Dear Elaine, 

By law, Medicare cannot cover medications prescribed for weight loss.   

However, medications that are FDA approved for weight loss may be covered if they’re prescribed for a different FDA approved indication. For context, some of the GLP-1 weight loss drugs can be prescribed for reasons other than weight loss. Certain weight loss drugs, for example, also treat diabetes. If a drug is medically necessary for you for one of these other FDA approved reasons, it can be covered by Medicare.  

If your doctor prescribes a GLP-1 medication for you for a non-weight loss indication, you should also check to ensure that the specific drug is on your Pard D plan’s formulary. If it isn’t, you and your doctor can consider other drugs on the plan’s formulary that treat your condition. Or, if these other drugs on the formulary won’t work for your specific circumstances, your doctor can help you request a formulary exception from your Part D plan. Remember, though, that formulary exception requests and appeals can be time consuming. Plus, plans can place drugs added to the formulary through the exception process on a high tier, meaning high costs for you.  

Like any new medication you anticipate taking in the new year, you may wish to keep it in mind when choosing plans during Fall Open Enrollment.   

I hope that helps! 

-Marci