Could Medicare & Medicaid Cover Your Weight Loss Drug?

The Biden administration plans to require Medicare and Medicaid to offer coverage of weight loss medications for people seeking obesity treatment. The new rule, which was proposed by the administration Tuesday, would dramatically expand access to anti-obesity medications such as Ozempic and Wegovy, from Novo Nordisk, and Mounjaro and Zepbound, from Eli Lilly. Medicare has been barred from paying for weight loss drugs, unless they’re used to treat conditions like diabetes or to manage an increased risk of heart disease. States can decide whether to cover obesity drugs under Medicaid, but the majority don’t. The Biden administration is proposing to reinterpret the law barring coverage by classifying obesity drugs as treatment for a “chronic disease,” rather than as weight loss medications. The change would dramatically reduce out-of-pocket costs for the drugs. Today, a month’s supply of weight loss drugs can cost $1,000 or more, according to estimates from a White House official. The federal government will pick up the majority of that cost, about $25 billion for Medicare and $11 billion for Medicaid over 10 years, government officials said Tuesday. States will need to pay about $3.8 billion.

Source: WHEC-TV