Insurance For Semaglutide Weight Loss Shots: What Coverage Looks Like

Although only recently approved by the U.S. Food and Drug Administration in 2021, Semaglutide for weight loss is quickly making a name for itself as one of the most effective obesity drugs on the market. Semaglutide offers a rapid weight loss solution by increasing the body’s production of insulin and inhibiting glucagon. The drug is administered through regular injections of Glucagon-Like Peptide-1 (GLP-1) which mimics a hormone that helps reduce food intake and appetite. In clinical trials, Semaglutide reduced patient body weight by around 15% or around 10 pounds per month.

Will Insurance Cover Semaglutide?

Despite the success of Semaglutide weight loss shots, the drug carries with it the same stigma that many weight loss drugs carry. Dr. W. Scott Butsch, director of obesity medicine in the Bariatric and Metabolic Institute at Cleveland Clinic, stated that “many physicians still see it [obesity] as a behavioral problem rather than a medical one.”

He went on to summarize that this belief — in addition to many older anti-obesity medications not being very effective — has made insurers reluctant to cover many of the new therapies, including Semaglutide. Insurance companies tend to be biased, and will ask for more proof from weight loss drugs than any other medications.

Furthermore, not every patient responds the same way to any given obesity drug. If a particular obesity drug covered by insurance isn’t effective for that patient, there are usually no other drug options left.

Obesity is considered a chronic illness and most patients are expected to take medication for it for their entire lives. With little to no coverage from their insurance companies, weight loss drugs are often incredibly expensive and inaccessible to middle-class patients and below.

What Needs To Change To Make Semaglutide More Accessible?

The biggest change that needs to happen in order to make obesity drugs more accessible starts from the inside. Insurance coverage for these types of drugs won’t improve until those in the medical field change how they view obesity and how they view the medications that will help patients overcome it.

Bias and stigma about this chronic illness run rampant throughout the medical community, and shifting the opinion of the community — and with it, insurance companies — may be the only way to ensure patients are able to afford the care that they require in order to lead healthy and fulfilling, lives.

Unfortunately, shifting the opinion of an entire group of people is incredibly difficult, which is why the only way any real change is going to happen is through legislative action.

According to an article by Berkeley Lovelace Jr. for NBC News, “In 2021, lawmakers in the House of Representatives introduced The Treat and Reduce Obesity Act, which would have allowed the federal government to expand Medicare Part D coverage to include anti-obesity medications. The legislation had 154 bipartisan co-sponsors, according to Congress.gov, but did not receive a vote on the House floor before the term ended.”

Despite the Act’s unfortunate demise, this is a major step in the right direction towards erasing bias and changing how the medical community and insurance companies view both obesity and the weight loss medications that are needed to treat it.

Semaglutide Weight Loss Shots at New Pathways Clinic

Weight loss and mental health are intricately related. One affects the other, which is why at New Pathways we are excited to provide Semaglutide treatments as part of our holistic and comprehensive mental health facility. New Pathways prioritizes your health above everything else, which is why despite the issues surrounding coverage for weight loss medications, we ensure that Semaglutide is accessible to any patient who is looking to change their life and improve their overall health

Our expert medical staff is ready to answer your questions about this promising new medication-assisted weight-loss treatment option. Reach-out to us for more information or to get started on your weight loss journey with the help of New Pathways Clinic!