Click here to see information about 2025 benefits
Click here to see information about 2025 benefits
Read the full announcement sent to all benefits-eligible employees.
Beginning January 1, 2027, The University of Kansas Health System medical plans will cover GLP-1 medications only for members who have a confirmed diagnosis of Type 2 diabetes. GLP-1 medications prescribed for any other diagnosis or purpose will no longer be covered.
To support the plan members who take a GLP-1 for a diagnosis other than Type 2 diabetes, we have gathered these resources to help you make a plan, together with your physician, to meet your medical and financial needs before this change goes into effect.
For help using these resources, set up a private meeting with a benefits specialist. They can answer your questions and help you consider options for 2027 benefits enrollment such as choice of medical plan and using pretax accounts.
The first thing you should do is talk with your physician. They are the best source for guidance about your health and medication options. They also are knowledgeable about manufacturer savings programs and other cost-saving strategies.
Please do not stop taking any medication without talking with your physician.
We encourage you to begin talking with your physician as soon as possible and no later than Dec. 1. This will give you time to review your options and make a plan before your last covered refill. Let them know your GLP-1 will no longer be covered by insurance starting Jan. 1.
If your prescribing physician is with our health system, contact their office through MyChart. This will help clinic teams respond efficiently and route your question appropriately.
To have the most productive conversation with your physician, gather the following:
Today, manufacturers offer direct-to-consumer pricing for GLP-1 medications that is substantially lower than the price they charge our employee medical plan for those same medications.
These direct, self-pay pricing programs are generally much less expensive than paying a pharmacy's retail cash price.
Some manufacturers also have income-based patient assistance programs for people who meet specific financial eligibility requirements. These programs are separate from savings cards and typically require an application and proof of income.
Your physician is likely familiar with these programs and may be able to provide guidance.
Enrollment should occur close to when the prescription needs to be filled. Don’t do it too soon before your last covered fill.
To enroll, most programs require:
Medication | Manufacturer | Typical savings program | Self-pay cost per dose as of August 2026 | How to access |
Wegovy Pen (semaglutide) | Novo Nordisk | Self-pay pricing discount | ||
Wegovy Oral (semaglutide) | Novo Nordisk | Self-pay pricing discount | ||
Zepbound KwikPen (tirzepatide) | Eli Lilly | Self-pay pricing discount | 2.5 mg $299/month 5 mg $399/month 7.5, 10, 12.5, 15 mg $449/month | |
Foundayo (orforglipron) | Eli Lilly | Self-pay pricing discount | 0.8 mg $149/month 2.5 mg $199/month 5.5, 9, 14.5, 17.2 mg $299/month |
Programs like GoodRx, SingleCare, Blink Health, Optum Perks, RxSaver, WellRx, TrumpRx and ScriptSave negotiate cash prices with manufacturers and pharmacy benefit managers for GLP-1 medications. Your prescriber may be familiar with these programs and can offer guidance on their benefits and drawbacks.
Please be aware that the health system pharmacy does not accept programs like these due to concerns about how those companies share patient data with manufacturers. We advise caution as you explore these programs.
Pharmacies at stores like Costco and Sam's Club sometimes have competitive pricing. In many states, you do not need a membership to use the pharmacy, though membership may provide additional savings in some cases.
Prices can vary surprisingly from one pharmacy to another. It can be worthwhile to call several pharmacies and ask:
Some mail-order pharmacies offer lower cash prices or work with manufacturer savings programs.
If weight loss is your primary goal for taking a GLP-1, you may ask your prescriber about these medications that are covered under our prescription drug formulary.
Drug Name | Formulary Tier | Limits or other notes |
Phentermine HCl-topiramate | 1 | Max quantity of 30 over 30 days Prior authorization required |
Phentermine HCl (phentermine HCl cap 15mg, 30mg, 37.5mg; phentermine HCl tab 37.5mg) | 1 | Max quantity of 30 over 30 days Prior authorization required |
Phentermine HCl tab 8 mg | 1 | Max quantity of 90 over 30 days Prior authorization required |
Our pharmacy benefit manager, Judi Rx (formerly known as Capital Rx), explains how coverage for GLP-1 medications will work in 2027 with this change. Read the FAQ for details.
