National-Level Legislation:

• SAFE Drugs Act of 2025 (H.R. 6509):This legislation is expected to reduce the availability of large-scale compounded GLP-1 medications, particularly those distributed through national telehealth and pharmacy networks. For patients, this may mean fewer compounded options, more variability in pricing, and potential disruptions for those who relied on compounded medications due to cost or insurance exclusions. While increased oversight and safety reporting may improve consistency, access could become more limited for patients who do not qualify for brand-name coverage or cannot afford out-of-pocket costs.

• What GLP-1 Studio is doing:We are tracking this legislation as it moves through Congress, monitoring enforcement guidance, and updating this page as the impact on patient access becomes clearer.

• What patients can do:Stay informed about coverage changes and talk with your provider early if you anticipate needing to adjust your treatment plan.

State-Level Legislation:

• Florida Senate Bill 860 (2026):This law significantly tightens access to compounded GLP-1 medications in Florida. Patients may see fewer pharmacies offering compounded options, higher costs due to increased compliance requirements, or interruptions in care if providers exit the market. At the same time, Florida Blue now requires prior authorization for all GLP-1 medications and excludes both compounded versions and off-label use for weight loss. Together, these changes make access more restrictive, especially for patients who depend on compounded medications or lack insurance coverage for GLP-1 treatment.

Weight Loss Coverage:Commercial insurance coverage for GLP-1 medications has tightened significantly heading into 2026, particularly for weight-loss indications. While coverage for Type 2 diabetes has largely remained intact, many plans have either excluded weight-loss coverage, moved it behind employer-paid riders, or revoked existing authorizations at renewal.Examples of documented commercial and employer-sponsored plan changes include:

• Blue Cross Blue Shield of Massachusetts (BCBSMA)

• CVS Caremark–managed employer plans (including Massachusetts GIC state employee plans)

• Express Scripts managed employer plans

• Health New England

Medicare (Part D)

• Weight Loss Coverage Begins July 2026:Starting July 1, 2026, Medicare will begin covering GLP-1 medications for weight loss, with costs around $50 per month and a built-in annual out-of-pocket cap of $2,100. Once you hit that cap, your medications are $0 for the rest of 2026.

• Who Qualifies:Eligibility is phased and based on clinical criteria, including:

  • BMI ≥ 27 with qualifying conditions such as prediabetes or cardiovascular disease

  • BMI ≥ 30 with obesity-related conditions

Medicare

• Coverage depends on the State:While some states are expected to expand access later in 2026, several have reduced or eliminated coverage for GLP-1s used solely for weight loss.

• Examples of current restrictions include:

  • Medi-Cal Rx (California Department of Health Care Services)

  • Pennsylvania Department of Human Services (Medicaid)

  • Michigan Medicaid