Why Medicare Still Won’t Cover GLP-1 Medications for Obesity—and What That Means for You

Last week, the Centers for Medicare and Medicaid Services (CMS) announced it would not move forward with a proposed rule that could have expanded access to GLP-1 medications like Mounjaro and Zepbound for weight loss treatment through Medicare and Medicaid.

This decision has raised questions and frustrations among many Americans, especially older adults and lower-income individuals struggling with obesity who hoped this policy might finally bridge a long-standing care gap.

To understand the significance of this, it’s helpful to go back to what was originally proposed. In November 2023, the Biden administration put forward a rule that would have allowed Medicare and Medicaid to cover anti-obesity medications for individuals with a BMI of 30 or higher.

This would have potentially made these breakthrough drugs available to over 7 million Americans currently insured under federal programs.. people who often face the greatest health risks from obesity but the least access to innovative care.

Currently, Medicare does cover GLP-1 medications like Ozempic or Mounjaro, but only when prescribed for type 2 diabetes or cardiovascular conditions, not specifically for weight loss. This is due to a restriction in a 2003 law that prohibits Medicare from covering medications intended solely for obesity treatment.

So while a patient with diabetes may be covered for Ozempic, another person with obesity but no related condition may be left paying out of pocket for Wegovy, which can cost more than $1,300 per month.

The decision by CMS to withdraw the proposal without comment left many advocates in the dark. Though the agency did not explain why the rule was dropped, speculation ranges from legal complications tied to the 2003 statute to broader concerns about budget impact and long-term cost-effectiveness. With demand for GLP-1 medications skyrocketing and new studies showing benefits beyond weight loss, such as improvements in heart and kidney health—it’s clear that the conversation around coverage is only just beginning.

Importantly, the issue isn’t entirely partisan. There has been bipartisan support in Congress for expanding coverage of anti-obesity treatments, most notably through the Treat and Reduce Obesity Act (TROA). While TROA has yet to advance in recent legislative sessions, it remains a key vehicle for lawmakers seeking to modernize how federal programs approach weight-related health conditions.

Public figures have also weighed in with varying viewpoints. Health and Human Services Secretary Robert F. Kennedy Jr. has been openly critical of GLP-1 medications, citing concerns about pharmaceutical influence and promoting lifestyle changes as a more sustainable solution. On the other hand, newly confirmed CMS Administrator Mehmet Oz has previously spoken favorably about GLP-1 drugs, calling their benefits “massive” and acknowledging their place in modern obesity treatment.

What this all points to is a healthcare system in transition. The science around obesity and metabolic health is evolving rapidly, but our policies haven’t quite caught up. For now, those using GLP-1 medications for weight loss who are not covered by private insurance or employer-sponsored plans may still face significant financial barriers. And while many providers and patients report life-changing results, access remains limited to those who can afford it.

At The GLP-1 Source, we’ll continue to follow this evolving conversation closely. Whether or not Medicare coverage expands in the near future, one thing is clear: obesity is a complex, chronic condition, not a character flaw. And it deserves evidence-based treatment options, compassionate care, and policies that reflect modern science.

Stay informed. Stay empowered. If you’re exploring GLP-1 options and want trusted support along the way, check out this link.

Michael Stephens is the founder of The GLP-1 Source, a platform built from personal experience navigating the overwhelming world of health, fitness, and GLP-1 medications. After struggling to find clear, reliable information in a sea of conflicting advice, Mike created this website as a straightforward, no-nonsense resource for those looking to make informed decisions about their health. Whether you're exploring GLP-1 medications, optimizing your fitness, or building sustainable habits, The GLP-1 Source provides practical insights, expert-backed tips, and real-world guidance to help you on your journey to a healthier life.