Despite 40% of Americans living with obesity, access to GLP-1 medications is rapidly eroding. Nearly two-thirds of Americans with insurance are now in plans that either exclude all, or cover only one, new-generation obesity medication.
In recent months, access to GLP-1 medications for weight management has been dealt a major setback, with insurers like Blue Cross Blue Shield announcing they will drop coverage for anti-obesity drugs in Massachusetts. Meanwhile, this past April, the Trump administration announced that Medicare and Medicaid will not be covering obesity medications, including GLP-1s.
Recently, the Washington Post reported that The Centers for Medicare & Medicaid Services (CMS) is planning to offer coverage to some patients for GLP-1 medications under a “five-year experiment”. This means that state Medicare Part D insurance plans and Medicaid programs would be able to voluntarily choose to offer coverage for GLP-1s for weight management.
This patchwork approach to coverage highlights a fundamental problem: patients are being forced to navigate an inconsistent and often opaque system just to access medically necessary care.
As coverage erodes and policies shift, providers are left advocating against red tape while patients face rising out-of-pocket costs, disrupted treatment plans, and worsening health outcomes.
This troubling reality for patients is due to one simple fact: obesity treatment is still not considered a standard benefit by many health plans. Without coverage, patients face monthly costs that can exceed $1,000, effectively putting these life-changing medications out of reach for many people. The lack of insurance support not only undermines individual health outcomes but also sacrifices long-term cost savings from preventing complications like diabetes, heart disease, and sleep apnea.
This coverage gap exists in part because legislation like the Treat and Reduce Obesity Act, which would make anti-obesity medications a standard, reimbursable benefit under Medicare—has yet to pass. Meanwhile, many employers are dropping obesity drug coverage due to short-term cost concerns, despite the overwhelming evidence that effective treatment reduces downstream healthcare costs. For patients, this means navigating a complex prior authorization process when coverage is available and facing abrupt medication loss when employers or insurers change policy.
At knownwell, we understand that prior authorizations can be one of the most frustrating parts of the patient and provider experience. That’s why we focus on making the process as simple and convenient as possible, working directly with insurers, employers, and providers to minimize delays. When coverage is denied or lost, we don’t stop there. We partner with manufacturers like Eli Lilly to connect patients with savings programs and other resources that can make GLP-1 medications more affordable without insurance.
Beyond GLP-1s, knownwell offers access to a full spectrum of evidence-based weight management treatments, including other prescription medications, personalized nutrition counseling, and ongoing support from our registered dietitians. This holistic approach ensures that each patient has a care plan tailored to their unique needs, because weight management is about more than a single medication, it’s about sustainable, whole-person health.
