With obesity rates steadily climbing, the demand for effective weight loss solutions has surged. Glucagon-like peptide-1 (GLP-1) medications, such as Ozempic, Rybelsus, Wegovy, Zepbound, and Mounjaro, have gained significant attention. Originally developed for managing type 2 diabetes, these drugs stimulate insulin production when blood sugar levels rise, effectively lowering glucose levels. Several GLP-1 drugs, including Wegovy and Zepbound, have been approved to treat obesity and prevent cardiovascular events like heart attack or stroke in high-risk individuals. As more advanced treatments emerge-such as Wegovy, a groundbreaking injectable weight loss medication-many are left wondering: Will UnitedHealthcare cover Wegovy? The answer isn’t always straightforward, as insurance coverage for weight loss drugs can vary based on plan type, employer decisions, and individual medical criteria.
The Rise of GLP-1 Medications for Weight Loss
The prevalence of obesity in America is a significant concern, with 2 in 5 adults and 1 in 5 children considered obese. This has led to increased interest in GLP-1 medications as a potential solution. However, experts like UnitedHealthcare's Chief Data & Analytics Officer Craig Kurtzweil and Chief Medical Officer Dr. Rhonda Randall advise caution, emphasizing that GLP-1s should not be viewed as a single-point solution. Dr. Randall notes that individuals achieve and maintain weight loss goals more successfully when these drugs are part of a comprehensive lifestyle management program.
The Role of GLP-1s in Weight Management
GLP-1 drugs like Ozempic, Rybelsus, Wegovy, Zepbound and Mounjaro are out in the market and surging in popularity. Originally developed to help manage type 2 diabetes, GLP-1 drugs stimulate the body to produce more insulin when blood sugar levels start to rise. The boost in insulin helps lower glucose levels, which helps control type 2 diabetes. Several of these drugs, such as Wegovy and Zepbound, were approved for use as a treatment for obesity, obstructive sleep apnea, heart attack or stroke prevention in those who have already experienced a cardiovascular event.
UnitedHealthcare's Approach to Weight Loss Drug Coverage
UnitedHealthcare constantly monitors drugs under development and potential new uses for those already approved. Susan Maddux, chief pharmacy officer for UnitedHealthcare Employer & Individual, emphasizes the importance of staying ahead of the curve to develop strategies around availability and cost. The average cost of GLP-1 drugs can exceed $1,000 per patient per month, which, combined with a large patient population, can have profound implications for employers’ overall health care spend. As a result, employers may find it difficult to decide whether they should cover these drugs or exclude them.
Cost and Adherence Challenges
Employers may face pressure from employees to cover GLP-1s, but it’s imperative for them to consider the costs and adherence challenges associated with these drugs. Kurtzweil notes a trend where many people stop taking GLP-1s after a few months. Dr. Randall adds that caution is necessary, as we’re still learning where they are most effective and what the long-term side effects are.
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The Importance of Comprehensive Programs
Weight-loss programs that take a whole-person approach - including pharmaceutical, clinical and behavioral support - can be more effective at treating all aspects of a person’s health. UnitedHealthcare offers Real Appeal, a healthy lifestyle and weight management program that provides online coaching, on-demand workouts, and science-backed health resources. Real Appeal is free through participating UHC insurance plans.
Understanding Wegovy Coverage Under UnitedHealthcare
United Healthcare coverage may cover Wegovy for approved uses, although the exact coverage can vary by plan. Wegovy is an injectable prescription medication approved to treat obesity in adults and children ages 12 and older. It is also approved for adults who are overweight with at least one weight-related health condition, such as diabetes or high blood pressure. Semaglutide, the active ingredient in Wegovy, is a GLP-1 agonist that regulates appetite and blood sugar. Wegovy is intended to be taken weekly alongside a balanced diet and increased physical activity.
Factors Influencing Coverage
Insurance coverage can vary greatly from plan to plan. Coverage for Wegovy may also depend on whether you have private insurance, Medicare, or Medicaid. Even with insurance, Wegovy’s cost and coverage vary by insurance plan-contact your insurance provider for details.
Navigating Coverage Options
If your employer-sponsored insurance doesn’t cover obesity medication, that may not be the end of the line. UHC Medicare plans aren’t likely to cover Wegovy because Medicare doesn’t cover obesity medications. Although Medicare doesn’t cover Wegovy for weight loss as of March 2025, legislators are trying to change that with the Treat and Reduce Obesity Act of 2023. If you have a UHC Medicaid plan, you may have coverage for Wegovy.
Cost of Wegovy and Potential Savings
Wegovy typically costs close to $1,850 for a one-month supply without insurance, but the retail cost can vary depending on the quantity prescribed and the pharmacy location. Without health insurance, the typical cash price of Wegovy is approximately $1,847 for a 30-day supply (four injector pens), although that cost varies by pharmacy and doesn’t include any discounts.
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Strategies for Saving on Wegovy
If your United Healthcare plan doesn’t cover Wegovy in its formulary, consider using a SingleCare coupon card to make it more affordable. A SingleCare Wegovy coupon card offers sizable savings. Depending on the pharmacy, you can save nearly $600 per month on out-of-pocket costs. Novo Nordisk has a program called NovoCare that offers support for people using Wegovy. This program might help lower the cost of a 28-day supply, depending on your insurance.
