Humana New Hampshire: Weight Loss Treatment Coverage Guide

Humana plans in New Hampshire may cover weight loss treatment under your medical or pharmacy benefits, depending on your specific plan design. Coverage may include medical evaluations, medication management, and follow-up appointments, depending on your specific plan, deductible status, and in-network provider selection. Klarity Health offers online weight loss treatment and works with many insurance plans. You can check whether your Humana plan may cover care at Klarity before booking.

Medicare GLP-1 Bridge Program: $50/Month for Eligible Humana MA Members

Effective July 1, 2026, CMS launched the Medicare GLP-1 Bridge Program, enabling eligible Medicare Advantage Prescription Drug (MAPD) members to access FDA-approved GLP-1 weight loss medications — including Wegovy (semaglutide), Zepbound (tirzepatide), and Foundayo — at a $50/month cost-share through CMS. This benefit is available outside the standard HPS Part D formulary and represents a significant opportunity for eligible Humana MA members in New Hampshire who have struggled with obesity medication access under traditional Part D coverage.

Eligibility criteria and enrollment steps for the Medicare GLP-1 Bridge Program are administered through CMS. Contact CMS at 1-800-633-4227 or visit medicare.gov for enrollment details. Contact Humana at 1-800-448-6262 to confirm your plan’s participation in this program and any additional coverage requirements.

How Humana May Cover Weight Loss Treatment in New Hampshire

Humana primarily offers Medicare Advantage (MA) plans in New Hampshire, governed by federal CMS 42 CFR Part 422 regulations. Pharmacy benefits are administered through Humana Pharmacy Solutions (HPS). New Hampshire state law does not mandate coverage of obesity medications for commercial plans, and ACA EHB provisions do not require weight loss medication coverage — making the Medicare GLP-1 Bridge a particularly important development for eligible MA members.

Important note for Medicaid enrollees: If you are enrolled in a Humana Medicaid plan, your benefits, coverage requirements, and provider networks may differ significantly from Humana Medicare Advantage plans. Contact Humana directly to confirm which type of plan you have.

Weight loss medications that may be covered under Humana MA/HPS plans include:

• Wegovy (semaglutide) — available at $50/month for eligible MAPD members through the CMS Medicare GLP-1 Bridge (July 1, 2026); Part D formulary coverage varies by plan
• Zepbound (tirzepatide) — available at $50/month for eligible MAPD members through the CMS Medicare GLP-1 Bridge (July 1, 2026); Part D formulary coverage varies by plan
• Foundayo — available at $50/month for eligible MAPD members through the CMS Medicare GLP-1 Bridge (July 1, 2026)
• Orlistat — typically Tier 1–2 under HPS Part D; often available without prior authorization
• Phentermine — Schedule IV, subject to EPCS requirements under New Hampshire RSA 318-B:21-a; quantity limits apply under Part D
• Qsymia — Schedule IV, EPCS required in NH; prior authorization and quantity limits apply under Part D

GLP-1 medications, Contrave, and orlistat are not controlled substances and are not subject to New Hampshire EPCS requirements. Contact Humana at 1-800-448-6262, HPS at 1-800-379-0092, or CMS at 1-800-633-4227 to understand your specific plan’s weight loss medication benefits and Medicare GLP-1 Bridge eligibility.

Frequently Asked Questions

Does Humana cover weight loss treatment in New Hampshire?

Humana Medicare Advantage plans in New Hampshire may cover weight loss treatment, including medical evaluations and prescription medications, depending on your specific plan design. Eligible MAPD members may access Wegovy, Zepbound, or Foundayo at $50/month through the CMS Medicare GLP-1 Bridge program (effective July 1, 2026). Verify your specific plan’s coverage before booking.

Does Humana cover weight loss medication in New Hampshire?

Humana MA plans with HPS Part D pharmacy benefits may cover weight loss medications. Eligible Humana MAPD members may access Wegovy, Zepbound, and Foundayo at $50/month through the CMS Medicare GLP-1 Bridge program. Standard HPS Part D formulary coverage for GLP-1 medications varies by plan. Contact HPS at 1-800-379-0092 or CMS at 1-800-633-4227 to verify your coverage options.

Is Klarity Health in-network with Humana in New Hampshire?

Klarity Health works with many insurance plans, including Humana. Network participation in Humana Medicare Advantage plans may vary by plan type and region within New Hampshire. Use Klarity’s benefits check tool or contact Klarity directly to verify in-network status for your specific Humana MA plan before booking a weight loss consultation.

What is the copay for weight loss treatment with Humana in New Hampshire?

Copay amounts for weight loss treatment vary by Humana MA plan type and deductible status. Eligible MAPD members may access GLP-1 medications at $50/month through the CMS Medicare GLP-1 Bridge. For standard Part D coverage costs, review your Evidence of Coverage or call Humana member services at 1-800-448-6262 for specific cost information.

Does Humana require a referral for weight loss treatment in New Hampshire?

Referral requirements depend on your specific Humana MA plan type. HMO-type MA plans may require a primary care referral for weight loss specialist visits. PPO-type MA plans typically do not require referrals. Review your Evidence of Coverage or call Humana member services to confirm your referral requirements before scheduling.

Does Humana cover online weight loss treatment in New Hampshire?

Many Humana Medicare Advantage plans include telehealth benefits that may cover online weight loss consultations and medication management. CMS telehealth flexibilities for Medicare Advantage have expanded virtual visit coverage. Verify your specific Humana MA plan’s telehealth coverage for weight management services before scheduling an online appointment.

How do I verify my Humana coverage for weight loss in New Hampshire?

Log into your Humana member portal at humana.com, call Humana member services at 1-800-448-6262, or contact HPS at 1-800-379-0092 for prescription drug coverage details. To inquire about the CMS Medicare GLP-1 Bridge program, contact CMS at 1-800-633-4227 or visit medicare.gov. Klarity’s benefits check tool is also available for quick verification.

What Humana plans may cover weight loss medication in New Hampshire?

Humana Medicare Advantage Prescription Drug (MAPD) plans in New Hampshire may offer weight loss medication access through both standard HPS Part D formulary coverage and the CMS Medicare GLP-1 Bridge program ($50/month for Wegovy, Zepbound, and Foundayo for eligible members, effective July 1, 2026). Contact Humana at 1-800-448-6262 to understand your specific plan’s weight loss medication benefits and Medicare GLP-1 Bridge eligibility. For NH Insurance Division questions, call 1-603-271-2261.

Disclaimer: Insurance coverage varies by plan, insurer, and state. The information on this page is intended as general guidance only and does not constitute a guarantee of benefits. Telehealth provider availability may vary by state. Please verify your specific plan’s mental health coverage with your insurer or through Klarity’s benefits check before booking.

Check if your Humana plan may cover weight loss treatment in New Hampshire