Weight loss medications covered by group health insurance in Canada (2025 Guide)

Obesity affects more than 26% of Canadian adults and has been recognized as a chronic disease by the Canadian Medical Association since 2015. Its impact goes far beyond physical health—Canada loses an estimated $21.7 billion annually in indirect costs such as reduced workforce participation and lost productivity. 

As the demand for effective weight loss treatments grows, weight loss medications like Ozempic and Wegovy have become increasingly sought after. However, access remains uneven across the country due to varying levels of coverage under health insurance, group insurance plans, and provincial drug programs. 

In this article, we’ll take you through the medications currently available in Canada and provide a comprehensive breakdown of how they’re covered under public and private plans.

Which weight loss medications are approved and eligible for insurance coverage in Canada?

Health Canada has approved several weight loss medications, but only a few are eligible for group insurance coverage, and even then, coverage depends on the insurer and the plan. Covered or potentially covered medications include Wegovy, Contrave, Ozempic (for diabetes), Mounjaro (for diabetes), Rybelsus (for diabetes), Saxenda, and Orlistat. 

These are the main medications currently approved and potentially eligible for coverage:

• Wegovy (semaglutide 2.4mg): Approved by Health Canada for chronic weight management. Coverage is emerging, primarily in group plans, and usually requires prior authorization or special criteria
• Contrave (naltrexone/bupropion): Approved for weight loss. May be covered under some group health plans, but typically needs prior authorization
• Ozempic (semaglutide 1mg): Approved for type 2 diabetes. Most insurers cover it only for diabetes, not for weight loss. Exceptions may be made for weight-related comorbidities under strict criteria.
• Mounjaro (tirzepatide): Approved for diabetes, not weight loss. Covered for diabetes under prior authorization. Off-label use for weight loss is not typically reimbursed
• Rybelsus (oral semaglutide): Approved for diabetes. Coverage is limited to diabetic use only
• Saxenda (liraglutide): Approved for weight loss but has limited coverage availability. May be included in some group plans under special conditions
• Orlistat: Approved for weight loss and available over the counter, but not typically covered by insurance due to lower cost and less clinical effectiveness

Does group health insurance in Canada cover weight loss drugs? 

Yes, weight loss medications are covered through group insurance plans. Coverage is uncommon in personal health insurance plans, which tend to exclude weight loss medications entirely. Even when group health plans offer access to these drugs, they typically require:

• Prior authorization: A pre-approval process where the insurer reviews medical information before agreeing to cover a medication
• Proof of medical necessity: Documentation from a healthcare provider showing that a specific treatment is essential for the patient’s health
• BMI thresholds or comorbidity documentation: Medical evidence showing a patient has a high BMI (typically 30+) or related health conditions like diabetes or hypertension
• Step therapy: A cost-control measure requiring patients to try lower-cost or first-line treatments before approving newer or more expensive drugs

Coverage is more likely if the medication is approved for diabetes management, as with Ozempic or Mounjaro. But newer drugs like Wegovy, approved specifically for weight loss, are slowly being added to select formularies.

What is required for prior authorization of weight loss medications?

Prior authorization for weight loss medications in Canada usually requires a BMI over 30 (or over 27 with comorbidities), documented failure of lifestyle changes, and a physician’s clinical justification. The process varies by insurer and drug but is commonly required to access GLP-1 medications.

Are weight loss medications covered by provincial health coverage plans in Canada?

As of 2025, provincial health plans do not cover weight loss medications like Wegovy or Contrave. GLP-1 medications such as Ozempic or Mounjaro are generally covered only for type 2 diabetes, and even then, coverage requires step therapy and prior authorization. However, no public plan currently covers GLP-1s for obesity treatment.

• Ontario (ODB): Covers Ozempic for diabetes only
• Quebec (RAMQ): Covers Ozempic for diabetes, excludes Wegovy
• Alberta (AHCIP): Requires special authorization for diabetes drugs
• British Columbia/BC (PharmaCare): Covers Ozempic for type 2 diabetes post-metformin
• Atlantic provinces: Coverage is limited and typically excludes weight loss drugs

Which Canadian insurance companies cover weight loss medications?

Coverage for weight loss medications in Canada is mostly available through group health plans, not personal plans. Whether a drug like Wegovy, Ozempic, or Contrave is covered depends on the insurer, plan design, and approval process, such as prior authorization. Here’s how top Canadian insurers handle this:

• Manulife: Some group benefit plans may cover Wegovy with prior authorization. Ozempic is generally only covered for diabetes, not weight loss
• Canada Life: Group plans can be tailored to include weight loss drugs. Coverage usually requires prior authorization and proof of medical necessity. As of Nov. 27, 2023, Ozempic and Rybelsus will be added to Canada Life’s prior authorization drug list and will only be eligible for coverage when used to treat diabetes. 
• Blue Cross (including Medavie Blue Cross): Coverage depends on the employer’s choices. Wegovy may be included if the sponsor opts in. Ozempic is typically covered for diabetes under StepTherapy, plans so that first-line treatments for diabetes have preferential coverage, and Ozempic and similar drugs are second-line and not for weight loss
• GreenShield: Has started including weight loss medications in standard group plans, but only with strict prior authorization and clinical guidelines
• Sun Life: Offers optional coverage for GLP-1 medications such as Ozempic, primarily for diabetes. Coverage for weight loss drugs like Wegovy may be available in customized group plans with prior authorization and plan sponsor approval