Anthem pays for Wegovy, Zepbound or Foundayo for weight loss only when a plan's benefits include weight-loss drugs, and its September 2026 criteria usually ask for 6 months in a supervised diet and exercise program first. None of the three is on Anthem's individual or Small Group Select drug lists, and Anthem approves Ozempic and Mounjaro only for type 2 diabetes.

You can switch, but it takes a new Zepbound prescription, and the label has no rule for converting a compounded dose, so your prescriber sets where you start. If you pay yourself, Lilly's LillyDirect charges $299 to $449 for 28 days with on-time refills (as of October 3, 2026), and none of the plan criteria we read counts earlier compounded use.

In the 27 states that use Centene's standard drug list, Ambetter's 2026 lists leave out Wegovy, Zepbound and Foundayo, and Centene approves Ozempic and Mounjaro only for type 2 diabetes, with prior authorization. Most California plans cover weight-loss drugs under strict rules; New York's contract allows exception requests, but we found nothing showing how a weight-loss request would be decided there. See what the lists, contracts and policies say, and how to check and appeal for your own plan.

Medicaid generally pays for GLP-1 drugs such as Ozempic, Mounjaro and Trulicity for type 2 diabetes, but paying for Wegovy, Zepbound or Foundayo for weight loss is each state's choice. As of October 3, 2026, we confirmed 10 states that still do. Here is what most of them require, what people in other states can still do, how to check your own list and how to appeal a denial.

Whether UnitedHealthcare pays for Ozempic, Mounjaro, Wegovy, Zepbound or Foundayo depends on why it is prescribed, which plan you have and sometimes your state. This page sets out UHC's rules for employer, Marketplace, Medicare and Community Plan members from UHC's and Medicare's own documents, explains the Medicare GLP-1 Bridge, and covers what to do after a denial.

The Zepbound approval criteria published by CVS Caremark, Express Scripts, Prime and FEP Blue as of October 2026, the federal deadlines for a decision, and step-by-step appeals for work, individual, federal employee and Medicare drug plans.

As of October 4, 2026: Lilly's card can cut a covered fill to as little as $25 (limits apply). Without coverage, Lilly's cash price is $149 to $299 a month by dose (on-time refills at the top two doses). Medicare's Bridge is $50 a month if you qualify.