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What each GLP-1 is approved to treat, and who pays

Insurance exclusions in this category are written against the use, not the molecule — so the same drug can be refused for weight and paid for under another approved indication. Which approvals a drug actually holds is printed on its label and is more than the coverage of these drugs suggests: Wegovy has three, Ozempic has three, and Zepbound is approved for sleep apnea as a separate indication from weight. Every line below is quoted from the label rather than summarised, because the wording is what a prior authorisation is judged against.

Does what the prescription is written for change whether it is covered?

Usually more than anything else does. A plan that excludes weight-loss drugs excludes the use, so the identical molecule can be covered when it is prescribed for an indication the plan does not exclude — and several of these drugs hold approvals most readers never hear about. Wegovy is approved for cardiovascular risk reduction and for MASH with moderate to advanced fibrosis as well as for weight. Ozempic is approved for glycemic control, cardiovascular risk and kidney outcomes, all in type 2 diabetes. Zepbound is approved for moderate to severe obstructive sleep apnea in adults with obesity. Medicare shows the mechanism at its starkest: Part D cannot cover a drug prescribed for weight loss at all — that is statute — and can cover the same molecule prescribed for diabetes. None of that is an invitation to claim a condition; it is a reason to know which of a drug's real approvals fits the person in front of you.

Approved for more than weight (4)

These hold at least one indication a weight-loss exclusion does not reach.

Zepbound — Zepbound (tirzepatide) injection

  • Chronic weight managementthe one an exclusion targets

    To reduce excess body weight and maintain weight reduction long term in adults with obesity, or adults with overweight in the presence of at least one weight-related comorbid condition, in combination with a reduced-calorie diet and increased physical activity.

  • Obstructive sleep apnea

    To treat moderate to severe obstructive sleep apnea (OSA) in adults with obesity. This is a separate approved indication, not an off-label use, and it is the one that changes the conversation with a plan that excludes weight-loss drugs.

FDA prescribing information for ZEPBOUND

Wegovy — Wegovy (semaglutide) injection

  • Cardiovascular risk reduction

    To reduce the risk of major adverse cardiovascular events — cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke — in adults with established cardiovascular disease and either obesity or overweight.

  • Chronic weight managementthe one an exclusion targets

    To reduce excess body weight and maintain weight reduction long term in adults and pediatric patients aged 12 years and older with obesity, and in adults with overweight in the presence of at least one weight-related comorbid condition.

  • MASH with moderate to advanced fibrosis

    For the treatment of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH), formerly known as NASH, with moderate to advanced liver fibrosis (stages F2 to F3) in adults. Approved under accelerated approval: continued approval for this indication may be contingent upon verification of clinical benefit in a confirmatory trial.

FDA prescribing information for WEGOVY

Ozempic — Ozempic (semaglutide) injection

  • Glycemic control in type 2 diabetes

    As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

  • Cardiovascular risk reduction in type 2 diabetes

    To reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease.

  • Kidney outcomes in type 2 diabetes

    To reduce the risk of sustained eGFR decline, end-stage kidney disease, and cardiovascular death in adults with type 2 diabetes mellitus and chronic kidney disease.

FDA prescribing information for OZEMPIC (semaglutide) injection

Mounjaro — Mounjaro (tirzepatide) injection

  • Glycemic control in type 2 diabetes

    As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus. Weight reduction is not an approved indication for this product — that is Zepbound, the same molecule under a different label.

FDA prescribing information for MOUNJARO

Approved for weight only (4)

No second indication to fall back on. Where a plan excludes weight-loss drugs, the argument on these is medical necessity rather than which approval applies.

  • Saxenda — Saxenda (liraglutide) injection

    To reduce excess body weight and maintain weight reduction long term in adults and pediatric patients aged 12 years and older with body weight greater than 60 kg and obesity, and in adults with overweight in the presence of at least one weight-related comorbid condition.

    FDA prescribing information for SAXENDA

  • Qsymia — Qsymia (phentermine and topiramate) capsules

    To reduce excess body weight and maintain weight reduction long term in adults and pediatric patients aged 12 years and older with obesity, and in adults with overweight in the presence of at least one weight-related comorbid condition.

    FDA prescribing information for QSYMIA

  • Contrave — Contrave (naltrexone and bupropion) tablets

    To reduce excess body weight and maintain weight reduction long term in adults with obesity, or overweight in the presence of at least one weight-related comorbid condition.

    FDA prescribing information for CONTRAVE

  • Foundayo — Foundayo (orforglipron) tablets

    To reduce excess body weight and maintain weight reduction long term in adults with obesity, or adults with overweight in the presence of at least one weight-related comorbid condition.

    FDA prescribing information for FOUNDAYO

Approved indications, answered

Does the indication really change whether insurance pays?
It is often the only thing that does. Plans that exclude weight-loss drugs write the exclusion against the use rather than the molecule, so the same drug can be paid for under a different approved indication and refused under weight. Medicare is the cleanest case, because there the rule is statute rather than plan design: Part D cannot cover a drug prescribed for weight loss, and can cover the identical molecule prescribed for type 2 diabetes or for cardiovascular risk reduction. Nothing here suggests writing an indication a patient does not have — it is a statement about which of a drug's real approvals is being used.
Which of these are approved for something other than weight?
Zepbound, Wegovy, Ozempic, Mounjaro — and the list is longer than the coverage of these drugs suggests. Wegovy holds three approved indications, not one: cardiovascular risk reduction, weight, and MASH with moderate to advanced fibrosis. Ozempic holds three as well, all in type 2 diabetes: glycemic control, cardiovascular risk and kidney outcomes. Zepbound is approved for moderate to severe obstructive sleep apnea in adults with obesity as a separate indication from weight.
Is using Ozempic or Mounjaro for weight loss off-label?
Yes, and the labels are explicit about it. Mounjaro is indicated only to improve glycemic control in type 2 diabetes; the same molecule is approved for weight as Zepbound. Ozempic's three indications are all in type 2 diabetes. Off-label prescribing is legal and common, but it is the point at which a plan's exclusion bites hardest, because the prescription is then for the use the plan excluded.
What if the drug is only approved for weight?
Then there is no second indication to reach for, and the argument with a plan is about medical necessity rather than about which approval applies. Saxenda, Qsymia, Contrave, Foundayo are in that position. The prior authorisation pack and the appeal pages on this site are built for exactly that conversation.
Does insurance cover it →Why Medicare is different →Prior authorisation pack →Appeal a denial →

Indications read from each product's FDA label on 2026-08-28 and quoted. Labels are revised and indications are added; the date is there so you can tell how old this reading is. Information only, not medical advice — which indication applies to a person is a clinical judgement, not a choice.

Last updated 2026-08-28 — the FDA labels these indications are quoted from