GLP-1 Coverage: Employer Options for Weight Loss in 2027

GLP-1 coverage for weight loss is becoming less common in employer health plans as workers review their benefits for 2027. Some employers are directing employees to buy the drugs themselves, offering partial reimbursement or providing weight-management programs instead.

Key Takeaways

• WTW found that 53% of employers with more than 100 employees cover GLP-1 drugs for weight loss, down from 57% in 2025.
• Alternatives range from self-pay drug programs to employer-funded coaching, but they do not necessarily replace full insurance coverage.
• FSA and HSA funds can be used for GLP-1 drugs prescribed to treat a diagnosed medical condition.

Why employers are changing GLP-1 coverage

The WTW survey, conducted in summer 2026, found the first decline in weight-loss drug coverage in three years among employers with more than 100 employees. Another 16% said they currently cover the drugs but are considering removing them, up from 9% in 2025.

Coverage typically costs employers from the mid-$500s to the mid-$600s per user each month. A Marsh survey of more than 1,800 U.S. employers projected an average 8.2% increase in health insurance costs per employee in 2027, with GLP-1 use accounting for one percentage point of that growth.

Not every employer is cutting the benefit. Bank of America CEO Brian Moynihan said in August that the company spends about $250 million or more annually on GLP-1 drugs and views them as an investment in employee health.

Self-pay and employer reimbursement options

Some employers are directing workers to drugmakers’ direct-to-consumer programs, including Novo Nordisk’s NovoCare and Eli Lilly’s LillyDirect. In WTW’s survey, 8% of employers had adopted that approach, while 28% were planning or considering it.

As of October 2026, Novo Nordisk’s lowest-dose Wegovy starts at $149 a month for the pill and $199 for the shot for self-pay customers. Novo says its promotional prices may be modified or canceled. Lilly’s Zepbound starts at $299 a month for a single-dose vial or multi-dose KwikPen.

Other employers are dropping traditional pharmacy benefit coverage but reimbursing some employee costs through a direct-to-employer program. The amount an employer contributes can vary.

Weight-management programs offer a different benefit

Some employers are replacing drug coverage with third-party weight-management services. These generally offer coaching on topics such as behavior change, diet, exercise and nutrition, though services vary.

Marsh’s Caroline Susie estimated that such programs cost about $65 to $100 per employee per month, depending on the services offered. Programs from vendors that also provide prescription services could cost $150 or more per participating employee each month. Employers typically pay for the programs.

Using FSA or HSA funds

Flexible spending accounts and health savings accounts can reimburse the cost of GLP-1 drugs when a licensed provider prescribes them to treat a diagnosed medical condition, such as obesity. These accounts help pay eligible out-of-pocket costs, but they are not a replacement for comprehensive insurance.

For 2027, the HSA contribution limit is $4,500 for an individual with self-only coverage and $9,000 for family coverage. As of October 27, 2026, the official 2027 FSA contribution limit had not been announced.

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