13220 Rosedale Hill Avenue, Huntersville, North Carolina 28078, United States
GLP-1 Medication Coverages: How These Changes Impact You
GLP-1 Coverage & Office Policy
Updated 07.01.2026
Effective July 1, 2026, Traditional Medicare began providing coverage for GLP-1 medications for some eligible beneficiaries. Please note that not all Traditional Medicare patients qualify and coverage is determined by Medicare eligibility requirements.
Office Requirements for All Patients Receiving GLP-1 Therapy
To ensure safe treatment, appropriate medical documentation and compliance with insurance requirements, our office requires the following for all patients receiving GLP-1 medications, regardless of insurance:
- An initial office visit with your provider is required before a GLP-1 medication can be prescribed, even if you have previously discussed these medications.
- Appropriate medical documentation is required before treatment can begin.
- Patients must be seen by their provider every 90 calendar days, or less, to continue receiving GLP-1 prescriptions. Refills will not be provided if this requirement is not met.
- At the initial GLP-1 visit, patients will be asked to sign an acknowledgment confirming they understand and agree to these office policies.
Insurance Information
Insurance coverage for GLP-1 medications varies by plan and may change at any time. Before starting GLP-1 therapy, we strongly encourage patients to contact their insurance company to verify:
- Whether GLP-1 medications are covered under their plan.
- Whether prior authorization (PA) is required.
- Any additional coverage requirements specific to their plan.
Please notify our office once coverage has been confirmed, so we may submit a prior authorization request, if needed.
If a prior authorization is denied, our office will notify you through the patient portal or by phone. Patients are responsible for working directly with their insurance company regarding denials and appeals. A virtual or in-person office visit may be required to provide updated documentation for an appeal.
While our office is happy to submit prior authorization requests and provide supporting medical documentation, insurance coverage and approval decisions are made solely by your insurance company.
Please remember that prior authorizations, insurance reviews and appeals often take time and are not processed immediately. While we understand that delays can be frustrating, GLP-1 medication requests are considered routine, non-emergency matters. We ask that patients allow adequate time for processing and treat our staff with kindness and professionalism. We appreciate your cooperation in maintaining positive and respectful interactions.
To schedule a GLP-1 consultation or follow-up appointment, please call (704) 766-0320, option 3.
Previous Coverage Updates
North Carolina Medicaid - 09.18.2025
Effective October 1, 2025, North Carolina Medicaid discontinued coverage of GLP-1 medications for the treatment of obesity. GLP-1 medications may still be covered for other medically appropriate indications, such as type 2 diabetes.