On July 1, 2025, Tufts Health Direct stopped covering certain prescription drugs for weight loss. Members taking these drugs were notified and transitioned to alternate, preferred weight loss drugs.  

Starting January 1, 2026, all weight loss drugs, including GLP-1 medications, will be excluded from Tufts Health Direct coverage for conditions other than diabetes, including cardiovascular conditions and other associated comorbidities.

Any active authorizations for weight loss drugs will no longer be effective as of January 1, 2026. If you’re affected by this change, we will notify you by mail. We will also notify participating providers who prescribe these drugs.  

What you should do if you’re affected by this change 

If you’re taking a prescription weight loss drug, we encourage you to discuss this change and your options with your health care provider.  

  • If you and your health care provider decide that weight loss medications are necessary, you’ll need to pay for these drugs out of your own pocket. Your plan will no longer cover them.
  • Prescription discount cards or manufacturer copay assistance programs may be available to help with the cost of weight loss medications. Ask your pharmacy or health care provider for details.
  • Your health care provider may also suggest other ways you can manage your weight and improve your overall health. 

Why is this change happening? 

Decisions to change plan benefits are never made lightly. We consider several factors when making benefit decisions including medical necessity guidelines, overall coverage affordability and member experience.  

We make every effort to avoid changes in our pharmacy coverage, but we also remain committed to keeping your health care coverage affordable. We apologize for any inconvenience or difficulty this change may cause. 

How Tufts Health Direct can help 

Your health plan gives you access to programs for improved nutrition and weight management — including ways you can save on gym memberships and more. 

Learn about health and wellness programs