IMPORTANT NOTICE FOR MEDICARE ELIGIBLE RETIREES AND MEDICARE ELIGIBLE DEPENDENTS
Monday, October 20, 2025
IMPORTANT NOTICE
FOR MEDICARE ELIGIBLE RETIREES AND MEDICARE ELIGIBLE DEPENDENTS
October 2025
Dear Medicare Eligible Participant:
This notice addresses important changes to the benefits offered by Aetna® to Medicare eligible retirees and dependents who participate in the National Automatic Sprinkler Industry (NASI) Welfare Fund (Fund). We encourage you to read this notice carefully. If you have any questions, please contact Labor First, your fully devoted third-party advocate, at 855-433-1675 (TTY 711).
Effective January 1, 2026, Aetna® Will Not Cover GLP-1 Medications Prescribed for Weight Loss
The Board of Trustees routinely reviews the prescription drug coverage offered through Fund, and its associated cost. Recently, the Fund has experienced an enormous increase in expenses arising from glucagon-like peptide-1 (GLP-1) medications. These medications are used to treat a variety of indications but are sometimes prescribed for weight loss.
Accordingly, in an effort to contain expenses and minimize insurance premium increases, Aetna® will not cover GLP-1 medications prescribed for weight loss if the prescription is filled on or after January 1, 2026.
If, in consultation with your doctor, you decide to continue taking GLP-1s prescribed for weight loss, please refer to the second page of this notice for a partial listing of independent resources for obtaining GLP-1s without insurance coverage, often at a discounted cost, at your expense. Please be mindful that this listing is current as of October 2025 and is subject to change at any time, without notice to you or the Fund Office.
Conclusion
The Board will continue to monitor and manage the Fund’s resources in an effort to ensure that it is able to provide high quality health coverage to members and their families. If you have any questions about this letter, please contact the Fund Office or Labor First, your fully devoted third-party advocate, at 855-433-1675 (TTY 711).
This notice is intended as a non-technical summary of certain rules regarding the benefits offered by the NASI Welfare Fund, so it does not contain all the details. In the event of a discrepancy between this notice and Aetna®’s official plan documents for Medicare eligible retirees and dependents who participant in the NASI Welfare Fund, those official plan documents, as interpreted and applied by Aetna®, will prevail. The Trustees reserve the right to modify the benefits offered by the NASI Welfare Fund at any time.
NON-EXHAUSTIVE LISTING OF INDEPENDENT RESOURCES FOR OBTAINING GLP-1 MEDICATIONS AT YOUR OWN EXPENSE AND WITHOUT PLAN COVERAGE
Effective for prescriptions filled on and after January 1, 2026, Aetna® will not cover GLP-1 medications prescribed for weight loss for Medicare eligible retirees and dependents. If, in consultation with your doctor, you decide to continue taking GLP-1 medications prescribed for weight loss at your own expense, below is a non-exhaustive listing of resources for obtaining GLP-1s without insurance coverage, often at a discounted cost. Of course, the Fund does not endorse or encourage you to use any of the following options. In addition, you should be mindful that this listing is current as of October 2025 and is subject to change at any time without notice to you or the Fund Office. Please speak with your doctor before taking these medications and discuss what options are best for you.
- Prescription Discount Cards and Offerings. Prescription discount cards are designed to provide lower drug costs to patients paying for their medications out-of-pocket. They are available even if you have insurance. You simply download a mobile application (or access online), search for your medication, show the coupon or discount at the pharmacy, and pay the discounted rate – just like any other coupon. Commonly known vendors for prescription discount cards are GoodRx and SingleCare. Both vendors offer discounts on GLP-1 medications at participating pharmacies. Also, the Costco Member Prescription Program offers a direct-to-members savings program that enables Costco-membership holders to obtain Wegovy and Ozempic with a prescription and without insurance coverage.
- Manufacturer Savings Programs. Manufacturer Savings Programs are typically for expensive, brand-name medications, so they are a useful resource for minimizing costs for GLP-1 medications. In the event your insurance doesn’t cover a medication, the manufacturer may cover all or some of your costs. Generally, you can obtain a manufacturer copay card through the manufacturer’s website. For many of these programs, there is an expiration date and/or maximum savings limit, but it varies per medication. Some states have enacted legislation to limit the use of these programs, so you should ask your provider or pharmacist about the availability of manufacturer copay cards for your medication. Manufacturers like Novo Nordisk (produces Wegovy, Ozempic, Rybelsus) and Eli Lilly (produces Mounjaro, Zepbound) offer savings cards for their medications. You can research the manufacturer’s website online, but a few examples are:
- Patient Assistance Programs. Some pharmaceutical manufacturers, non-profits, and foundations have developed programs to provide financial assistance for patients to afford medications when their insurance does not cover a specific drug. Each program has unique enrollment and qualification requirements. In many cases, there is an income threshold to qualify for such programs. Search online for patient assistance programs that cover the specific medication you need or ask your doctor for recommendations. The following are examples of organizations that provide patient assistance programs:
- Telehealth Services. Online telehealth services provide a convenient way to access GLP-1 medications without insurance. After creating a profile, you will meet with a licensed provider via video or online intake to determine if you qualify. They offer a cash-pay model, where you pay a fixed monthly fee for the prescription, medication, and ongoing support. The following is a popular telehealth service: Calibrate (www.joincalibrate.com).
