No Medicare coverage for obesity treatment? These are the states where it’s still available

If you’re hoping to use a GLP-1 drug like Wegovy to treat obesity and you’re on Medicare, you’re out of options. The program still doesn’t cover obesity drugs, even as more Americans face the condition and a handful of state Medicaid programs inch forward.

Which states cover GLP-1s for obesity?

As of late 2024, only 14 state Medicaid programs cover GLP-1 drugs like Wegovy, Saxenda, or Zepbound for the treatment of obesity. These states are: California, Connecticut, Indiana, Maryland, Michigan, Minnesota, North Carolina, Oregon, Pennsylvania, Rhode Island, South Carolina, Virginia, Washington, and Wisconsin.

The other 36 states - along with Medicare – still exclude these drugs when prescribed for weight loss alone.

Even in the states that do offer coverage, getting it isn’t easy. Most require patients to try and fail at traditional weight loss methods – low-calorie diets, counseling, physical activity – for at least six months. Some require proof of ongoing weight loss to stay eligible.

Why aren’t these drugs more widely covered?

The simple answer is cost. These medications often exceed $1,000 per month without insurance, and while Medicaid gets manufacturer rebates, spending has surged. From 2019 to 2023, Medicaid’s gross spending on GLP-1s grew by over 500%.

That’s why some states have drawn hard lines. North Carolina, for instance, covers GLP-1s for Medicaid patients but dropped coverage for state employees after estimating a six-year cost of $1 billion.

Still, other states are watching closely. About half that don’t cover GLP-1s say they’re considering it, weighing future savings in chronic disease care against current budget strain.

What about Medicare?

Medicare remains the most rigid of all. Despite FDA approval and growing public pressure, Medicare is prohibited from covering anti-obesity drugs - even, take note, if your doctor recommends them.

A proposed rule that could have changed that was shelved in early 2025. There’s been some vague talk of future changes if prices drop, but nothing concrete.

Get your game on! Whether you’re into NFL touchdowns, NBA buzzer-beaters, world-class soccer goals, or MLB home runs, our app has it all.

Dive into live coverage, expert insights, breaking news, exclusive videos, and more – plus, stay updated on the latest in current affairs and entertainment. Download now for all-access coverage, right at your fingertips – anytime, anywhere.