Medicare now covers Wegovy—but only for patients with heart disease
Medicare has announced limited coverage for Wegovy, a prescription drug used for weight management. The approval comes with strict conditions, focusing on patients with heart disease rather than general weight loss. This marks a shift in policy, though legal restrictions still block broader use of the medication under Medicare plans.
Wegovy received FDA approval in March 2024 for a specific purpose: reducing the risk of heart attacks and strokes in overweight or obese individuals with cardiovascular disease. Until now, Medicare had excluded weight loss drugs entirely due to the Medicare Modernization Act of 2003.
The change allows some patients with heart disease to access Wegovy through Medicare, but only under narrow conditions. Those seeking the drug for weight loss alone will still need to pay out of pocket. The decision reflects both medical advancements and ongoing legal limitations on Medicare’s drug coverage policies.