A pretax savings account can help you save money on the out-of-pocket expense for GLP-1 medications. If you are not enrolled, it’s something you may want to consider for your 2027 benefits.
When prescribed by a physician or other licensed healthcare provider for a medical condition, the cost of the medication can be paid with HSA or FSA funds. Using HSA/FSA funds won't lower the price itself, but it does let you pay with pretax dollars, which can effectively reduce your cost depending on your tax bracket.
Fidelity, our HSA/FSA administrator, or the IRS may require documentation if the expense is ever questioned. As a caution, it’s a good idea to keep your pharmacy receipts.
Not every GLP-1 purchase qualifies: Use caution if purchasing through a program that doesn’t require a valid prescription or uses compounded medications not reviewed by the FDA for safety, effectiveness or quality. These may not qualify as an eligible expense. To verify if your medication is eligible for HSA or FSA reimbursement, contact Fidelity.
If you are at or near age 65 (or qualify by disability) and choose to transition to a Medicare Part D or Advantage prescription plan, you may be eligible for the Medicare GLP-1 Bridge Program. Running through December 2027, this 18-month pilot provides covered weight-loss medications for a flat $50 monthly copay.
If you already have Medicare prescription coverage, simply ask your physician to submit the clinical approval directly to your pharmacy.
If you are eligible or nearing eligibility for Medicare, take advantage of our MedicareConnect program. It’s free to all employees and their family members to help explore options for Medicare coverage, including help enrolling if that’s what you decide. You may also review your enrollment options at Medicare.gov.
A variety of weight-loss resources are covered under the health system’s medical plans offered to employees and their covered dependents.
The University of Kansas Health System offers scientifically proven programs for successful weight loss and maintenance. All programs are managed by board-certified physicians, registered dietitians, exercise physiologists and/or behavioral counselors. The clinic’s services are in high demand and wait times vary for first appointments. A referral is needed from your physician. Our medical plans cover weight management program visits with a physician in the same manner as other specialists. The plan also covers a minimum of seven sessions with a registered dietitian each year.
The health system’s “It’s About You” wellness program is free to all employees as well as employee spouses covered by our medical plans. It offers a variety of resources to help with positive lifestyle changes including nutrition with hundreds of healthy recipes and cooking tutorials, nutrition label education, guidance on a well-balanced diet, a food log and more. There are also free resources for physical exercise with workout options to accommodate all fitness levels and interests, group and personal challenges, fitness facility discounts, mobility exercises and more.
Employees and their family members who need support for mental and emotional health may use the free, confidential services provided by the health system’s EAP program, provided by ComPsych. This benefit includes 8 free counseling sessions for each person per topic. There are also free online resources to support your physical health. To access, visit GuidanceResources.com (Web ID: health system) or call 855-784-2052.
The health system’s Perks For You program is free to all employees and their spouses. It can help save on products and services to support lifestyle changes. It includes health and wellness deals such as grocery delivery, fitness trackers, health clubs and virtual fitness programs.
The Kirmayer Fitness Center offers health system employees a discounted membership. The 55,000-square-foot facility offers group classes, personal training and other services and equipment. It is located at the southeast corner of Rainbow and Olathe Boulevards. The cost can be payroll deducted.
The Sports Medicine and Performance Center: Overland Park offers medically based fitness programs supporting bone health, cardiovascular wellness, and neurological conditions, including POTS, Alzheimer’s disease, dementia, Parkinson’s and more.
Bariatric surgery is covered by our medical plans for those with morbid obesity. One surgery within the health system network or an in-network provider is covered during the member’s lifetime, up to a $20,000 maximum. Added criteria may apply, and prior authorization is needed.