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Here's what you need to know: Medicare Coverage (Effective Mid-2026) Following the November 2025 Trump administration agreements, Medicare will cover GLP-1 medications for obesity with: $50 monthly copay for eligible patients $245 government cost (down from $1,000+ list prices) Medicare Eligibility Requirements: BMI over 27 with prediabetes OR established cardiovascular disease, OR BMI over 30 with uncontrolled hypertension, kidney disease, or heart failure, OR BMI over 35 (severe obesity) Medicaid Coverage States can opt into $245 monthly pricing for all covered uses

Obesity is the biggest risk factor for Type 2 diabetes, and substantial weight loss can help in reversal and remission of the disease, as well as reduced risk for conditions like high blood pressure, dyslipidemia, heart disease, and stroke

GS then multiplies these impacts by their projected number of GLP-1 users (30 million in baseline, up to 60 million) and expected effectiveness rates (70 percent in baseline, up to 90 percent)

these are foundational to the process

Medical history review identifies contraindications and helps determine likely underlying causes

The advantage here is obvious