{"id":4952,"date":"2026-07-19T12:04:34","date_gmt":"2026-07-19T12:04:34","guid":{"rendered":"https:\/\/durhammovinghub.com\/?p=4952"},"modified":"2026-07-19T12:04:34","modified_gmt":"2026-07-19T12:04:34","slug":"can-medicare-help-you-get-glp-1s-requirements-you-need-to-know","status":"publish","type":"post","link":"https:\/\/durhammovinghub.com\/?p=4952","title":{"rendered":"Can Medicare Help You Get GLP-1s? Requirements You Need to Know"},"content":{"rendered":"

Medicare’s new Part D program is aiming to cover certain GLP-1 medications for people with obesity, potentially lowering costs for eligible patients (with a co-pay mentioned around $50\/month). In this episode, Liz Seegert, Health & Aging Journalist, breaks down what’s actually changing-and why access isn’t as simple as “yes, GLP-1s are covered.”<\/strong><\/p>\n

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Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

Liz, it’s so great to see you. Thanks for joining us on the program this morning.<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

My pleasure, Jeff.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

Always great to catch up with you. And I know you write about so many different topics as it relates to aging, healthcare, senior care. This particular topic, I think, is right in your wheelhouse.<\/p>\n

We’re gonna talk about Medicare again this morning, but now Medicare is covering GLP-1s. Wanna get your reaction to that? I know you wrote a story this week.<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

Yeah, there’s a new program under Medicare for people with Part D drug coverage, which is the separate drug coverage you have to buy if you’re on traditional Medicare. And they will pay for several of the GLP-1s specifically for obesity. And the co-pay will be $50 a month, which is a significant cost savings if you can get into the program.<\/p>\n

But of course, there’s some catches.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

All right, so you piqued my interest, obviously. There are some catches, and you said that you couched it as if you can get into the program. So I’m not yet Medicare age, but if I wanted to have access, how would I go about getting access to these drugs?<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

Well, first of all, your physician has to enroll you, and they have to go through prior authorization. So that’s something a little bit different from the Medicare side. Traditional usually doesn’t require that.<\/p>\n

Second, you can’t be taking this drug already for diabetes or for any kind of cardiovascular issue. Some of these drugs are already Medicare approved for those purposes. Third, you can’t be on a Medicare Advantage plan that covers these drugs, or on a drug plan that will pay for this drug for what they call other purposes.<\/p>\n

This is the first time Medicare has specifically covered obesity as a diagnosis. So it’s very specific because it’s Medicare. There’s a whole bunch of hoops to jump through.<\/p>\n

But in the long run, people that need this drug for overweight obesity can really benefit at least for the next year and a half.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

So very, very timely. I think one of the biggest creators or conditions that lead to chronic conditions is obesity. I think many Americans, I don’t know what the numbers are, you probably do, but so this is very timely.<\/p>\n

Did you get reaction at all from any experts out there? I mean, of course you’re an expert, but I’m talking about physicians or people that are in the healthcare community. What was their reaction to this?<\/p>\n

Because overall, sounds like a good thing. And I like the acknowledgement of healthcare, excuse me, obesity as a disease.<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

Yeah, obesity has long been considered a disease and you’re right, it can exacerbate many other chronic conditions. Certainly not good for cardiovascular, not good for diabetics, and not good for even people with arthritis because it puts more strain on your joints and that can lead to other problems down the road. The doctors I spoke with who are all endocrinologists and geriatricians are cautiously optimistic, but as they told me, it wouldn’t be their first go-to.<\/p>\n

First, we try diet, exercise, lifestyle changes because when you put anybody on a new drug, particularly older people, you run the risk of unintended side effects. So for example, these drugs in particular don’t necessarily have bad interactions with let’s say blood pressure medication or something like that, but they can cause gastrointestinal distress. That can lead to dehydration.<\/p>\n

They can cause muscle fatigue and weakness, which has been well-documented. That can lead to falls. So it’s almost a cautionary tale of you’re taking care of one condition, but you could wind up having to deal with the side effects from the side effects, so to speak.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

Yeah, obviously, they always say that the doctors weigh the risks versus the reward on prescribing drugs. I think, I guess every drug has a side effect, but you’re right. I would think that older Americans, people who are Medicare age, would certainly probably feel the repercussions of any drug a lot more than the average person potentially.<\/p>\n

I like that you talked about or the experts recommended that you try some of the other behavior modifications first, lifestyle, your diet, what you’re doing. Is that your sense just for the general population? I mean, I think that’s a good question as well, not just Medicare age people.<\/p>\n

You do the right habits, lifestyle changes, you’re gonna be better off.<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

Oh, absolutely. Most physicians don’t reach for their prescription pad as their first option. And if anybody that’s been to a physician, they’ll ask you about what you’re eating, how you’re sleeping, how much exercise you get, how much alcohol you drink.<\/p>\n

Just minor modifications in those areas can often do wonders for things like your cholesterol, for things like your A1C count, which is an indicator for diabetes. And the older we get, the harder it is to sometimes manage those biomarkers. So, you may have to cut out more carbs, for example, you may have to walk more, you may have to cut out alcohol, which is very, beer is very carby, wine is very sugary.<\/p>\n

