At least four Minnesota health systems are ending or limiting weight loss drug coverage for employees in 2024.
Starting Jan. 1, Minneapolis-based Fairview Health Services will limit coverage of Wegovy and Saxenda to employees with a body mass index of 40 or higher, according to a letter sent to employees obtained by Becker's. The coverage change applies to the Fairview, Ebenezer and MNA health plans. The health system said it anticipated $10 million in annual cost for the two drugs without the new policy. Fairview's health plans are administered by UMR, a subsidiary of UnitedHealthcare.
A spokesperson for Bloomington-based HealthPartners told Becker's the organization will also limit employee coverage for weight loss medications such as Wegovy but did not elaborate on what the restrictions will entail.
Rochester-based Mayo Clinic will limit coverage for weight loss drugs through its employee health plan. The Mayo Medical Plan, administered by Medica, will impose a new lifetime limit of $20,000 for weight loss medication coverage. The coverage limit does not apply to GLP-1s prescribed to employees for diabetes, such as Ozempic.
Minneapolis-based Hennepin Healthcare is ending coverage for Wegovy and other injectable weight loss drugs from its employee plan, which is also administered by Medica. Hennepin cited high costs and questions around employee adherence to the medications.
Elsewhere in the U.S., St. Louis-based Ascension dropped coverage for weight loss drugs from its employee plan in July, and the University of Texas System in Austin ended coverage under its employee and retiree health plans in September, also citing high costs and low adherence rates.
GLP-1s come with a steep price tag, costing upward of $10,000 per year without insurance. Ozempic, Trulicity, Victoza and Mounjaro are FDA approved to treat Type 2 diabetes, and Wegovy and Saxenda are approved for weight loss.