Wegovy is not covered by OHIP in Ontario.
Some private insurance plans may offer partial coverage, but approval depends on your plan design, medical indication, and insurer rules.
Below is the clear, realistic breakdown — without confusion or false promises.
Is Wegovy Covered by OHIP in Ontario?
No. OHIP does not currently cover Wegovy.
OHIP-funded drug programs focus on medications used to treat specific medical conditions such as diabetes, cancer, or severe chronic illness. Wegovy is approved in Canada for chronic weight management, which places it outside OHIP’s public coverage scope at this time.
This means:
- You cannot receive Wegovy for free through OHIP
- A doctor’s prescription alone does not make it publicly covered
- Coverage decisions are policy-based, not pharmacy-based
Why OHIP Does Not Cover Wegovy
OHIP coverage decisions are based on:
- medical necessity definitions
- cost-effectiveness at a population level
- long-term public funding sustainability
While weight management is clinically important, weight loss medications are not yet classified as essential publicly funded therapies in Ontario. This is why medications like Wegovy are treated differently from diabetes medications such as insulin.
Coverage rules may evolve over time, but as of 2026, Wegovy remains private-pay or privately insured.
Is Wegovy Covered by Private Insurance in Ontario?
Sometimes — but not automatically.
Private insurance coverage for Wegovy varies widely. Some plans may cover part of the cost, while others exclude weight loss medications entirely.
Coverage may depend on:
- your employer’s benefits design
- whether your plan includes obesity or metabolic treatment coverage
- prior authorization requirements
- proof of medical necessity
- BMI thresholds or documented health risks
Even within the same insurance company, coverage can differ from one plan to another.
What “Partial Coverage” Usually Means
If your plan does cover Wegovy, it may:
- reimburse a percentage of the cost
- cap annual reimbursement
- require special authorization
- classify Wegovy under specialty medications
In many cases, patients still pay a portion out of pocket.
This is why verifying coverage before filling the prescription is critical.
What About the Trillium Drug Program?
The Trillium Drug Program helps Ontario residents with high prescription drug costs relative to their income.
However:
- Trillium does not automatically cover Wegovy
- Eligibility depends on drug classification and program rules
- Most weight loss medications are not routinely included
If affordability is a concern, Trillium may still be worth exploring — but expectations should remain realistic.
What If Wegovy Is Not Covered?
If Wegovy is not covered under your plan, you still have options:
- paying out of pocket
- reviewing alternative medications with your prescriber
- comparing pharmacy pricing
- checking if your plan allows medical exceptions
Understanding the average monthly cost of weight loss medications in Canada can help you plan realistically before starting treatment.
Why Prices and Coverage Can Be Confusing
Many patients assume:
- “If it’s prescribed, it must be covered”
- “All insurance plans work the same way”
Unfortunately, neither is true.
Coverage depends on policy design, not prescription validity. Pharmacies do not control insurance approvals — but they can help clarify your options before you commit financially.
How a Pharmacist Can Help
A pharmacist can:
- review your insurance plan details
- explain coverage limitations
- help estimate out-of-pocket costs
- discuss timing and refill considerations
Having this information upfront helps avoid surprise expenses and delays.
- Wegovy is not covered by OHIP
- Private insurance coverage is possible but not guaranteed
- Verification before starting is essential
- Costs and coverage vary by plan and pharmacy
Making informed decisions early can save time, stress, and unexpected expenses.