Prior Authorization
Prior authorization is an important topic to discuss with your insurance company. “Insurance plans have different requirements for weight loss medications,” explains Christie Kunde, Pharm.D., owner of InformedRx. “Some may cover Wegovy with no restrictions, while others may need prior authorization. For those looking to streamline prior authorization for Wegovy, Suneye Koohsari, MD, owner of Manhattan Medical Weight Loss, recommends assembling a history of your chronic weight management efforts and sharing them with your healthcare provider. “This information will be invaluable for your medical team in expediting the prior authorization process,” Dr.
Alternative Weight Loss Options
If your UHC plan doesn’t cover Wegovy, there are other options for weight loss, such as Saxenda (liraglutide) and Adipex-P (phentermine). Some medications are approved for other conditions but also help manage weight. For example, Mounjaro is approved to treat Type 2 diabetes, but it also reduces appetite. Without a weight-related condition, you might not be eligible for insurance coverage, but your healthcare provider may be able to prescribe it off-label. You’ll most likely need prior authorization, depending on the medication prescribed.
UnitedHealthcare's Additional Support Programs
For added support, UHC offers Real Appeal, a healthy lifestyle and weight management program. Real Appeal is free through participating UHC insurance plans and provides online coaching, on-demand workouts, and science-backed health resources. Call the number on the back of your UHC membership card to see if your plan is eligible for Real Appeal benefits.
Prescription Drug List (PDL) and Preventive Care Medications
A Prescription Drug List (PDL) - also called a formulary - is a list of commonly used medications, organized into cost levels, called tiers. These costs are decided by your employer or health plan. Sign into your member account or call the number on your health plan ID card to see your PDL and get specific information about your pharmacy benefits.
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As part of Health Care Reform, health plans must cover certain Preventive Care Medications at no cost to you. The health reform law (Affordable Care Act) requires most health plans to pay for birth control (contraceptives and sterilization) for women at no cost to you. Some organizations can choose not to cover birth control (contraceptives) as part of their group health plan for religious reasons.
Shapely's Partnership with UnitedHealthcare
Shapely is an in-network provider with UnitedHealthcare, making their evidence-based weight loss care more accessible and affordable for millions of Americans. Through this partnership, eligible UnitedHealthcare PPO members can receive personalized medical care, lifestyle coaching, and expert weight loss support-all covered by their insurance plan.
What Shapely Covers
As an in-network provider for UnitedHealthcare, Shapely helps patients access physician-led weight loss care, including medical consultations, lifestyle coaching with a dietitian, and weight loss prescriptions. Coverage for weight loss medications under UnitedHealthcare varies by plan. Some plans may cover FDA-approved medications, such as Wegovy® (semaglutide) or Zepbound® (tirzepatide), but they often require prior authorization or proof of medical necessity. Shapely specializes in completing prior authorizations to help you maximize your insurance benefits. If your plan does not cover weight loss medications, they offer affordable alternatives through their compounding pharmacy partners at a fraction of the cost of brand-name options.
Shapely's Membership and Services
Shapely offers monthly video visits with expert weight loss providers, weight loss prescriptions (if appropriate), support getting meds covered by insurance, assistance finding meds at local pharmacies, 1:1 access to a personalized dietitian, and unlimited support via chat and their app. They are in network with United Healthcare PPO plans, as well as Medicare and other major PPO insurances. Shapely memberships do not include labs (typically covered by insurance or $75) or medications they prescribe, such as Semaglutide, Tirzepatide, Wegovy®, Ozempic ®, Zepbound ®, Mounjaro ®, and Contrave®. Prescriptions are at the medical provider’s discretion and may not be appropriate for everyone.
Real Patient Success Stories with Weight Loss Medications
Many individuals have experienced significant weight loss and improved health through the use of weight loss medications and comprehensive programs. Here are a few examples:
- Vanessa: Lost 53 lbs in 9 months, going from 190 pounds to 137 pounds.
- Kathy: Lost 42 lbs in 6 months and is no longer on blood pressure medication.
- Tara: Lost 72 lbs in 12 months, normalizing her A1c and lowering her risk for diabetes and heart disease.
- Mary Jane: Lost 40 lbs in 5 months, going from 190lbs to 150lbs and maintaining the weight loss.
- Jeanine: Lost 57 lbs in 6 months, overcoming emotional eating and cravings.
- Cynthia: Lost 74 lbs in 6 months, transforming her health and confidence.
- Patricia: Lost 36 lbs in 8 months, going from around 210 to 174 lbs.
- Robin: Lost 85 lbs in 9 months, experiencing no food noise and feeling more in control of her weight.
- Laurel: Lost 56 lbs in 7 months, shutting off food noise and cravings.
Eligibility for Shapely
Currently Shapely serves adults age 18 and older in the states of California, Florida, New York, and Texas. They will soon be expanding to all 50 US states.
Insurance Coverage with Shapely
Shapely navigates insurance on your behalf and is able to work with the vast majority of insurances to get cost-effective access to GLP-1 medications like Wegovy® and Zepbound® . For patients with commercial insurance, medication co-pays are typically $25 per month but depending on the plan may be higher. At this time, Medicare only covers these medications for patients with diabetes, cardiovascular disease (such as stroke or heart attack), and obstructive sleep apnea. If you do not have insurance, or if insurance doesn't cover the cost of medications, they offer an accessibility program and can send your prescriptions to a compounding pharmacy. Labs are also typically covered by insurance though there may be a co-pay. For patients without insurance, they offer labs for a flat-rate of $75, requiring you to go to a Labcorp location for lab draw. For members choosing to use insurance for their visits with Shapely, insurance covers any visits with their expert team of providers and dietitians, though you may be responsible for any cost-sharing.