As new GLP-1 medications make their way into the U.S. market and Medicare coverage becomes available, a significant issue persists: many employers are still not covering these drugs for weight loss.
In fact, various health plans are finding workarounds.
“It’s really a challenge to manage costs,” remarked Justin Held, who leads educational programs at the International Foundation of Employee Benefit Plans, in an interview. “It looks like they’re not specifically offering coverage for weight loss but are more focused on general employee health.”
The insights are from a survey released recently by IFEBP, a nonprofit comprising over 33,000 member organizations. Conducted in June, it focused on nearly 300 employer health plans across the nation.
About 36% of employers reported offering GLP-1 coverage for both diabetes and weight loss, which remains unchanged from 2025 but shows a slight increase from 34% in 2024.
On the other hand, 60% indicated they only provide coverage for diabetes, up from 55% in 2025 and 57% in 2024. Additionally, around 45% of plans said they cover GLP-1s for other conditions like obstructive sleep apnea and heart disease.
The stagnation in coverage for weight loss isn’t particularly surprising.
Health plans have a long history of hesitance when it comes to the high costs associated with covering GLP-1 medications from Eli Lilly and Novo Nordisk, especially given the rising demand in the U.S. Consequently, many plans have either restricted this coverage or eliminated it altogether.
Cost continues to play a major role in employer decisions regarding GLP-1 coverage, with respondents noting that these drugs accounted for 11.4% of annual claims in 2026, a jump from 6.9% in 2023.
However, employers are exploring alternative ways to assist employees wanting to utilize these medications.
“The financial burden is substantial, so they are saying there are different avenues to explore, all while trying to attract and keep talent,” Held noted.
Approximately 27% of employers encourage employees to obtain GLP-1s through direct-to-consumer channels, and 21% suggest using FSA, HSA, or HRA accounts for these treatments.
As costs rise, Held indicated that it presents a chance for employers to highlight existing benefits they provide in this area.
For instance, 74% of plans offer disease and chronic care management, 61% provide nutritional counseling, and another 61% have bariatric surgery included. Employers also report covering benefits related to lifestyle change programs, other non-GLP-1 medications, and various medication-free weight loss interventions.
So, what would prompt more employers to expand their GLP-1 coverage to include obesity?
According to Held, demonstrating that such coverage can ultimately lower costs in different domains could change things. This might involve fewer knee replacements, reduced bariatric surgeries, or improved productivity and wellness outcomes.
“If we start seeing those benefits, they might conclude it’s worthwhile to offer comprehensive coverage for weight loss, given the positive impact on other parts of our organization,” he said. “But we haven’t observed that yet.”
While some studies hint that the long-term savings from GLP-1 could balance out the high initial costs, there hasn’t been extensive real-world evidence supporting this yet.
We might begin to see some tangible savings after a new 18-month program launches, allowing Medicare to provide coverage for GLP-1s for obesity for the first time.
Until then, approximately 9% of employers are contemplating including GLP-1 coverage for obesity. We’ll continue to monitor any developments in this area.
