Medicare's weight-loss drug Wegovy coverage poses potential premium hike for millions of enrollees
Medicare’s recent move to cover the weight-loss drug Wegovy for some recipients with heart disease risk could drive up the cost of monthly premiums for millions of enrollees.
Medicare’s recent move to cover the weight-loss drug Wegovy for some recipients with heart disease risk could drive up the cost of monthly premiums for many of the 65 million adults enrolled in the federal health insurance program, experts warn.
How much of a price jump isn’t yet known. The premium increase would depend on how many millions qualify for the popular medication, which is priced at around $1,300 a month.
It’s possible premiums could go up as soon as 2025, although 2026 or beyond is more likely, according to at least one health policy expert.
“I worry greatly, both in terms of higher premiums and also Medicare funds over the next decade,” said Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University. “The drug needs to be taken lifelong to be effective, so we’re looking at potentially enormous lifelong costs.”
The drug will be covered under Medicare Part D, which pays for prescription drugs people take at home, according to the Centers for Medicare and Medicaid Services. Last year, more than 50 million of Medicare’s enrollees used Part D plans, according to KFF, a nonpartisan group that studies health policy issues.
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