The arrival of powerful weight loss injections like Wegovy and Mounjaro has transformed the conversation around obesity management in the UK. As an expert FCA-authorised broker that has helped arrange over 900,000 policies, our team at WeCovr is increasingly asked: will my private medical insurance cover the cost? This guide provides the definitive answer for 2026.
The definitive guide to accessing weight loss injections in the UK NHS eligibility vs. private prescriptions, and which insurers cover the consultation fees
The landscape for these revolutionary GLP-1 agonist drugs is complex, involving strict NHS criteria, a burgeoning private market, and the fundamental principles of UK health insurance. Let's break it down.
The Short Answer: Why UK PMI Generally Excludes Wegovy and Mounjaro Prescriptions
To get straight to the point: standard UK private medical insurance (PMI) does not cover the ongoing cost of prescription drugs like Wegovy and Mounjaro for weight management.
The reason is fundamental to how health insurance works in the UK.
PMI is designed to cover the diagnosis and treatment of acute conditions. An acute condition is a disease or illness that is likely to respond quickly to treatment and lead to a full recovery, such as a joint replacement, cataract surgery, or treatment for a new cancer diagnosis.
Weight management, including the long-term use of medication for obesity, is classified as the management of a chronic condition. A chronic condition is an illness that cannot be cured but can be managed through medication and lifestyle changes, such as diabetes, high blood pressure, or asthma.
UK private medical insurance does not cover the management of chronic conditions. This single principle is the primary reason why the monthly cost of these injections is not an insured benefit on standard policies. The insurance model is built on covering unforeseen, short-term health events, not predictable, long-term medication costs.
Wegovy & Mounjaro: A Quick 2026 UK Overview
Before diving into the insurance specifics, it's helpful to understand what these medications are. Both are part of a class of drugs called GLP-1 receptor agonists, originally developed for type 2 diabetes, which have proven highly effective for weight loss.
| Feature | Wegovy (semaglutide) | Mounjaro (tirzepatide) |
|---|
| Manufacturer | Novo Nordisk | Eli Lilly |
| Mechanism | Mimics the GLP-1 hormone to regulate appetite and food intake. | Mimics both GLP-1 and GIP hormones for a dual effect on appetite and blood sugar. |
| Administration | Weekly self-administered injection. | Weekly self-administered injection. |
| Primary Use | Chronic weight management. | Approved for type 2 diabetes and chronic weight management. |
| Typical Private Cost | £170 - £300 per month. | £200 - £350 per month. |
These drugs are not a quick fix; they are prescribed as part of a comprehensive, medically supervised weight management programme that includes diet and exercise.
Accessing Weight Loss Injections: NHS vs. Private Pathways in 2026
If you're considering these treatments, you have two main routes in the UK: the NHS or a private prescription.
1. The NHS Pathway
Accessing Wegovy or Mounjaro on the NHS is possible, but it comes with stringent criteria set by the National Institute for Health and Care Excellence (NICE).
To be eligible for an NHS prescription, you typically need to:
- Have a Body Mass Index (BMI) of at least 35, or a BMI of at least 30 with at least one weight-related health condition (like high blood pressure or sleep apnoea).
- Be referred to a specialist tier 3 or tier 4 NHS weight management service. A GP cannot prescribe it directly for weight loss.
- Commit to a comprehensive lifestyle modification programme.
- The prescription is usually for a maximum of two years.
The reality for 2026 is that waiting lists for these specialist services can be exceptionally long, often stretching for many months or even years, depending on your local NHS trust.
2. The Private Prescription Pathway
This is the most common route for individuals who don't meet the strict NHS criteria or wish to avoid the long waiting times.
- How it works: You have a consultation with a private GP or a clinician at a registered online pharmacy (like Boots, LloydsPharmacy, or digital health clinics).
- Assessment: The clinician will assess your BMI, medical history, and suitability for the medication.
