The numbers, and the date that matters
On August 25, 2026, the Business Group on Health reported that about 14% of US employers have already dropped or plan to drop GLP-1 drugs for weight loss in 2027, and that the share of surveyed employers covering them fell from 72% in 2025 to 60% in 2026. In June the same group had put the figure at 10% of covering employers. Mercer's survey found 5% of large employers (500 or more employees) plan to drop coverage for 2027. The surveys use different samples, so do not add them up.
The date that matters for an operator is January 1. Employees find out during open enrollment, which for most employer plans runs through October and November. The last covered fill is in December. The first cash decision lands in the first two weeks of January, usually when a refill is due and the pharmacy quotes the uncovered price. Wegovy's list price is $1,349.02 a month today.
We wrote the funnel design for this moment in September in the coverage-loss funnel post: landing page, intake branch, copy. This post is about the patients themselves and what has to work on January 4.
Four patients in the same wave
Not everyone losing coverage wants the same thing.
| Patient | What they had | What they want in January | What a brand should offer |
|---|---|---|---|
| Mid-titration on injectable Wegovy or Zepbound | Covered pens, 2 to 6 months in | Same drug, next dose step, no gap | Continuity visit, cash route through NovoCare or LillyDirect, dose plan |
| At goal, on maintenance dose | A year or more, stable | Keep the weight off at the lowest cost | Maintenance program, discussion of pill or dose options with a clinician |
| Price-first | Coverage, now quoting retail | The cheapest legal option | Honest comparison, including the manufacturer's own channel; the Wegovy pill from $149 |
| Turning 65 or on a retiree plan | Employer or retiree coverage | To know whether Medicare helps | Screening for the Medicare GLP-1 Bridge |
The first two groups are the ones worth building for. They are mid-treatment, they value continuity over price, and they stay. The price-first patient will often go straight to NovoCare or a $29 CVS visit, and a brand that chases them with discounts loses margin on the patients least likely to stay.
The fourth group is small but specific. The Medicare GLP-1 Bridge, live since July 1, covers branded GLP-1s for eligible beneficiaries at $50 a month through December 31, 2027, with prior authorization through a central processor that telehealth prescribers can use. Our Bridge playbook covers the eligibility screen.
The calendar from today to the first cash refill
| When | What the patient is doing | What the brand should have live |
|---|---|---|
| Now through late November | Reading the benefits guide; choosing a plan and an FSA election | A page that answers "my plan dropped Wegovy" with real prices; HSA and FSA eligibility stated |
| November 1 to January 15 | ACA marketplace open enrollment for anyone shopping individual plans | Nothing new; coverage rarely includes weight-loss GLP-1s |
| December | Last covered fill; some refill early | Pre-January intake with current drug, dose and last fill date |
| December 31 | NovoCare's $199 first-two-fills promotion ends | Pricing that does not depend on it |
| January 1 | Coverage ends; Novo's new $675 Wegovy list price takes effect | Cash checkout working; list price change explained |
| First half of January | First uncovered refill comes due | Clinician review within a day or two; prescription to the manufacturer's pharmacy |
The $675 list price is worth a sentence on your page because patients will read the headline and expect it to help them. It mostly helps people with coinsurance or a high-deductible plan where cost sharing tracks list price. A patient whose plan stops covering the drug entirely still compares against the $349 cash price.
What they want: continuity of the dose
A patient at 1.7 mg of Wegovy who switches to a new prescriber does not want to be restarted at the lowest dose and walked up the ladder again. Whether they can continue at their current dose is a clinical decision, made by the new prescriber with the patient's history in front of them. A gap of several weeks off the drug can change that decision, which is why the timing above matters.
What the brand controls is how much history the prescriber has. Intake should ask for the current drug, current dose, how long they have been on it, the date of the last dose and the last covered fill, side effects, and the original prescriber. It should accept an uploaded pharmacy label or a photo of the pen. A provider looking at a structured continuity case can make a same-week decision. A provider looking at a blank intake starts from scratch.
What they want: their records, moved for them
Most patients do not know they have a right to their own records under HIPAA, or that a covered entity generally has 30 days to respond to an access request under 45 CFR 164.524, with one 30-day extension. Waiting a month is too slow for a January refill.
So do the work: a records-request form inside the portal that the patient signs once, sent by your team to the prior prescriber or pharmacy, with status visible to the patient. In the meantime, a pharmacy label and the patient's own history are usually enough for a provider to act on, and the formal records arrive later. This is not legal advice; your counsel should review the authorization form.
What they want: a price they can pay with pre-tax money
November is when patients set their 2027 FSA election, and the decision they make in the benefits portal decides whether your membership is paid with pre-tax dollars. Prescription drugs are qualified medical expenses. Program fees for a diagnosed condition such as obesity generally need a letter of medical necessity, and the HSA and FSA implementation guide has the receipt and letter workflow. Put one line on the coverage-loss page now: "If you are setting your 2027 FSA election, our program and your medication can be paid with FSA or HSA funds with the documentation we provide." Then make sure that is true. This is not tax advice.
The full monthly cost to show: $349 for Wegovy from NovoCare (or from $149 for the Wegovy pill) plus your membership. On a $149 membership that is $498 or $298, the same arithmetic as in our business plan example.
Where a platform helps, and where it does not
The parts of this that are software: intake that branches on coverage status and captures dose history, a portal with a records-request form and HSA receipts, billing that starts only after a provider approves (so nobody is charged before a clinician has looked at their history), and prescriptions routed to the right pharmacy with live status. Turbopills ships those as one configured system under your brand, along with state-aware provider routing and a mobile app, and launch is weeks, not months. The parts that are not software stay with you: the clinical protocol for continuing a dose, your medical director, your PC and the employer and broker relationships that send patients to you. The employer handoff post covers that channel. We are in private beta and quote per program; check the January workflow in a demo.
We do not know yet how many of these patients will skip a brand and buy straight from NovoCare or LillyDirect. Our guess is that price-first patients will and mid-titration patients will not, and we would change that view if the manufacturers add clinician follow-up to their own channels.
FAQ
What percentage of employers are dropping GLP-1 coverage in 2027? About 14% have dropped or plan to drop weight-loss GLP-1 coverage, per the Business Group on Health's August 2026 survey. Mercer found 5% of large employers plan to drop it for 2027.
My employer dropped Wegovy coverage. What are my options? Manufacturer cash pricing ($349 a month for Wegovy from NovoCare, the Wegovy pill from $149), a telehealth program that adds clinician follow-up and dose management, a spouse's plan during open enrollment, or the Medicare GLP-1 Bridge if you are eligible for Medicare.
Can I stay on my current GLP-1 dose with a new provider? Possibly. A new prescriber decides based on your history, current dose and how long you have been off the drug. Bring your pharmacy label, dose history and last fill date.
Can I use my FSA or HSA for Wegovy or Zepbound? Prescription drugs are generally qualified medical expenses. Program or membership fees for a diagnosed condition usually need a letter of medical necessity. Check your plan administrator's rules.