GLP-1 Coverage by Insurance Plan
Where your own plan stands on Wegovy, Ozempic, Zepbound and Mounjaro as things sit in 2026.
Editorial note: Cover for these drugs is moving fast, as plans react to new evidence and to federal and state policy that keeps shifting under them. Before you decide anything clinical or financial on the strength of this page, ring your own plan administrator or member services line and confirm where you actually stand.
Blue Cross Blue Shield
119,100,000 members · Coverage: varies
Medicaid
90,000,000 members · Coverage: varies
Medicare
67,000,000 members · Coverage: limited
UnitedHealthcare
49,800,000 members · Coverage: varies
Anthem
47,000,000 members · Coverage: varies
Aetna
39,000,000 members · Coverage: varies
Cigna
18,000,000 members · Coverage: varies
Humana
17,000,000 members · Coverage: limited
Kaiser Permanente
12,700,000 members · Coverage: limited
TRICARE (Military)
9,600,000 members · Coverage: limited
The states worth reading first
A few states have made decisions strange enough to be instructive. Start with these and the shape of state Medicaid GLP-1 coverage in 2026 becomes much easier to read.
North Carolina — positive coverage
Cut in October 2025 and restored 73 days later, in December. It is also the first state to list Wegovy as Preferred for long-term weight management.
Pennsylvania — policy reversal
California in reverse. Pennsylvania ended GLP-1 obesity cover on 1 January 2026, 34 months after starting it, citing $836M a year in FY26-27 savings. Three documents anchor it: MAB2025112403, 55 Pa.B. 8828 and 55 Pa. Code § 1121.54.
California — reversed course
Both Wegovy and Zepbound came off for weight loss on 1 January 2026. Wegovy returned on 1 April, but for MASH alone under ICD-10 K76.0 or K75.8 — not for weight management.
New York — strongest-evidenced
Triple-anchored on federal 42 USC + state regulation 18 NYCRR § 505.3(g)(3) + NYRx contractor brand-named exclusion. Narrow Wegovy MACE pathway with NY-specific BMI ≥ 40 + 2-attempt cap.
Florida — silent operational exclusion
Nothing states the exclusion outright. It works by omission from the AHCA PDL, backed by deferrals we quote word for word from five plans: Sunshine, Humana, Simply, Molina and Aetna BH FL.
Tennessee — positive-coverage expansion
TennCare ADDED obesity-indication coverage Aug 1, 2025 via Sequence 10-34-25 rulemaking. Broadest AOM panel + 5-indication GLP-1 PA form (T2D + obesity + MACE + OSA + MASH).
Looking for a different state? See the full state-by-state coverage hub →
Sources & methodology — as of September 2026
- 1.KFF — Medicaid coverage research (anti-obesity & GLP-1 drug policy)— Kaiser Family Foundation.
- 2.CMS — Medicare Part D Prescription Drug Coverage Program— Centers for Medicare & Medicaid Services.
- 3.IRS Publication 502 — Medical and Dental Expenses (HSA/FSA eligibility)— Internal Revenue Service.