Employer coverage of GLP-1s for weight loss holds steady as drug share of claims rises
Health plans are keeping obesity coverage where it was last year while GLP-1 spending climbs, so the plan a patient is enrolled in often determines whether the prescription is paid for.
A June 2026 survey of nearly 300 U.S. employer health plans found that 36% cover GLP-1 medications for weight loss as well as diabetes — the same share as a year earlier, even as spending on the drug class keeps rising [1][2].
The International Foundation of Employee Benefit Plans, which has tracked GLP-1 coverage since October 2023, ran the poll in June and published the results on July 7 [1][2]. The nonprofit's membership includes more than 33,000 companies and public institutions [2]. In the survey, 60% of plans said they cover the drugs for diabetes alone, a share that has climbed from 49% in 2023 and 57% in 2024 to 55% in 2025 [1]. Another 45% cover GLP-1s for other FDA-approved conditions such as obstructive sleep apnea and heart disease [1][2]. On the combined diabetes-and-weight-loss question, the figure has gone from 26% in 2023 to 34% in 2024 to 36% in both 2025 and 2026 [1].
Cost is the main driver. GLP-1 drugs made up 11.4% of annual claims in 2026, up from 6.9% in 2023 [1][2]. "It's a battle to try to keep costs down," Justin Held, the foundation's director of educational programs, said in an interview. He said employers aren't necessarily offering coverage for weight loss, and are instead focusing on how to support their workers' overall health [2].
Plans that stop short of covering obesity often point members elsewhere: 27% encourage workers to get the drugs through a direct-to-consumer platform, and 21% encourage use of an FSA, HSA or integrated HRA [1]. Among employers that don't cover the drugs for weight loss, 9% are weighing whether to add it, and 83% of that group keep the drugs out through a carve-out from the medical or prescription drug plan [1].
Other weight-related benefits are more widespread. Disease and case management is offered by 74% of plans, nutritional counseling by 61% and bariatric surgery by 61%, with some employers also covering lifestyle modification programs, non-GLP-1 prescriptions and medication-free weight-loss options [1]. The factors employers say matter most when considering obesity coverage are recommendations from brokers, consultants or pharmacy benefit managers (58%); obesity as a risk factor for chronic disease and its costs (46%); and the effect of cost-control measures on premiums (44%). Oral pill forms were cited by 34% [1]. Carey Wooton, CEBS, associate vice president of education at the foundation, said the findings indicate most employers are not covering the drugs for weight loss and are focusing instead on workers' overall health [1].
Why it matters for patients
Coverage is decided plan by plan, and many plans sort it by diagnosis. A GLP-1 that is paid for when prescribed for type 2 diabetes may not be covered when the same prescription is written for obesity. The survey does not specify which products sit on which formulary, what members pay in copays or deductibles, or how prior authorization is handled; those details have not been reported [1]. The drugmakers involved include Eli Lilly and Novo Nordisk [2].
The survey also shows how often employers steer patients outside the insurance benefit. Direct-to-consumer platforms generally mean paying cash, while FSAs, HSAs and integrated HRAs draw on pre-tax money a worker has set aside [1].
Medicare began an 18-month program on July 1, 2026 that pays for GLP-1s for obesity for the first time [2]. Held said what could persuade more employers to cover the drugs for weight loss is evidence that doing so lowers costs in other areas — fewer knee replacements or bariatric surgeries, for example, or better productivity and wellness results. "If those things are happening, then they might say it's worth it to offer full coverage for weight loss as well, because the impact on the other areas of our organization is so positive," he said. "But we just haven't seen that yet" [2].
What happens next
The 9% of plans now considering obesity coverage could add it in a future plan year, though the survey offers no timeline [1]. Results from the Medicare program that started July 1 may give the first real-world look at whether covering obesity treatment produces savings elsewhere. Some studies and estimates point to downstream savings, but CNBC reported there is no broad measured proof from real-world data so far [2].
Sources
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