Insurance coverage for weight loss medications is typically stricter than for diabetes treatment
doi:10.2991/jegh.k.191028.001 Petito LC, McCab M, Allen NB, OBrien MJ, Carnethon MR
The requirement of coverage for at least one GLP-1 drug from every FEHB plan remains true for each EGWP
Peak Wellness versus Hims and Hers Hims and Hers have entered the GLP-1 market aggressively, with some oral formulations advertised as low as $49 to $199 per month
Gastrointestinal adverse events nausea, vomiting, diarrhea are fairly common, while pancreatitis and intestinal obstruction are rarer but documented
On April 21, 2026, the day after the application deadline for Medicare Part D plan sponsors to participate in the BALANCE Model, CMS announced that it would not be moving forward with implementation of the BALANCE Model in Medicare in 2027 and instead would be extending the Medicare GLP-1 Bridge to run through the end of 2027