Health Insurance Premiums to Surge by Nearly 10% Due to Weight Loss Drugs

Health insurance premiums in the United States are expected to rise by nearly 10% next year, marking the most significant increase in five years. This surge is primarily driven by the widespread use of GLP-1 weight loss drugs, such as Ozempic, along with increased tariffs on pharmaceutical imports.

The Kaiser Family Foundation (KFF) estimates that approximately 6% of the U.S. population, equating to over 20 million Americans, are currently using these popular medications. As a result, businesses will face a 9% increase in health insurance costs, which is likely to impact employee premiums significantly. Those enrolled in the Affordable Care Act will experience even higher costs, with a projected 75% increase in premiums next year, according to a report from The Washington Post.

The rising costs are attributed to the increasing utilization of GLP-1 medications. According to Debbie Ashford, chief actuary at Aon, there was a 92% increase in the use of these drugs in 2023, followed by another 56% increase in 2024. As GLP-1 drugs continue to gain popularity, users can face monthly expenses of up to $800.

Employers are responding to this trend by instituting prior authorization reviews for coverage of these medications. Approximately 90% of employers now require this process, with nearly half stipulating that patients must be significantly overweight, as determined by their body mass index, to qualify for coverage.

As users of GLP-1 medications navigate these changes, it is crucial for them to understand the implications for their health insurance. Individuals traveling with these medications must declare them to their travel insurers. Failure to do so could result in policies being invalidated, even for unrelated claims.

Kara Gammell from the price comparison website Money Supermarket emphasizes the importance of declaring both the medication and any underlying health conditions when purchasing insurance. She cautions that “failing to do so could invalidate your cover – even if your claim has nothing to do with the treatment.”

GLP-1 drug users are advised to consult their insurance providers before traveling to determine whether any specific rules apply to their policies. This proactive approach can help mitigate potential financial risks associated with health insurance claims.

The intersection of weight loss medication and health insurance costs illustrates a growing concern in the U.S. healthcare landscape, highlighting how medical advancements can significantly influence financial burdens on consumers and businesses alike. As the healthcare industry adapts to these changes, stakeholders will need to navigate the complexities of insurance coverage and medication use to ensure adequate protection and affordability for patients.