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Bill

SB 455

relative to coverage for GLP-1 medication under the state Medicaid plan.

2026 Regular Session Introduced by Sue Prentiss

SB 455 mandates health plan coverage standards for GLP-1 medications in New Hampshire, affecting diabetes and weight-loss treatment accessibility and insurance costs.

Inexpedient to Legislate: MA VV 05/14/2026 HJ 13
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Bill Summary · SB 455

Legislative bill overview

SB 455 addresses health insurance coverage requirements for GLP-1 medications (such as semaglutide and tirzepatide, commonly known by brand names like Ozempic and Wegovy). The bill establishes standards for when and how health plans must cover these medications, which are used for diabetes management and weight loss treatment.

Why is this important

GLP-1 medications have become increasingly expensive and in-demand, with costs sometimes exceeding $1,000 monthly without insurance coverage. This bill determines whether insurers must provide access to these drugs and under what conditions, directly affecting affordability for New Hampshire residents and potentially influencing state healthcare costs and insurance premiums.

Potential points of contention

  • Coverage scope and cost limits: Whether plans must cover GLP-1s for weight loss (cosmetic use) versus only diabetes management, and what out-of-pocket maximums apply
  • Prior authorization requirements: How restrictive insurance companies can be in requiring medical justification before covering the medication
  • Budget impact: Whether mandated coverage increases insurance premiums for all enrollees, potentially shifting costs across the market
  • Manufacturer pricing vs. insurance mandates: Whether legislative mandates address the underlying high drug prices or simply shift costs between payers

Compiled from official sources — confirm details with the bill’s official record.

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