- Cost: You bear the full cost. This includes the initial consultation fee (if any) and the ongoing monthly cost of the medication, which can range from £170 to over £350.
The private market offers speed and convenience but at a significant personal expense. This is where the question of private health insurance becomes critical.
The Crucial PMI Question: Can Health Insurance Cover Any Part of the Process?
While PMI won't pay for the monthly drug prescription, there is a specific scenario where it might help with a small part of the cost: the initial diagnostic consultation.
If your GP is unsure about the cause of your weight gain or suspects an underlying medical issue (like a hormonal imbalance or thyroid problem), they might refer you to a private specialist, such as an Endocrinologist, for investigation.
If your PMI policy has good outpatient cover, it could potentially cover the cost of that specialist's consultation fee.
Here’s how it would work:
- GP Referral: You visit your NHS or private GP with concerns. They provide a referral to a specialist to diagnose a potential underlying condition.
- PMI Authorisation: You contact your insurer with the referral. They authorise the consultation with a specialist from their approved network.
- Consultation: Your PMI policy covers the specialist's fee (£200-£400).
- Outcome: The specialist may conduct diagnostic tests (which could also be covered). If they ultimately recommend Wegovy or Mounjaro for weight management, the policy coverage ends there. You would then have to pay for the private prescription yourself.
Which Insurers Might Cover a Diagnostic Consultation?
Most major UK insurers could cover this, provided you have the right level of outpatient cover. It is not a special "weight loss" benefit but a standard feature of comprehensive policies.
| Insurer | Potential Cover for Diagnostic Consultation? | What's Typically Covered | Key Consideration |
|---|
| AXA Health | Yes, with outpatient cover. | Specialist consultation fees and eligible diagnostic tests. | The referral must be for diagnosis of a condition, not just for a weight loss prescription. |
| Bupa | Yes, with outpatient cover. | Consultant fees as part of diagnosing symptoms. | Chronic care and weight loss treatments themselves are explicit exclusions. |
| Vitality | Yes, with outpatient cover. | Consultant fees and diagnostics under their "Full Cover" option. | Vitality focuses heavily on incentivising healthy behaviour, but the core insurance still excludes chronic care funding. |
| The Exeter | Yes, with outpatient cover. | Fees for eligible specialist consultations. | Like all others, the policy is for acute conditions. The consultation must be diagnostic in nature. |
Expert Adviser Tip: Do not purchase a policy assuming it will lead to a funded prescription. The value of PMI lies in its core benefits (cancer care, surgery, diagnostics). The potential to cover a single consultation fee is a minor, incidental benefit and should not be the reason you buy a policy. A WeCovr adviser can help you understand the true value and limitations of any policy.
Understanding Why PMI Excludes Chronic Care and Weight Loss Drugs
To make an informed decision, it's vital to grasp the "why" behind these exclusions.
- The Insurance Model: Private health insurance is based on a "risk-pooling" model to pay for unexpected events. If insurers were to cover predictable, long-term, and widespread costs like obesity medication for millions of people, the premiums for everyone would become astronomically high and unaffordable.
- Pre-existing Conditions: When you apply for PMI, you undergo underwriting. Any condition, symptom, or medication you've had in the past (typically the last 5 years) is considered "pre-existing." Obesity and its related conditions would almost always be excluded from day one under a new policy.
- Lifestyle vs. Medical Treatment: While obesity is a medical condition, insurers draw a line between treatments that "cure" an acute problem and those that "manage" a chronic or lifestyle-related one. PMI is firmly in the former camp.
Navigating these rules can be complex. Working with an independent PMI broker like WeCovr ensures you get clear, unbiased advice tailored to your actual needs, preventing you from buying a policy based on false expectations.
Are There Any Alternatives or Future Possibilities?
While direct funding for Wegovy is off the table, some elements of the PMI ecosystem can support your health goals.
