HUSKY Health does not cover Wegovy or Zepbound for weight loss

HUSKY Health does not cover GLP-1 drugs such as Wegovy or Zepbound for weight loss. Under the state plan amendment CMS approved in 2025, the only weight-loss drugs HUSKY Health covers are orlistat (or Xenical) and phentermine. A 2026 DSS hearing decision upheld a Zepbound denial because HUSKY Health does not approve Zepbound for weight loss with a diagnosis of obesity.1234

HUSKY Health has no prior authorization path for a GLP-1 prescribed for weight loss. Zepbound is covered with prior authorization only to treat obstructive sleep apnea in adults. A 2025 state law says that if DSS covers obesity drugs, it must require prior authorization and may require step therapy for up to 180 days.389

• Zepbound for obstructive sleep apnea: age 18 or older, an established diagnosis of obstructive sleep apnea with an apnea-hypopnea index (AHI) of 15 or more, and no type 1 or type 2 diabetes, mixed sleep apnea or central sleep apnea.
• The member must be using and continue to use positive airway pressure (PAP) treatment unless PAP is contraindicated, and the DSS prior authorization form asks whether the BMI is 30 or more.
• The treatment plan must include active participation in lifestyle interventions such as diet changes, physical activity, nutritional counseling or behavioral therapy.
• Diagnosis code G4733 (obstructive sleep apnea) must be on the pharmacy claim, and the prescriber must submit a prior authorization request for new therapy and every year after.
• Requests that do not meet the criteria go to a letter of medical necessity review.

Coverage for other uses the FDA has approved:

• Zepbound, moderate to severe obstructive sleep apnea in adults 18 or older (new prescriptions from July 1, 2025): Covered with prior authorization310
• Wegovy (injection), reduction of the risk of major adverse cardiovascular events (MACE): DSS provider bulletins 2025.04 and 2025.54 are titled for this use; their criteria could not be read, so the terms of coverage are not confirmed.10
• Wegovy (injection), MASH (metabolic dysfunction-associated steatohepatitis): DSS provider bulletins 2025.04 and 2025.54 are titled for this use; their criteria could not be read, so the terms of coverage are not confirmed.10

What changed, and when:

CMS BALANCE model: CMS's BALANCE model page names no participating states, and we found no DSS announcement that Connecticut has joined.11

Since July 1, 2023, the state employee health plan covers drugs prescribed for weight loss only when they are prescribed through FlyteHealth, its virtual weight management program, or Connecticut Children's Weight Management providers. Adult members qualify for FlyteHealth with a BMI of 30 or more, or 27 or more with a weight-related condition. Participants pay a $12.50 monthly program fee ($25 if they do not complete the required activities) and must complete program activities; prescriptions are billed under the member's CVS Caremark coverage.121314

Pharmacy benefit: CVS Caremark (prescription drugs); FlyteHealth (medical weight management program).

Marketplace (ACA) plans: Connecticut's essential health benefits benchmark plan for 2025 to 2027, a ConnectiCare small-group FlexPOS plan, excludes prescription drugs used for weight reduction or obesity.16

HUSKY Health covers GLP-1 drugs for type 2 diabetes through its preferred drug list class for incretin mimetics and enhancers, including the two generic GLP-1s approved for type 2 diabetes. Since April 1, 2026, members on a non-preferred diabetes GLP-1 are no longer kept on it under the earlier grandfathering. DSS also requires a diabetes diagnosis for GLP-1 prescriptions.567

In 2025, HUSKY Health paid for 174,165 GLP-1 prescriptions, $202.5 million before rebates: 47 per 1,000 residents, against 32 across the states and DC, 10th of 51.66 It reimbursed 7 GLP-1 products that year. Every state, ranked.

CMS hides counts under 11 in a quarter, so 6 rows count as zero here and the totals are a floor.

