Pay / Ask your insurance plan
Will insurance help with the bill?
Give your plan both the medicine's name and the medical reason for using it. Ask for a written answer about the medicine and the visits separately.
Coverage can depend on why the medicine is used
The usual Medicare prescription plan excluded medicines used to lose weight (September 26, 2026).
Medicare could consider paying for the same medicine when used for another accepted medical purpose (September 26, 2026).
Possible payment does not mean the bill will be paid. The medicine still had to meet the plan's medicine-list and approval rules.
Get answers from your own plan
- Does my plan's medicine list include this exact product?
- Is it covered for the reason my clinician gives?
- What records are needed for prior approval?
- What is my share at the pharmacy?
- Are the visits and tests covered separately?
Ask the plan which process applies if it declines the request. Keep the written response and share it with the prescriber.
A national program may not pay your bill
BALANCE is a federal program for negotiating weight-loss medicine prices and coverage terms with drug companies for state Medicaid programs and Medicare drug plans. Its public page named no state taking part on September 26, 2026.
BALANCE did not guarantee payment for any individual's medicine.
For Colorado Medicaid or a private plan, ask that plan directly about the exact product. A national announcement leaves that question open.