‘The great uninsuring’: Some Americans are paying $500 for weight-loss drugs their spouses pay only $25 for — and it comes down to one word

Kristi's insurance no longer covered Zepbound for obesity, according to Business Insider (1). But her husband Keith was diagnosed with diabetes, which their insurance covers.

Millions of Americans are in a similar boat—caught between massive price hikes and access to what could be transformative weight loss drugs.

Insurers are rolling back weight loss coverage

Two trends explain price hikes like the one Kristi experienced: rising demand and dropping coverage.

More Americans want weight loss drugs, often called GLP-1s. J.P. Morgan estimates patients on GLP-1 drugs grew from about 6 to 10 million from 2024 to 2025 (2). The bank forecasts 25 million Americans will take these drugs by 2030.

While Americans scramble for drugs amidst shortages—sometimes ordering drugs through "grey market" manufacturers in China (3)—insurers respond to rising claim costs by rolling back coverage.

Health insurance companies have been scaling back coverage for years. GoodRx, a company with a mission to make healthcare easy, tracks which weight loss drugs popular insurers cover (4).

Here are some notable highlights from 2024 through January 2026 from GoodRx's tracking:

• Insurers refusing to cover Zepbound rose from about 18 to 56%.
• Insurers covering Wegovy without restrictions dropped from about 14 to 9%.

Americans affected can be counted in the millions. In 2026, 12 million Americans lost some form of Wegovy coverage by non-government insurers, per GoodRx.

Some insurers cover weight loss drugs, but require prior authorization, the process by which your doctor offers proof that a medication is medically necessary (5). The process is a legitimate way to restore coverage. But some patients find it more trouble than it's worth.

Get your coverage back, maybe

When Kristi was notified she was no longer automatically covered for Zepbound, her insurer offered her a way forward: a six-month program that includes physical therapy and lab tests.

The program, and programs like it, often come with a major caveat. They might request dietary and other lifestyle changes users find difficult to implement. Healthcare provider knownwell says it's not unusual for programs to take three to six months (6) to complete. And even if Kristi completed the program, her insurer might decide not to cover her.

Kristi added up how long it would take and decided not to enroll in the program.

For some, weight loss drugs continue to break budgets. The good news: you can get drugs for cheaper than list price, in some cases.

Where to get cheaper weight loss drugs

Drug coupon websites like TrumpRX or GoodRX offer discounts on major weight loss drugs.

TrumpRX is a federal program for discounts on popular drugs, including GLP-1s. U.S. residents who aren't enrolled in federal insurance programs may be eligible.