A version of this article first appeared in CNBC's Healthy Returns newsletter, bringing the latest healthcare news directly to your inbox. Subscribe here to receive future editions.
As new GLP-1 drugs enter the U.S. market and historic Medicare coverage is implemented, one thing remains the same: Most employers still do not cover those weight-loss drugs.
In fact, many health plans are finding ways around it.
“It's a battle trying to keep costs down,” Justin Held, director of educational programs at the nonprofit International Employee Benefit Plan Foundation, said in an interview. “It appears that they don't necessarily offer coverage for weight loss, but instead focus on how to support the overall health of their workers.”
The results come from a survey published on Tuesday by the IFEBP, which includes more than 33,000 member companies or public institutions. It was held in June at nearly 300 employer health plans in the US.
About 36% of employers said they provide GLP-1 coverage for both diabetes and weight loss, the same percentage as in 2025 and up from 34% in 2024, according to the survey.
Meanwhile, 60% of employers said they offer coverage only for diabetes, up from 55% in 2025 and 57% in 2024. About 45% of plans said they cover GLP-1 for other approved conditions, such as obstructive sleep apnea and heart disease.
The fact that employer coverage of weight loss is flat compared to last year is not a surprise.
Health plans have long opposed the high costs of covering GLP-1 drugs. Eli Lilly and Novo Nordisk, especially as demand soars in the U.S. To curb costs, plans have restricted coverage or stopped it altogether.
Cost remains a major factor in employers' decisions about GLP-1 coverage, Held said. In 2026, respondents said medications accounted for 11.4% of annual claims, up from 6.9% in 2023.
But employers are finding other ways to support workers who want to take those medications.
“The cost burden is so great that they say there are other ways to do this while still wanting to use those benefits to recruit and retain those people,” Held said.
About 27% of employers encourage employees to obtain GLP-1 through a direct-to-consumer platform, while 21% pressure workers to use their integrated FSA, HSA, or HRA dollars for treatments.
Held said that as costs increase, it becomes a “great opportunity for employers to communicate the benefits they already offer in this space.”
For example, 74% of plans said they offer disease management and chronic care, 61% provide nutritional counseling, and another 61% offer bariatric surgery. Employers said they also cover benefits such as lifestyle modification programs, other non-GLP-1 medications, and non-drug weight loss interventions.
So what will it take for more employers to adopt GLP-1 coverage for obesity and foot the bill?
What could change the situation, according to Held, is evidence that covering those drugs ultimately reduces costs in other areas. That could mean fewer knee replacements and bariatric surgeries or greater productivity and better wellness outcomes.
“If those things happen, then you might say it's worth offering comprehensive weight loss coverage as well, because the impact on the other areas of our organization is very positive,” he said. “But we haven't seen that yet.”
While some studies and estimates suggest that the downstream savings from GLP-1 could offset the high costs to the healthcare system, there has not yet been any widespread measured evidence of this based on real-world data.
We may get our first glimpse of what the savings look like after a recently launched 18-month program that allows Medicare to cover GLP-1 for obesity for the first time.
Until then, about 9% of employers are considering adopting GLP-1 coverage for obesity. We'll continue to watch to see how that might change over time.
Feel free to send any tips, suggestions, story ideas and facts to Annika at a new email: [email protected].
