Coverage hub
GLP-1 coverage & prior authorization (2026)
Whether a GLP-1 is covered turns on the diagnosis, not the drug: the same molecule has a diabetes brand (broadly covered) and a weight-loss brand (often excluded or PA-gated). Source-cited 2026 criteria below — by drug, and by payer.
Last verified · Reviewed by the D3rx Clinical Billing Team. Coverage policy moves fast — confirm against the plan policy.
By drug
Weight-loss brand · weight loss / obesity, cardiovascular risk reduction, MASH
Weight-loss brand · weight loss / obesity, obstructive sleep apnea
Weight-loss brand · weight loss / obesity
Diabetes brand · type 2 diabetes, cardiovascular risk reduction
Diabetes brand · type 2 diabetes
Diabetes brand · type 2 diabetes
Medicare GLP-1 coverage
The Part D weight-loss exclusion, the 2026 Medicare GLP-1 Bridge, and what Part D does cover.
Does Medicare cover GLP-1 drugs? →By payer
Source-cited prior-authorization criteria for each payer — pick a drug above, or jump to a payer's flagship GLP-1 below.
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Check a specific drug + payer
Run any GLP-1 + payer in the PA lookup, or ask Ask D3 a coverage question — free, cited, no signup.