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October 3, 2026·7 min read·Erick Rodriguez, Founder

Open Enrollment Is Now. Here's What Your 2027 GLP-1 Benefits Actually Say.

Open enrollment is under way.

Most employer open enrollment periods run in October and November. The plan you choose in that window decides what your GLP-1 coverage looks like from January 1.

This year, that choice matters more than it has in any previous enrollment cycle.

What Changed in 2026

Business Group on Health's 2027 Employer Healthcare Strategy Survey, published in August, covered 127 large employers and 8.7 million people in the United States.

  • Coverage of GLP-1s for weight management: 72% in 2025, 60% in 2026
  • 14% of employers have already eliminated GLP-1 coverage for weight loss or plan to in 2027
  • Pharmacy now accounts for 25% of employers' total healthcare spending, and employer drug costs were estimated to rise 12% in 2026

Named employers have followed. Starbucks is ending coverage of GLP-1s prescribed for weight loss from October 2026, while coverage may continue when they are used for other medical conditions. PepsiCo is ending coverage of prescription weight-loss drugs in October. Cigna dropped weight-loss GLP-1 coverage from its own employee health plan from July 1. Bank of America's chief executive has said the bank spends about $250 million a year on GLP-1s, up from almost nothing four or five years ago.

The enrollment materials arriving now are where the 2027 version of this shows up.

What to Check Before You Pick a Plan

1. Does the plan cover GLP-1s for weight management, or only for type 2 diabetes?

The cuts are mostly to weight-management coverage. Coverage for type 2 diabetes has generally been kept.

Ask your HR or benefits team directly: Does this plan cover GLP-1 medications for weight management (obesity), not just for type 2 diabetes? Then confirm how your plan treats your own prescription.

2. Is prior authorization required?

Plans that cover GLP-1s often require prior authorization: documentation from your prescriber that you meet the plan's criteria, such as a BMI threshold or a related health condition. If a new plan requires it, your prescriber has to submit it before you can fill at the covered cost. Starting that before January 1 avoids a gap.

3. What does the formulary say?

The formulary decides which medications are preferred (lowest cost to you), non-preferred (higher cost) or excluded. It differs between plans, so check it for each option you are considering.

One example: CVS Caremark added Zepbound back to its commercial template formularies as a preferred option from October 1, 2026. Lilly says Zepbound and Foundayo can cost as little as $25 a month for eligible patients with commercial coverage through its savings program. Your own plan's formulary is what decides your cost.

4. Is there step therapy?

Some plans require you to try a different, usually cheaper, medication before they will cover a GLP-1. If you are already on one, ask whether the rule applies to you or only to new prescriptions.

If Your Coverage Is Ending January 1

Talk to your prescriber now, not in January

A coverage change is a reason to plan with your prescriber before it happens, not after a gap has already started. Decisions about continuing, changing or stopping therapy belong with your prescriber.

Know the self-pay prices

Manufacturers sell some GLP-1s directly at cash prices. As of October 3, 2026, according to the manufacturers' own pages:

  • LillyDirect: Zepbound from $299 a month; Foundayo from $149 a month
  • NovoCare: Wegovy injection at $199 a month for the first two months (through December 31, 2026), then $349 a month; the Wegovy pill from $149 a month

Prices rise with the prescribed strength and change often. Check the manufacturer's page for the current price that applies to you.

Know the marketplace rule

Losing GLP-1 coverage on your employer plan does not, on its own, let you switch to an Affordable Care Act marketplace plan mid-year. The special enrollment period applies when you lose qualifying health coverage, not one drug benefit. Few marketplace plans cover GLP-1s for weight management in any case.

What the research says about stopping

A large share of people on GLP-1s worry about what happens when they stop. The research on that question is consistent:

  • A 2026 meta-analysis of six studies and 8,993 adults found that weight change differed by an average of 17.9 percentage points between people who stopped GLP-1 therapy and people who continued (95% CI 14.1 to 21.7).
  • A 2026 BMJ review of 37 studies found average regain of about 0.4 kg a month after stopping weight-loss medication, and about 0.8 kg a month after semaglutide or tirzepatide specifically, with weight projected to return to baseline in about a year and a half.

Published guidance on keeping results during and after GLP-1 therapy repeatedly emphasises adequate protein and regular resistance training to protect lean mass. What that means for you is a question for your prescriber or a registered dietitian.

What you can do yourself is keep a record. A consistent record of weight and how you feel, started before coverage changes, gives you and your prescriber something concrete to work from if it does.

If You're on Medicare

The Medicare GLP-1 Bridge runs from July 1, 2026 to December 31, 2027 and covers certain GLP-1s for weight loss at $50 for a monthly supply. It is a time-limited demonstration, not a permanent benefit.

Eligibility is tiered by BMI and specific health conditions set by CMS. People with type 2 diabetes, obstructive sleep apnea or MASH are not covered by the Bridge and use their regular Part D coverage instead. Access runs through a central processor, with your prescriber completing a prior authorization through the pharmacy. KFF has estimated that nearly 4 million Medicare beneficiaries could be eligible.

Ask your prescriber or pharmacist whether you qualify.

The Honest Summary

Coverage is splitting. People in plans that still cover GLP-1s for weight management have broader access than before. People whose employers have dropped it are being left with the question of what happens next, and a January start date.

Open enrollment is the moment to find out which group you are in, and to make a plan with your prescriber before January 1 rather than after.

Checklist for the next two weeks:

  • Pull your 2027 enrollment materials and check GLP-1 coverage on the formulary
  • Confirm whether coverage is for weight management, type 2 diabetes, or both
  • Talk to your prescriber before your employer's enrollment window closes
  • If coverage is ending, ask your prescriber what your options are
  • If you're on Medicare, ask whether you qualify for the GLP-1 Bridge

→ PeptidesGPT keeps a daily check-in that records weight, energy, sleep and mood: https://peptidesgpt.com

Sources:

PeptidesGPT is an educational platform. This content is for informational purposes only and does not constitute medical, insurance or legal advice. Coverage and eligibility should be verified with your employer, insurer and healthcare provider. Do not start, stop or change any medication without your prescriber.

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