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Blue Cross Massachusetts Ends GLP-1 Coverage, Point32Health Retains It

Amid surging demand and costs, insurers diverge on covering high-priced weight-loss and diabetes drugs, while new data highlights potential long-term savings.

A combination image shows an injection pen of Zepbound, Eli Lilly's weight loss drug, and boxes of Wegovy, made by Novo Nordisk. REUTERS/Hollie Adams/Brendan McDermid/Combination/File Photo
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Overview

  • Blue Cross Blue Shield of Massachusetts has announced it will no longer cover GLP-1 drugs like Ozempic and Wegovy, citing financial losses from soaring demand.
  • Point32Health, the state’s second-largest insurer, will continue covering GLP-1 medications, positioning itself competitively despite rising costs.
  • The Trump administration recently rescinded a Biden-era proposal that would have mandated Medicaid coverage of GLP-1s for obesity, leaving coverage decisions to individual states.
  • A new Aon study shows that GLP-1 treatments can reduce overall healthcare costs by 7% within two years, driven by significant decreases in cardiovascular events and related conditions.
  • Medicare continues to exclude GLP-1 drugs for weight loss but covers them for cardiovascular risk reduction, reflecting ongoing policy limitations on broader access.