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There are lots of new people here as Zepbound and other GLP1s grow in popularity. I have been on this medication since early 2024. The amount of employer/insurance coverage changes for GLP1s in that time could give you whiplash. If you are fortunate to have insurance coverage, please remember to check your coverage during open enrollment (coming up for many people in the fall). Don’t assume coverage will be there for 2027. Don’t assume coverage criteria will stay the same. Don’t assume your initial BMI will still qualify you for coverage. Don’t assume anything, really. And it doesn’t matter how large or small your employer is. The rising costs of healthcare, including GLP1s, are not sustainable without increasing premiums greatly or cutting benefits or both. And that’s what we are seeing. Starbucks pulled coverage of GLP1s. And Disney just announced it’s dropping coverage of health insurance benefits altogether for spouses of employees if those spouses are offered insurance through their employer. Remember: even if you have coverage, insurance can drop an on-formulary medication any time they want (see Caremark debacle). Some people will see that Zepbound is added back to Caremark’s standard formularies on 10/1… only to see coverage drop altogether a few months later. Be prepared for open enrollment. Hopefully cash pay prices drop again soon as more meds come to...
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