Weight-loss prescriptions of GLP-1 drugs fell by half in Massachusetts in a single quarter after several of the state's largest health plans stopped covering the medications for obesity.
Between the end of 2025 and the first quarter of 2026, 112,000 fewer commercial insurance customers had a GLP-1 prescription covered for weight loss, according to a Massachusetts Health Policy Commission report presented on September 17, 2026.
Blue Cross Blue Shield of Massachusetts, Point32Health, Mass General Brigham Health Plan, MassHealth and the state's Group Insurance Commission all ended blanket coverage of GLP-1s for weight loss this year. Diabetes prescriptions were left in place.
Blue Cross membership using the drugs for weight loss fell from 6.1% to 3.7%, and Point32Health from 6.5% to 3.3%, in three months.
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Massachusetts is a snapshot of a wider retreat. A Business Group on Health survey of 105 large US employers, published in June 2026, found that 67% currently cover GLP-1s for weight management.
Only 72% of those employers plan to keep the benefit in 2027, and about 10% expect to drop it. Consulting firm Mercer's estimate for the largest employers was closer to 5%.
Why coverage is being cut
The drugs work, and that is the problem for payers. Wegovy, from Novo Nordisk, and Zepbound, from Eli Lilly, are the two GLP-1 medications the FDA has approved specifically for weight loss.
Both belong to a class that mimics GLP-1, a gut hormone that curbs appetite and slows digestion. On average, GLP-1s reduce body weight by roughly 15 to 20% after a year.
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Massachusetts private insurers spent close to $1 billion on GLP-1s in 2025. Roughly three quarters of that went to weight-loss prescriptions. Annualized 2026 spending is now projected at $662 million.
"Against the backdrop of anticipated double-digit health care cost increases, fueled to a large degree by GLP-1s and overall prescription drug costs, companies cannot ignore the reality that GLP-1s have significant implications for health care budgets," said Ellen Kelsay, president and CEO of the Business Group on Health.
Employers who keep the benefit are tightening the rules. In a Peterson-KFF review of large firms, 34% required lifestyle or clinical support before approval, up from 10% in 2024, and some added minimum BMI thresholds.
What patients pay when coverage ends
Without insurance, the list price for a monthly Wegovy prescription can run above $1,300. Novo Nordisk and Eli Lilly now offer direct-to-consumer options for their branded injectables at about $349 a month.
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Telehealth platforms selling compounded semaglutide, the active ingredient in Ozempic and Wegovy, start around $199 to $400 a month.
For someone paying a $50 monthly copay, dropped coverage can mean hundreds more per month, or stopping treatment entirely.
What is still covered
The cuts target weight-loss indications. GLP-1s prescribed for type 2 diabetes, including Ozempic (semaglutide) and Mounjaro (tirzepatide, from Eli Lilly), remain covered by most plans.
Ozempic and Wegovy contain the same active ingredient at different doses and under different FDA-approved labels. That distinction, not the drug itself, is what determines coverage.
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Patients whose plans are changing should check the effective date in their benefits documents and speak with their prescribing clinician about clinical options and manufacturer savings programs before their current supply runs out.
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This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.