By Whitney Stidom, Vice President of Consumer Enablement, eHealth

Most Americans — about 92% — have health insurance, either at work, through Medicare or Medicaid, or an individual Affordable Care Act (ACA) plan.

If you are among them, one question may be top of mind as you use your benefits in 2026: Does my health insurance help cover the cost of GLP-1 drugs?

The short answer: Coverage varies depending on the type of insurance plan and what these drugs are being prescribed for. But recent and upcoming changes are starting to make these drugs more accessible for more Americans, including if you have Medicare.

Originally developed to help treat type 2 diabetes, GLP-1 drugs have proven effective at promoting weight loss, at least for as long as the medications remain in use. Whether you have health insurance or not, here’s the latest on how to potentially access GLP-1s:    

Paying out of pocket without insurance
The Trump Administration is taking steps to make it more affordable for people without insurance, including from any state, government or federally funded program, to access GLP-1s through TrumpRx.gov. The new site offers certain types of drugs with monthly prices that average $350 and as low as $199, depending on dosage. That compares to previous monthly prices of over $1,000. If you don’t have insurance, this is among the most affordable ways to access a GLP-1 for weight loss or the treatment of a chronic condition such as diabetes.       

Paying through an employer-sponsored plan
Most Americans get their health insurance through an employer. If you have an employer plan, coverage for GLP-1 drugs can vary widely depending on the plan sponsor, insurer, the plan type, and the medical reason for prescribing the drug. While some plans may cover these medications for diabetes management, coverage for weight loss alone is far less common. For instance, 55% of employers cover GLP-1s for diabetes, but just 36% of companies cover these drugs for weight loss. If your employer-plan does not cover GLP-1s, it may be more affordable to pay the cash price rather than using insurance, especially for plans with high deductibles.  

Paying through Medicare or Medicaid
If you have Medicare or Medicaid, GLP-1 drugs are generally covered for the treatment of certain chronic conditions. For instance, 98% of Medicare Advantage plans cover at least one GLP-1 drug for the treatment of diabetes. Coverage for weight loss is far less common, with fewer than 1% of Medicare Advantage plans offering that.  

Like people paying cash, the Trump Administration is seeking to expand access to GLP-1 drugs for individuals with Medicare and Medicaid coverage. Starting later this year and continuing into 2027, the monthly cost of certain GLP-1s will be less than $245 for Medicare and Medicaid enrollees, with Medicare beneficiaries potentially paying a co-pay of just $50 per month.

Paying through an Affordable Care Act (ACA) plan
Similar to Medicare and Medicare, people enrolled in ACA plans will often have coverage of GLP-1s for the treatment of diabetes, but less so for weight loss. More than 90% of ACA plans include GLP-1 coverage for diabetes; when it comes to weight loss, just 3% of such plans include coverage.     

If you or a loved one is considering a GLP-1 drug, it is important to review your health benefits carefully to understand when these drugs may be covered and at what price, especially with insurance policies continuing to evolve.