Get a quick read on whether your plan is likely to cover Wegovy, Zepbound, or Ozempic.

Insurance carrier Medication Employer / plan type

Coverage outlook

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This is general guidance only — your specific plan formulary is the authoritative source. Check directly with your carrier for binding coverage details.

Insurance coverage for GLP-1 weight-loss medications is highly variable. Whether your plan covers Wegovy or Zepbound depends on the carrier, your specific plan, your employer's group structure, and your clinical history.

Major coverage drivers

Self-funded employer plans often exclude weight-loss drugs entirely, regardless of carrier.
Group employer plans with carrier-determined formularies typically cover Wegovy/Zepbound with prior authorization.
Individual marketplace plans frequently exclude weight-loss drugs.
Medicare Part D historically excluded weight-loss drugs but has expanded coverage when GLP-1s are prescribed for FDA-approved indications other than weight loss alone.
Compounded GLP-1s are not covered by any major payer.

How this checker works

The checker uses 2026 carrier-typical coverage patterns based on observed prior-authorization approval rates and formulary tier placements. Actual coverage depends on your specific plan, your employer's group structure, and your clinical history. The checker is a directional indicator, not a definitive answer.

For a definitive answer, ask your prescribing clinician's office to submit a prior authorization. Most carriers respond within 7-14 days. Denials can typically be appealed, and appeals succeed in 40-60% of cases when properly documented.

How patients use this tool

Pre-consultation expectation-setting: Before booking with a clinician, get a directional read on whether your plan is likely to cover.
Self-funded plan check: If your employer plan is self-funded (you'll see this on your benefits portal), your employer determines coverage, not the carrier. Self-funded plans frequently exclude weight-loss drugs.
Pathway pre-decision: If your plan is likely to deny brand-name, you can plan for compounded telehealth as the realistic pathway.

What carriers cover most reliably

Carrier	Wegovy	Zepbound	Compounded
Aetna	Often (PA)	Often (PA)	No
UnitedHealthcare	Often (PA)	Often (PA)	No
Cigna	Variable	Variable	No
Anthem BCBS	Variable	Variable	No
Kaiser	Strict criteria	Strict criteria	No
Medicare Part D	No (weight only)	Yes (OSA)	No

Frequently asked questions

How do I know if my plan is self-funded?

Check your benefits portal for "ASO" or "self-funded" language, or call HR. Self-funded plans use a third-party administrator (often a major carrier brand like Aetna or BCBS) but the employer makes coverage decisions, not the carrier. Self-funded plans frequently exclude weight-loss drugs.

What if my plan denies my prior authorization?

Appeal it. Appeals succeed in 40-60% of cases when properly documented. Your prescribing clinician's office handles the appeal paperwork. Documentation of failed prior weight-loss attempts and weight-related comorbidities strengthens the case.

Will my employer plan cover Zepbound for sleep apnea but not weight?

Possibly. The 2024 sleep apnea indication for Zepbound has expanded coverage in some plans that previously excluded weight-loss-only prescribing. If you have moderate-to-severe OSA confirmed by a sleep study, the OSA indication may unlock coverage.

What if I have Medicare?

Medicare Part D historically did not cover GLP-1s for weight loss. The Zepbound sleep apnea approval is shifting this — Medicare beneficiaries with confirmed OSA may now have a covered pathway for Zepbound. Wegovy and other weight-loss-only indications remain excluded from Medicare coverage.

Other free tools

Cost calculator BMI calculator Savings calculator Insurance checker Provider matcher Dosing schedule Weight projection

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