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What's Confirmed for 2026 Coverage depends on employer opt-in: The standard Express Scripts National Preferred Formulary does not include Wegovy for weight loss, but employer plans can opt into coverage [8] $200/month cap expanding: The Evernorth cost-cap program launched in May 2025 is being offered to more employer groups [6] Medicare still excluded: No change expectedfederal statute continues to block weight loss drugs in Part D [9] What This Means for You Check your specific plan: Coverage depends on your employer's benefit designdon't assume During open enrollment: Ask HR if your employer is adding the $200/month cap or GLP-1 coverage Self-funded employers: Large employers can add or modify GLP-1 coverage at renewal Consider alternatives: If you have Type 2 diabetes, Ozempic (same active ingredient as Wegovy) may be covered for diabetes CALL YOUR INSURANCE Verify Your Specific Coverage Verify Your Specific Coverage Even though it takes a little more time, we recommend calling so you can speak with a person who may have more information than the online directory or PDF formulary listing