GLP-1 Medications FAQ & Weight Loss Resources
As part of ongoing efforts to manage rising healthcare costs and ensure long-term sustainability of the County’s health plan, certain medications are being excluded from coverage. Below are answers to common questions about GLP-1 medications and available options.
What is changing on July 1, 2026?
Medications classified as GLP-1 agonists that are FDA-approved for weight loss will no longer be covered under the County’s health plan. This includes Wegovy, Zepbound, Saxenda.
Why are these medications being excluded?
GLP-1 medications for weight loss have seen significant increases in utilization and cost nationwide. This change helps maintain the affordability and sustainability of the health plan for all employees.
What if I am currently taking one of these medications for weight loss?
Coverage for these medications will end on July 1, 2026. You are encouraged to speak with your healthcare provider about alternative treatment options, including other medications or lifestyle-based approaches.
What if I am taking a GLP-1 medication and have Type 2 diabetes?
If you have a diagnosis of Type 2 Diabetes, you may still be eligible for coverage of GLP-1 medications that are FDA-approved to treat diabetes (Ozempic, Mounjaro, Rybelsus, Trulicity, or generic Victoza).
Switching to any of the listed medications will require a prior authorization to confirm a diagnosis of type 2 diabetes.
The prior authorization will require lab results for your current and pre-treatment A1c. It is required for the prescriber to send Liviniti your A1c lab value from before the start of any GLP-1 agonist to support a diagnosis of type 2 diabetes.
What if I am taking Zepbound for sleep apnea?
Zepbound's FDA-approval for sleep apnea only applies to patients with obesity and is not a standalone indication. Sleep apnea is a weight-related comorbid condition and Zepbound is only approved to treat sleep apnea as a comorbidity in patients with obesity.
Because the health plan is excluding medications used for weight loss and related conditions, Zepbound will not be covered for sleep apnea or other weight-related comorbidities effective July 1, 2026.
What if I am taking Wegovy for MASH?
Wegovy is FDA-approved for treatment of metabolic dysfunction-associated steatohepatitis (MASH). If you are prescribed Wegovy for the treatment of MASH, please email HR: benefits@unioncountync.gov.
Are there alternative medications covered for weight loss?
Yes; Effective GLP-1 alternatives for weight loss still covered by the health plan include FDA-approved medications like Qsymia (phentermine/topiramate), Contrave (naltrexone/bupropion), and Orlistat (Alli, Xenical), which target appetite and fat absorption.
Talk with your healthcare provider to determine what option is best for you.
What other weight management resources are available?
Employee Health & Wellness Center: Offers weight management counseling and ongoing support.
Nutritional Counseling Benefits (see included flyer following FAQs)
Under the health plan, covered employees have access to:
• 30 visits per benefit year for services not related to obesity. Includes both in-network and out-of-network providers. Visits limit does not apply to mental illness diagnosis.
• Four visits per benefit year for services related to the evaluation and treatment of morbid obesity. Includes both in-network and out-of-network providers.
• Unlimited visits per benefit year for services related to diabetes.
Wellhub
Wellhub gives you access to gyms and studios near you, live-streamed and on-demand fitness classes, private sessions with certified wellness coaches, a library of wellbeing apps supporting nutrition, mental wellbeing, meditation, and more. The County covers the cost of the Starter Wellhub plan ($11.99/month).
Can I still access GLP-1 medications outside the health plan?
Yes. Employees may explore direct purchasing programs:
Zepbound: Authentic Zepbound® (tirzepatide) Shipped to You | Vial or Pen | LillyDirect®
Ask your doctor to send your prescription to:
• LillyDirect Self Pay Pharmacy Solutions
• NPI: 1689411712 | NCPDP: 3692539
• 4343 Equity Dr, Columbus, OH 43228
Wegovy: Mail Order from Novocare: NovoCare® pharmacy | NovoCare®
Information for your provider on how to send Rx to NovoCare® Pharmacy
• Send an electronic prescription via EHR/EMR to NovoCare® Pharmacy.
• NPI#: 1710671854
• NCPDP#: 5758074
Speak with your provider for assistance in submitting prescriptions to these programs.
Who should I contact with questions?
• Benefits consultants team with McGriff/MMA: mcg.ucservice@marshmma.com
• Human Resources: benefits@unioncountync.gov
• Your healthcare provider for treatment options and medication changes.
Your Nutritional Counseling Benefits
Under your health plan, you have access to:
-
30 visits per benefit year for services not related to obesity
Includes both in-network and out-of-network providers
Visits limit does not apply to mental illness diagnosis -
4 visits per benefit year for services related to the evaluation and treatment of morbid obesity.
Includes both in-network and out-of-network providers -
Unlimited visits per benefit year for services related to diabetes
Did you know that your health plan covers nutritional counseling? If you or your family are interested in meeting with a registered dietician or nutritionist, please review the guidelines below.
Who Can Benefit from Nutritional Counseling?
The goal of nutritional counseling is to help you make gradual dietary changes that you can sustain over time. You may benefit from nutritional counseling if you:
- Have a chronic disease like diabetes, high blood pressure, heart disease, high cholesterol or kidney disease
- Are at risk of developing a condition such as osteoporosis or diabetes
- Are looking to manage your weight
- Have a digestive or eating disorder
- Want to improve your physical fitness or overall health
- Are pregnant or planning to have a child
- Have one or more food allergies.
What is Nutritional Counseling?
Nutritional counseling offers personalized assistance in adopting healthy eating habits, especially when it comes to managing certain health conditions like obesity or diabetes. You’ll meet with a healthcare professional with training in nutrition who can help you make dietary changes and reach your health goals. Nutritional counseling can assist with meal planning, portion control and addressing eating patterns.
Understanding Your Nutritional Counseling Benefits
How to Find a Provider?
Visit your member service portal or log into the MyCreateHealth app and select “Find a Provider” from the drop-down menu to search for a registered dietician or nutritionist near you.