Why Insurance Coverage Could Make Or Break Eli Lilly’s Weight Loss Pill – Forbes Advisor
Eli Lilly announced this week that its new weight-loss pill, orforglipron, cleared its latest Phase 3 trial, bringing it closer to potential Food and Drug Administration (FDA) approval. Compared with injectables such as Zepbound, Ozempic and Wegovy, this daily pill could be easier for patients to take regularly.
Although the new pill could be a game-changer for many if it’s approved by the FDA, it remains to be seen whether health insurance companies will cover it.
Already, more than 16 million Americans have turned to weight-loss injectables to help manage their weight, according to SingleCare, a drug discount company. Insurance coverage varies, but plenty of health plans already cover injectables.
In the meantime, there are other approaches to weight management, including structured diet and weight-loss programs .
Insurance Coverage: The Big Question The big question for many patients remains: Will insurance cover Eli Lilly’s new pill, orforglipron, if it’s approved? At this stage, the answer is uncertain. Coverage for GLP-1 drugs is already inconsistent. If you’re wondering about insurance, here are some solid health insurance options that could potentially cover these weight-loss drugs.
5.0 See Plans On Healthcare.com’s Website Our Expert Take Best for low-cost plan Average Monthly Silver Plan Cost $504 4.5 See Plans On Healthcare.com’s Website Our Expert Take Best provider network Average Monthly Silver Plan Cost $679 4.2 See Plans On Healthcare.com’s Website Our Expert Take Best for low complaints Average Monthly Silver Plan Cost $630 Company Forbes Advisor rating Our expert take Average monthly silver plan cost Learn more 5.0 Best for low-cost plan $504 See Plans On Healthcare.com’s Website 4.5 Best provider network $679 See Plans On Healthcare.com’s Website 4.2 Best for low complaints $630 See Plans On Healthcare.com’s Website See More See Less Some health plans require prior authorization, meaning patients must show medical necessity before a prescription is approved. Others may cover only certain medications in this class or exclude weight-loss drugs entirely.
Even if orforglipron is approved, access could be limited. Many patients might have to pay out-of-pocket or rely on insurance plans that specifically cover these medications. Costs could vary widely depending on the plan, dosage and pharmacy.
Some employers or assistance programs may help cover part of the cost or offer discounts, but it’s not certain.
Other Weight Loss Options For people who want to explore weight management but aren’t ready, or able, to take a GLP-1 drug, there are still other options. Structured weight loss programs remain popular and can be surprisingly effective, including:
WeightWatchers (WW): WW is a holistic program blending meal planning, digital tracking and coaching. Some branches even integrate telehealth options, including GLP-1 prescriptions. Noom: Noom is a psychology-based approach focusing on habit change rather than calorie counting. Weight Loss by Hers: Weight Loss by Hers is a personalized, telehealth-based program to help individuals achieve sustainable weight loss. It combines prescription medications—such as GLP-1s and oral medication kits—with lifestyle support. Medication Isn’t a Magic Bullet While orforglipron could make weight loss simpler for some, it’s important to remember that medication alone won’t do all the work. Lifestyle habits—like consistent exercise, balanced nutrition and sleep—still matter, and weight loss programs can provide guidance in these areas.
Bottom Line If approved, orforglipron could change the weight-lo ss landscape. A daily pill that delivers noticeable results is especially appealing for people who have trouble with injections. However, access will depend on insurance coverage, cost, and how quickly doctors prescribe it.
For those who can’t—or prefer not to—take a GLP-1 drug, established weight loss programs remain a solid alternative.
Forbes Advisor is not a licensed insurance agency. Insurance offerings are provided by CompareCoverage, NPN 20753534 and CA License # 6011227. © 2025 CompareCoverage. All Rights Reserved.
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