GLP-1 Coverage Set to Expand

Current rules limit obesity-drug coverage, but temporary demonstrations aim to widen GLP-1 access for eligible public-program enrollees while lowering medication costs overall.
Federal drug-benefit enrollees may access select obesity GLP-1s from Early-Q3 2026 through 2027, with a $50 monthly copay outside regular plan benefits.
Because the bridge operates separately, $50 copays will not count toward deductibles or the $2.1K out-of-pocket cap in 2026, keeping costs consistent.
The broader model begins for state-federal programs in Mid-Q2 2026, while insufficient federal drug-plan participation delayed the 2027 drug-benefit rollout indefinitely for now.
After 2027, continued federal obesity GLP-1 coverage remains uncertain unless the delayed model or another coverage pathway moves forward through future action.