- Wellness Programmes: Providers like Vitality are leaders in this space. They don't pay for the drug, but their programme actively rewards you with discounts and perks (like cinema tickets or Apple Watches) for hitting activity goals, exercising, and eating well. This can be a powerful motivator to support the lifestyle changes required alongside these medications.
- Digital GP Services: Almost all modern PMI policies include access to a 24/7 digital GP. This can be a convenient way to get initial advice, discuss your health concerns, and obtain a referral if needed, often faster than waiting for an NHS appointment.
- Complimentary Health Tools: At WeCovr, we believe in supporting our clients' holistic health. That's why we provide complimentary access to our AI-powered calorie and nutrition tracking app, CalorieHero, to all our health and life insurance clients. This tool can be invaluable when undertaking a medically supervised weight management programme.
- Future Add-ons: It is conceivable that in the future, insurers might offer a specific, high-cost "add-on" for weight management programmes. However, this would be an optional, separately-priced benefit, not part of standard cover, and is not expected to be available in the UK market in 2026.
How to Choose the Right Private Medical Insurance in 2026
If you've understood that PMI won't cover Wegovy but are still interested in its core benefits, here is the right way to approach it.
- Define Your True Needs: What are you most worried about? Is it long NHS waiting lists for surgery? Getting a fast diagnosis for a worrying symptom? Access to the latest cancer drugs? Focus on these core reasons.
- Understand Key Policy Options:
- Outpatient Cover: Do you want cover for consultations and tests before being admitted to hospital? This is a key variable that affects the price.
- Hospital List: Are you happy with a local list of hospitals, or do you want access to prime central London facilities?
- Excess: How much are you willing to pay towards the first part of any claim? A higher excess (£250 or £500) can significantly lower your monthly premium.
- Use an Expert Broker: A broker's job is to do the hard work for you. At WeCovr, we compare policies from across the market to find the best fit for your needs and budget. Our service is free to you, and we can often find better terms than going direct. We also provide support if you ever need to make a claim. We can also help you secure discounts on other policies, such as life insurance, when you purchase a PMI plan.
Will my company's private health insurance cover Wegovy or Mounjaro?
It is extremely unlikely. Employer-provided PMI schemes operate on the same principle as individual policies: they cover acute conditions, not the long-term management of chronic conditions like obesity. While the specific benefits can vary, the exclusion of chronic care and weight loss treatments is a standard feature across the UK group PMI market.
Can I get a private prescription for Wegovy without any insurance?
Yes, absolutely. This is the most common way for people in the UK to access Wegovy, Mounjaro, and other weight loss injections. You can book a consultation with a private GP or use a registered online pharmacy. They will assess your suitability and, if appropriate, issue a private prescription which you pay for yourself on a monthly basis.
Is private medical insurance still worth it if it doesn’t cover weight loss drugs?
Yes, for many people, it is highly valuable. The primary purpose of PMI is not to cover lifestyle medications, but to provide fast access to diagnosis and treatment for serious, acute conditions. The key benefits include bypassing NHS waiting lists for surgery (e.g., hip/knee replacements), prompt access to specialist consultations, and access to advanced cancer drugs and treatments not always available on the NHS.
What should I declare about my weight when applying for health insurance?
You must be completely honest and declare your accurate height and weight, as well as any related conditions like high blood pressure, high cholesterol, or sleep apnoea. Failing to disclose this information can be classed as non-disclosure, which could lead to a future claim being denied or your policy being voided. An adviser can help you complete the application accurately.
The Final Word
While the buzz around Wegovy and Mounjaro is justified, it’s crucial to have realistic expectations about funding. In 2026, private medical insurance remains focused on its core purpose: providing fast, high-quality care for acute medical conditions. It is not a tool for funding long-term weight management medication.
The real value of PMI lies in the peace of mind that comes from knowing you can bypass long waiting lists and get the expert diagnosis and treatment you need, when you need it most.
Ready to explore how a private health insurance policy could protect you and your family? Get a free, no-obligation quote and expert advice from our friendly, FCA-authorised team today.