And most doctors I know, my own physician included, will tell you, unless you’re really at high risk, everything in moderation. If you want a glass of wine, for example, one glass of wine with a meal, occasionally, that’s probably fine, but don’t make it a habit. I think physicians are being reasonable and not putting people on very strict protocols unless their other conditions really require it.<\/p>\n

So, the more you can do to stay off medication by just making some lifestyle modifications, the better.<\/p>\n

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Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

Well, I do have to echo the sentiment that the older you get, the more difficult it is, one, to lose weight, you have more stress, I mean, things, your body just changes. It really happened for me when I started to hit age 50. Let me ask you about, you talked about modifications, a lot of insurance programs, and I wonder if this is the case with Medicare and Medicare Advantage and all the other components.<\/p>\n

Some insurance will cover, private insurance will cover a nutritionist, seeing somebody for like maybe five sessions, 10 sessions. Is that, so that would be, to me, a good medium to cure the problem with behavioral changes. Is that something that traditional Medicare or Medicare Advantage plans would potentially treat?<\/p>\n

And by the way, it’s done through telehealth a lot of it.<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

Yes and no. I guess that’s the best way to explain it. Traditional Medicare usually has to have a much more serious diagnosis.<\/p>\n

For example, my husband is diabetic. He can get telehealth visits with his physician occasionally to talk about his sugar levels and so on, but he’s got the underlying condition already. For preventive care, some Medicare Advantage programs will cover things like behavioral health counseling.<\/p>\n

Unfortunately, there’s so many different plans and so many different requirements and regulations within each plan and depending on, oh, just so many factors. It’s hard to make a blanket statement that Medicare Advantage will or won’t. The best advice I can say is look over your plan, contact them to see if they will cover a few nutrition or dietary counseling sessions if you’re interested.<\/p>\n

Often with a physician referral, that makes a difference.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

I know that there’s a lot of reform. You talked about the GLP-1s. There’s also the privacy, excuse me, not privacy, the drug prices that are kind of on the marketplace to bring costs down.<\/p>\n

I wonder, and I know they’re discussing or have tried to discuss physician pay as part of Medicare, and I wonder if we can get to a place where preventative, right? I mean, just because you’re 65 doesn’t mean you’re old. By the way, I’m getting closer to that, so I don’t think I’m old by any stretch.<\/p>\n

So I wonder if we can kind of shift the conversation or if you think Medicare policy will kind of catch up to the private sector, which is, let’s be preventative. If we can be preventative, actually costs will go down over time. That might actually help the Medicare trust fund.<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

You’re absolutely correct. There are efforts within the Medicare system, CMS, Center for Medicare and Medicaid Services, have been doing pilot programs. They’ve been doing things like bundled payments where they pay physicians on outcomes rather than a fee-for-service model.<\/p>\n

Physicians that belong to accountable care organizations, for example, are often subject to those parameters. And I think people in charge are really understanding that as the aging population continues to grow, it can’t just be the, oh, I don’t feel well, I’m gonna go to the doctor and they’ll prescribe me something or they won’t treat me until after I become a diabetic, for example. I think there’s a lot more effort now.<\/p>\n

I’ve seen it, at least in my own encounters and in talking with my friends, and I am Medicare age, to do things like, hey, you need to get out and exercise for half an hour a day or you need to really watch your carbs. So if you wanna splurge a little on the weekends, you don’t have to worry about it as much. And again, this is a personal experience.<\/p>\n

It’s not gonna apply to everybody, but I think more and more doctors are realizing that they’re gonna keep their patients healthier the more they do preventive care. One of the challenges, of course, is that, for example, Medicare only pays for a wellness visit once a year when you go in and you make your game plan for the year. So if people don’t take advantage of those kinds of opportunities, they’re kind of left floundering.<\/p>\n

A lot of people won’t see a doctor until they’re not feeling well. And often by then, some damage has been done.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

Well, Liz, I’ve gotta wrap up the interview, but I wanna give you an opportunity to tease out any future stories you’re gonna be doing, because I think this one’s great, but I know you cover a wide range of topics. What do you have on tap, or can you tease out anything for us?<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

Well, I just finished a story for the Stanford Center for Longevity Magazine on family caregivers, and particularly looking at women family caregivers who are caught in that middle squeezed sandwich generation, and the need for them to be aware of their own financial health, because a lot of them retire early or cut back on hours or work schedules to take care of an aging parent, and that kind of messes them up down the road. So there’s that. And I will say I am starting to do some research for a new book.<\/p>\n

So I wanna be talking to older women who have found a third act in life, people who have maybe left the workforce and started their own business, or become a heavy duty volunteer or something like that. So people are welcome to get in touch with me if they’d like to share their stories.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

Yeah, and what’s that email address, just so you can, we’ll put it up below, but what’s your email address?<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

They can send it to me at Liz Seegert, one word, L-I-Z-S-E-E-G-E-R-T, at gmail.com.<\/p>\n

Jeffrey Snyder, Broadcast Retirement Network<\/strong><\/p>\n

That’s pretty easy. Well, Liz, when the book’s ready, you let us know, we’ll bring you back. But until then, thank you so much for joining us, and we look forward to having you back again very soon.<\/p>\n

Liz Seegert, Health & Aging Journalist<\/strong><\/p>\n

Thank you, Jeff.<\/p>\n

The Arena Media Brands, LLC THESTREET is a registered trademark of TheStreet, Inc.<\/i><\/p>\n

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This story was originally published July 19, 2026 at 7:30 AM.<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

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