Medicare has covered GLP-1 drugs for diabetes and some other medical conditions: for example, Wegovy for slashing cardiovascular risks. But under the new deals, Medicare will start covering the drugs for obesity for the first time starting in mid-2026, which could allow more seniors to qualify for them and spur more private insurers to cover them.

Certain Medicare patients will pay a copay of $50 per month for all approved uses of GLP-1 drugs, including diabetes and obesity treatment. 

But the Trump administration is putting some constraints on which Medicare beneficiaries will be eligible to receive GLP-1s for obesity and cardiovascular and metabolic benefits. 

Patients are eligible if they fall into these three cohorts:

• The first includes those who are overweight — with a body mass index greater than 27 — or with prediabetes or established cardiovascular disease.
• The second group is people with obesity – with a BMI greater than 30 – and uncontrolled hypertension, kidney disease or heart failure.
• The third group is patients with severe obesity, or anyone with a BMI greater than 35.

Eli Lilly and Novo Nordisk voluntarily agreed to reduce the prices the government pays for existing GLP-1 drugs already approved for diabetes and other uses to $245 a month, across all non-starting doses. Savings generated by those price reductions will allow Medicare to start paying that same price point for GLP-1s for patients with obesity and a high metabolic or cardiovascular risk. 

The agreement will also allow patients to get GLP-1s on direct-to-consumer platforms at steeper discounts than they already receive through drugmakers’ existing sites.

On TrumpRx – the government’s direct-to-consumer platform for buying prescription drugs with cash expected to launch next year – the average monthly cost for Wegovy, Zepbound and other injectable GLP-1s will start at $350 and drop to $250 within the next two years, according to senior administration officials.

Starting doses of upcoming obesity pills from Eli Lilly and Novo Nordisk, pending approvals, will be $149 per month on TrumpRx, Medicare and Medicaid. Under the deals announced Thursday, Eli Lilly will get fast-track reviews of its forthcoming pill.

Eli Lilly on Thursday said it would lower prices by $50 on its own direct-to-consumer platform, LillyDirect, which already offers Zepbound and other drugs at a discount to cash-paying patients. The multidose pen of Zepbound will be available for $299 per month at the lowest dose, with additional doses being priced up to $449 per month. 

Eli Lilly’s pill, once approved, will be available at the lowest dose starting at $149 per month

State Medicaid coverage of GLP-1 drugs for obesity is spotty. 

But Novo Nordisk and Eli Lilly agreed to extend lower government pricing for their GLP-1 drugs – $245 per month across all other non-starting doses – to all 50 Medicaid programs for all covered uses. 

States will have to opt into those prices, meaning some may not. Check with your state government about coverage.