Trouble getting weight loss drugs covered by insurance? Here's what to know

If your doctor prescribes a GLP-1 medication for weight loss but your insurance won't cover it, you have options. Oona Zenda/KFF Health News hide caption toggle caption Oona Zenda/KFF Health News Deborah Finley, 50, of Lodi, Calif., says her weight started to worry her during the early days of COVID. That's when she noticed a lot of the people who were on ventilators or dying had something in common: obesity. "It was a scary time," she says. As a single mom, she was afraid "that I wouldn't be here for my daughter." Finley had been diagnosed with sleep apnea and nonalcoholic fatty liver disease, and she was prediabetic. Her pulmonologist suggested bariatric surgery but couldn't get Finley's insurer to cover it. She exercised and watched what she ate, but she wasn't losing weight and her mental health suffered. She remembers telling her doctor: "Look, I'm at 223 pounds. I feel like I'm hitting this wall. I don't know what else I can do." That's when he suggested Zepbound, a GLP-1 drug for obesity. Finley says she still had to put in a lot of work to get healthy. But the drug helped. Her sleep apnea improved dramatically. She lost weight. Then her insurance plan stopped covering Zepbound for weight loss at the end of last year. That has become common because GLP-1 drugs are expensive for health plans and the employers that pay for them. "They started sending out notices to all the patients," Finley says. "And they said: 'Look, we're pulling this medication. …