Part D still excludes drugs used for weight loss alone: the Part D drug definition excludes drugs and uses Medicaid may exclude under SSA §1927(d)(2), which lists agents used for weight loss. Part D plans can cover GLP-1s for type 2 diabetes, MACE risk reduction (Wegovy), moderate-to-severe obstructive sleep apnea (Zepbound) and noncirrhotic MASH with fibrosis (Wegovy). For weight loss alone, the Medicare GLP-1 Bridge demonstration (July 1, 2026 – Dec 31, 2027) gives eligible Part D enrollees Foundayo, Wegovy or Zepbound KwikPen for a $50 monthly copay, outside the Part D benefit. The BALANCE Model's Part D component is not launching in 2027.4142323328362131

• Medicare GLP-1 Bridge (demonstration) (active, from 2026-07-01): Runs July 1, 2026 to December 31, 2027 (extended). Outside the Part D benefit: $50 copay per one-month supply (28 or 30 days), Part D deductible does not apply, the copay does not count toward TrOOP, no low-income subsidy. Covers Foundayo, Wegovy (injection or tablet) and Zepbound KwikPen only (not Zepbound single-dose vials or pens). Eligibility: age 18+ and, when starting GLP-1 therapy, BMI ≥35; or BMI ≥30 with heart failure with preserved ejection fraction, uncontrolled hypertension, or CKD stage 3a+; or BMI ≥27 with prediabetes, prior heart attack or stroke, or symptomatic peripheral artery disease. People with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease are not eligible (their Part D plan may cover GLP-1s for those conditions). Prior authorization required; valid through Dec 31, 2027 unless the patient changes GLP-1s.2829302136373839403534
• BALANCE Model — Medicare Part D component (not launching in 2027; future implementation described by CMS only as 'potential'): Originally announced to launch in Part D in January 2027. CMS's BALANCE page FAQ now refers to 'the BALANCE Model not launching in Medicare in 2027' and extends the Bridge through Dec 31, 2027 to collect data 'ahead of potential implementation of BALANCE in Part D'. No new start date is published.232521

In 2024, Medicare Part D drug plans paid for 265,056 GLP-1 claims from prescribers in Connecticut, $355.7 million in total drug cost.67

The lowest price among the programs that ship to every state is WellMedr: $492 for 12 months ($41 a month); $99 month to month, fees in.71 Includes a sale seen on November 5, 2026; the price returns to the standing price when it ends. The cheapest programs, ranked, or every program, ranked on our score.

Prices are what each program charged at its own checkout, fees in, with the total due for the plan length first. Compounded GLP-1s are prepared by a pharmacy to a prescription, and they are not FDA-approved; the section on compounding explains what that means.

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29 more programs we rank ship to fewer than 50 states, or don’t say how many. We don’t record which states they leave out, so check Connecticut on their sites: Embody, Collective, SnagRx, Enhanced, Direct Meds, Gala Health, GobyMeds, CoreAge Rx, Maximus Tribe, Brightmeds, SkinnyRx, Willow, Strut Health, Enhance MD, LumiMeds, VivioMD, MEDGm, MyDrHank, Zevay, LevelsRx, Hume Care, ReadyRx, Hers, Luvo Health, Remedy Meds, Hims, DudeMeds, G-Plans and Found.

The makers also sell some brand-name GLP-1s for cash, at the same price in every state, with a prescription:

These are standing prices. The Zepbound and Wegovy rankings list each dose and the terms of each offer.

Compounded GLP-1s are prepared by a pharmacy to a prescription. They are not FDA-approved: the FDA doesn’t review their safety, effectiveness or quality before they’re sold, and they are not the same as Wegovy or Zepbound. Formulas can differ from one pharmacy to the next, and some add ingredients such as vitamin B12.7273 Compounding pharmacies are licensed and inspected by state boards of pharmacy; outsourcing facilities (503B) also register with the FDA and are inspected by it. The FDA can issue warning letters when either breaks rules on safety or sterility.

The FDA’s register lists 2 outsourcing facilities (503B) in Connecticut, as of November 6, 2026; 0 show no inspection date and 2 were issued a Form 483.68