy® and Zepbound® are registered trademarks of their respective owners; NovoCare, LillyDirect, KwikPen and Foundayo are trademarks of their respective owners. Cora Health is not affiliated with Novo Nordisk or Eli Lilly.

• Reuters: more US employers drop weight-loss drugs for 2027 (August 25, 2026). reuters.com
• SHRM: growing number of employers dropping GLP-1 coverage (September 1, 2026). shrm.org
• Business Insider: Starbucks cuts GLP-1 coverage for weight loss (August 7, 2026). businessinsider.com
• The Irish Times (Financial Times): PwC US to drop cover for weight-loss drugs (May 1, 2026). irishtimes.com
• ABC News: companies and GLP-1 weight-loss coverage (August 29, 2026). abcnews.com
• Mass.gov: June update on Vida Health program and GLP-1 coverage (June 8, 2026). mass.gov
• CVS Health: CVS Caremark GLP-1 weight management coverage options (May 28, 2026). cvshealth.com
• KFF: Medicaid coverage of and spending on GLP-1s (January 16, 2026). kff.org
• KFF Health News, as published by the New Hampshire Union Leader (January 13, 2026); Medi-Cal Rx member notice; NH Healthy Families notice; Pennsylvania Bulletin, Vol. 55, No. 52.
• MassHealth Pharmacy Facts #271 (March 12, 2026, corrected). mass.gov
• CMS: status update on the Medicare GLP-1 Bridge and the BALANCE model Part D portion for CY2027 (April 21, 2026). cms.gov
• CMS: BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model page (updated August 14, 2026). cms.gov
• CMS: Medicare GLP-1 Bridge (checked September 24, 2026). cms.gov
• Eli Lilly: LillyDirect Zepbound self-pay pricing (checked September 24, 2026). lilly.com
• Eli Lilly: Zepbound Savings Card and KwikPen self-pay program terms (checked September 24, 2026). zepbound.lilly.com
• Novo Nordisk: NovoCare Pharmacy Wegovy pricing and Wegovy savings offer (checked September 24, 2026). novocare.com
• Medicare.gov: Joining a plan (checked September 24, 2026). medicare.gov
• HealthCare.gov: Dates and deadlines for 2027 coverage (checked September 24, 2026). healthcare.gov