Medicare’s GLP-1 discount excludes its sickest patients – a lesson for group plans

Medicare’s GLP-1 discount excludes its sickest patients – a lesson for group plans


In group plans, the relevant question is whether GLP-1 coverage is structured around diabetes only, weight loss only, or both. A 2026 survey by the International Foundation of Employee Benefit Plans (IFEBP) of nearly 300 US health plans found that 60% of employers cover GLP-1 drugs for diabetes only, up from 55% in 2025. Just 36% cover them for both diabetes and weight loss, unchanged year over year. GLP-1 drugs now account for 11.4% of annual claims among employers that cover them for weight loss, up from 6.9% in 2023.


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