Nearly 60% of medically eligible seniors are considering switching Medicare Part D plans to access obesity medications, new survey data show, raising the prospect of enrollment shifts tied to coverage decisions.
The findings, based on a national survey of more than 2,130 Americans age 65 and older conducted by the Obesity Care Advocacy Network, place Medicare Part D plan participation at the center of beneficiary decision-making.
Among medically eligible respondents, nearly three-fourths (74%) identified GLP-1 coverage as a top-tier health priority. One-third of all respondents said obesity care is a primary benchmark in evaluating whether a Medicare plan is high quality.
Survey data show that switching intent extends beyond diagnosed populations. While nearly 60% of medically eligible seniors are considering changing plans, about one-third of all respondents indicated a likelihood of switching if their current plan does not participate. More than half of those considering a switch - 52% - have not been told by a doctor that they qualify for treatment.
Coverage decisions are tied to federal program design. The BALANCE Model, introduced by the Centers for Medicare & Medicaid Services, requires an 80% participation threshold among Part D plans for the model to proceed for the 2027 plan year.
Applications from Part D plans are due April 20, with CMS set to determine by April 30 whether participation levels meet the required threshold. If approved, eligible beneficiaries would gain access to obesity medications through participating plans starting Jan. 1, 2027.
The model runs through December 2031 and includes both pharmaceutical treatment and lifestyle support components delivered by manufacturers.
Ahead of the BALANCE Model, CMS is implementing a separate bridge program to provide short-term access to medications. Under the Medicare GLP-1 Bridge, eligible beneficiaries can receive obesity drugs between July 1 and Dec. 31, 2026, outside the Part D system.
The program sets a $50 copay per prescription fill, with manufacturers supplying medications at a net price of $245 per month. Access requires enrollment in a Part D or Medicare Advantage prescription drug plan and prior authorization submitted through a centralized CMS processor.
Continuation of treatment beyond 2026 depends on enrollment in a Part D plan that participates in the BALANCE Model.
Despite the structure being put in place, awareness remains limited. Survey data show that 82% of respondents are not aware that Medicare is introducing a program to enable access to obesity medications. A similar finding shows that 81.5% had not heard about the availability of GLP-1 drugs at an estimated $50 monthly cost.
At the same time, 26.8% of respondents said a doctor had told them they qualify for medical weight management. The report notes that about 40% of older Americans meet the clinical definition of obesity, indicating a gap between eligibility and clinical engagement.
Survey responses indicate that many seniors view obesity treatment within the same framework as other chronic conditions. About 61.3% said it is important that Medicare covers obesity treatments similarly to conditions such as diabetes or heart disease, with 28.6% assigning the highest importance rating.
Among those identified as medically eligible, 81.8% rated the importance of coverage between 7 and 10. Even among those without a diagnosis, 53.8% rated it at that level.
The issue of obesity treatment access has also been raised in other federal contexts. In February 2026, the American Security Project, alongside OCAN and more than 70 stakeholders, sent a letter to the US Secretary of War calling for expanded access to obesity prevention and treatment across the Armed Forces.
The letter cited obesity as a factor in recruitment disqualification, early separation, and health-related readiness concerns. It called for broader access to evidence-based treatments, including FDA-approved medications, along with preventive measures and policy guidance to support care delivery.
Survey data show that views on Medicare coverage for obesity treatments extend across political affiliations, with 67% of Democrats and 60% of Republicans identifying it as a high-priority issue.
Additional data indicate that 55% of Democrats and 50% of Republicans consider it important that their Part D plan includes GLP-1 coverage.
Cristy Gallagher, coordinator of OCAN, said the findings indicate that older Americans are seeking access to obesity care and treatment. She said that with the BALANCE model enrollment deadline approaching, Medicare Part D plans have an opportunity and a responsibility to consider participation.
She said older Americans have been waiting for access to medications that address obesity as a chronic disease and will have a chance to obtain them if their Part D plans take part in the model.
The survey and program details place plan participation, beneficiary awareness, and execution timelines at the center of how access to obesity medications may develop within Medicare.
