GREENSBORO, N.C. — Seems like we all know someone who has lost weight using drugs like Ozempic, Mounjaro, or Wegovy. But if you're over 65, it can be hard to get the medication for that reason.
Right now, Medicare will only cover the medications if you use them to treat diabetes. Medicare will not cover the medicines just for weight loss.
Back in 2003, Congress made a law that Medicare can't cover drugs for weight loss. Back then, weight loss was seen as more of a cosmetic issue than a health issue. The law came along right after all the problems with the weight loss drug Fen-Phen, which was taken off the market.
Fast-forward to 2024, and Triad Congressman Richard Hudson says it's time to rethink the ban on weight loss drugs.
“There's an upfront cost that's pretty significant," Hudson said. "But over the long haul, a 10-year period, we believe it will save Medicare $66 billion in healthcare costs. If you're looking at it in a 10-year window, it's a no-brainer.”
For eight years, Hudson has co-sponsored bills to get Medicare to cover the drugs. Each time the bills faced pushback because of those upfront costs; however, his latest bill has bipartisan support in the House. And a similar version is working through the Senate. North Carolina's Ted Budd and Thom Tillis are both co-sponsors of that bill. But Hudson cautions:
“If you've been paying attention to Congress recently, nothing is easy," he said. "But I am hopeful because it's the right thing to do. Medicare is really the only federal program that doesn't fund these medications already. Indian Health Services, Medicaid, and Tricare all reimburse for these medications. I think Medicare ought to follow suit.”
Without insurance coverage, it costs about $900 per month to get Ozempic for weight loss.