Excellus Clarifies GLP-1 Coverage: Diabetes Still Covered; Weight-Loss Plans Narrow in 2026

Excellus BlueCross BlueShield says GLP-1 drugs for diabetes will remain on formulary, countering reports of a blanket halt. Effective January 1, 2026, three GLP-1s for weight loss—Wegovy, Zepbound, and Saxenda—will be removed from covered lists for certain plans, though members can seek exceptions if prescribers verify criteria. The insurer cites Pharmacy & Therapeutics Committee review and surging spend since 2021, noting research that 58% of users discontinue before achieving health-improving weight loss. Current members can maintain coverage if they meet guidelines. Excellus frames the shift as balancing access with affordability, pairing coverage criteria with nutrition and fitness supports through providers. The move mirrors broader payer scrutiny of high-cost anti-obesity meds amid utilization spikes and mixed persistence, while maintaining access for diabetics where GLP-1 efficacy is established.

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Source: Rochester First