Will your employer or Marketplace plan cover Wegovy or Zepbound in 2027?

How many employers cover GLP‑1s for weight?

KFF found that 16% of firms with 200 to 999 workers, and 43% of firms with 5,000 or more, covered GLP‑1s for weight in 2025.¹

Covering GLP‑1 medicines such as Wegovy and Zepbound for weight is a choice each employer makes. The share rises with company size.¹

Other surveys ask different employers, so their numbers can’t be compared directly:

• Mercer (2025 National Survey of Employer-Sponsored Health Plans, 2,010 employers; this figure is for employers with 500 or more workers): 49% covered GLP‑1 weight-loss drugs in 2025, up from 44% in 2024.²
• International Foundation of Employee Benefit Plans (2026 GLP‑1 pulse survey of US corporate, multiemployer and public employers): 36% of corporate employers cover GLP‑1s for both diabetes and weight. Among multiemployer and public employers, 31% do.⁶ The Foundation’s summary says the share covering both was the same as in 2025, and 60% of employers cover them for diabetes only, without splitting that figure by employer type.⁵
• Business Group on Health (2026 survey of 127 employers covering 8.7 million people, as reported by SHRM): 60% covered GLP‑1s for obesity in 2026, down from 72% in 2025. 14% have dropped coverage for weight or plan to by 2027.⁷

Why are some employers cutting coverage for 2027?

Mostly cost, because more workers use these drugs than employers expected and the bills are a growing share of prescription spending.^1,6

• Higher use than planned: in KFF’s 2025 survey, 59% of firms with 5,000 or more workers that cover GLP‑1s for weight said use was higher than expected. 66% said it had a “significant” impact on their drug spending.¹
• A bigger slice of claims: GLP‑1s for weight made up 11.4% of total annual claims for corporate employers in 2025, in the International Foundation’s survey.⁶
• Rising premiums: Mercer’s 2026 survey of more than 1,800 US employers expects health costs per employee to rise 8.2% in 2027. Its actuaries put about 1 percentage point of that on rising GLP‑1 use.^3,4

In Mercer’s words, “some employers needing immediate cost relief chose to drop this coverage for next year”.⁴ Few employers not covering them plan to start: in KFF’s 2025 survey, 1% of firms with 200 or more workers that don’t cover them said they were “very likely” to begin within a year.¹

One public example shows the scale. North Carolina’s State Health Plan spent about $102 million on these drugs in 2023, roughly 10% of its prescription costs, before ending weight-loss coverage.⁸

What should you ask HR before open enrollment?

Ask whether GLP‑1s are covered for weight in 2027, which brand is preferred, what the prior authorization needs, and what you will pay each month.

Employers that keep coverage often add conditions. In KFF’s 2025 survey, 34% of firms with 200 or more workers that cover GLP‑1s for weight require a dietitian, case manager or therapist, or a lifestyle program.¹ Questions to ask HR or the number on your insurance card:

• Does the 2027 plan cover GLP‑1s for weight, or only for diabetes or other approved uses?
• Which brands are on the drug list, and which is preferred?
• What does the prior authorization ask for: a BMI level, a weight program, a renewal test?
• What is the monthly copay or coinsurance, and does it count toward the out-of-pocket maximum?
• Is the plan self-funded or fully insured? This decides whether state insurance laws apply (see below).

Our doctor questions tool builds a printable list that includes these coverage questions. The steps of a prior authorization are in our prior authorization guide, and drug-list codes are in how to read your plan’s drug list. Paying from an HSA or FSA is covered in HSA and FSA rules for GLP‑1s.

What are state employee health plans doing?

They are moving in different directions, with some ending weight-loss coverage, some adding limits or higher copays, and at least one covering them.^13,12,8,14

NCSL, the national group for state legislatures, cites research that at least 15 states included anti-obesity drugs in their employee health plans in 2025.¹⁴ These are the changes we could confirm:

From each plan’s own notices where we could open them; North Carolina and West Virginia from named, dated news reports; Illinois from NCSL. Checked Oct 14, 2026.

Delaware applies the $200 copay even when Wegovy or Zepbound is prescribed for heart disease or sleep apnea alongside an obesity diagnosis.¹²

Do ACA Marketplace plans cover Wegovy or Zepbound?

Rarely for weight: KFF’s review of 2024 HealthCare.gov plans found Wegovy on 1% of Marketplace drug plans, all with prior authorization.¹⁶

Ozempic, the same medicine as Wegovy but approved for type 2 diabetes, was covered by 82% of those plans.¹⁶ KFF’s review didn’t include states that run their own Marketplace, where coverage may differ.¹⁶

How to check a plan: HealthCare.gov has a prescription look-up tool while you shop. It shows whether a plan’s drug list includes your medicine and what you would pay. State-run Marketplaces may have a similar feature.¹⁷

If the drug isn’t listed: you can ask the insurer for an exception if your doctor says you need that specific drug. If granted, you may pay the cost-sharing of the plan’s most expensive tier.¹⁷

Dates on HealthCare.gov: open enrollment runs November 1 to January 15. Enroll by December 15 for coverage that starts January 1.¹⁸

Do state laws make plans cover GLP‑1s?

Only some plans, because state laws reach state-regulated plans and private employers’ self-funded plans are exempt from most state insurance laws.^14,1

• Who state law reaches: NCSL says state legislation applies only to state-regulated plans, such as state employee plans and plans sold on the ACA individual and small-group marketplaces.¹⁴
• Who it misses: 67% of covered workers are in self-funded plans, where the employer pays claims itself. Federal law (ERISA) exempts private employers’ self-funded plans from most state insurance laws, including mandated benefits.¹
• How active states are: since 2022, NCSL has tracked 66 bills in 25 states on GLP‑1s for obesity. At least 6 states expanded access; others restricted it.¹⁴

Colorado is the clearest example. From January 1, 2027, its large-group health plans must cover obesity treatment such as intensive lifestyle therapy, nutrition therapy and bariatric surgery.¹⁵ Insurers must also offer the employer the option to add coverage for anti-obesity medicines, including at least one GLP‑1. The employer decides whether to add it.¹⁵

What if your plan stops covering your GLP‑1?

Check whether another approved use is still covered, ask about an exception or appeal, and compare the makers’ self-pay prices.^13,17

Some plans that drop weight-only coverage still cover the same medicines for heart disease, sleep apnea or MASH, as Massachusetts does.¹³ Those uses are explained in Wegovy for the heart and fatty liver and Zepbound for sleep apnea.

The makers’ copay cards need commercial coverage of the drug. Novo Nordisk’s Wegovy card lets you “pay as little as $25”, with savings capped at $100 a month.¹⁹ Without coverage, the cash routes are in GLP‑1 costs without insurance. If a claim is denied, how GLP‑1 appeals work covers the steps and deadlines.

Questions people ask

How we researched this

More on insurance

USUnited StatesYour GLP‑1 was denied: how do appeals work?USUnited StatesHow do you read your plan’s drug list, and ask for an exception?USUnited StatesDo TRICARE, the VA and federal employee plans cover Wegovy, Zepbound and Ozempic?