{"id":11,"date":"2026-09-07T16:00:00","date_gmt":"2026-09-07T16:00:00","guid":{"rendered":"http:\/\/blogs.room-vu.com\/joeduerrinsuranceagent-com\/2026\/09\/07\/us-health-program-costs-shift-in-2026\/"},"modified":"2026-09-07T16:00:00","modified_gmt":"2026-09-07T16:00:00","slug":"us-health-program-costs-shift-in-2026","status":"publish","type":"post","link":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/2026\/09\/07\/us-health-program-costs-shift-in-2026\/","title":{"rendered":"US Health Program Costs Shift in 2026"},"content":{"rendered":"<div class=\"video-zmyer\">\n<div class=\"video-frame-zmyer\">\n        <iframe loading=\"lazy\" width=\"640\" height=\"640\"\n                src=\"https:\/\/www.roomvu.com\/agent\/embed\/joe-68\/health-insurance-glp1-89ed\"\n                frameborder=\"0\"\n                allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\"\n                allowfullscreen><br \/>\n        <\/iframe>\n    <\/div>\n<div class=\"video-description-zmyer\">\n<p>Understanding what your health plan covers\u2014especially for newer medications like GLP-1s\u2014can feel overwhelming. Many of you have asked about coverage for these drugs, especially in the context of diabetes and weight management. Here\u2019s what I\u2019ve been seeing: most US health plans do cover GLP-1 medications if they\u2019re prescribed for diabetes or certain related conditions. However, if you\u2019re seeking them for weight loss alone, coverage is much less common and varies quite a bit from plan to plan. Some require prior authorization or a minimum BMI before approving these medications for weight management.<\/p>\n<p>If you have an individual plan, it\u2019s rare to find coverage for weight-loss use. Among employer-based plans, about 60% cover GLP-1s for diabetes, and only around 35% extend that to include weight loss. For those on federal senior programs, standard drug benefits still exclude weight-loss-only use, though a pilot program is offering certain GLP-1s for $50 per month. State-federal plans can differ, too.<\/p>\n<p>Because every situation is unique, I encourage you to review your plan\u2019s specific rules, consider appealing if you face a denial, and keep an eye on updates to these programs. My role is to help you make sense of your options and ensure you feel confident about the protection you have in place\u2014so you\u2019re prepared, informed, and supported at every step.<\/p>\n<\/p><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Understanding what your health plan covers\u2014especially for newer medications like GLP-1s\u2014can feel overwhelming. Many of you have asked about coverage for these drugs, especially in the context of diabetes and weight management. Here\u2019s what I\u2019ve been seeing: most US health plans do cover GLP-1 medications if they\u2019re prescribed for diabetes or certain related conditions. However, [&hellip;]<\/p>\n","protected":false},"author":190,"featured_media":37,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-11","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-latest-posts"],"_links":{"self":[{"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/posts\/11","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/users\/190"}],"replies":[{"embeddable":true,"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/comments?post=11"}],"version-history":[{"count":0,"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/posts\/11\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/media\/37"}],"wp:attachment":[{"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/media?parent=11"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/categories?post=11"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.joeduerrinsuranceagent.com\/blog\/wp-json\/wp\/v2\/tags?post=11"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}