Is Your Weight Loss Drug Covered by Medicare?

Medicare can start covering certain weight loss drugs for the first time — as long as they are approved for an added health benefit, the Centers for Medicare and Medicaid Services said Thursday. That opens the door for broader coverage of some highly popular weight loss medications such as Novo Nordisk’s Wegovy, which is now approved in the U.S. for heart health. Those treatments have skyrocketed in demand over the past year despite their hefty price tags and spotty insurance coverage.

Under the new CMS guidance, Medicare Part D plans can cover obesity treatments that receive Food and Drug Administration approval for an additional health benefit. Medicare prescription drug plans administered by private insurers, known as Part D, currently cannot cover those drugs for weight loss alone.

The agency’s guidance means Medicare patients could soon get coverage for Wegovy, as long as they have obesity and a history of heart disease and are prescribed the treatment to reduce their risk of heart attacks and strokes. Earlier this month, the Food and Drug Administration approved Wegovy for that purpose. The guidance also will open the door to future coverage of other weight loss medications, many of which are being tested for additional health conditions.

Excerpted from CNBC

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