American Airlines’ flight attendant union is expressing frustration over an upcoming change to the company’s healthcare plan, as flagged by PYOK. I’m curious to see how this plays out.
In this post:
American angers union with 2026 healthcare changes
The Association of Professional Flight Attendants (APFA) isn’t happy about some changes that American is making to employee healthcare coverage for 2026. Specifically, this impacts members who rely on GLP-1 medications for their health.
Beginning January 1, 2026, the company’s health plan will only cover GLP-1 medications for individuals with type 2 diabetes. This means that unless flight attendants have diabetes, they will no longer be eligible to have drugs like Ozempic covered as part of the plan, even if considered to be medically necessary, and prescribed by a physician.
The union informed management that this raises serious concerns for members, and that reasonable alternatives are available to preserve member access to these medications, while addressing cost management.
For example, the union recommended implementation of copay caps to limit out-of-pocket exposure for members, use of prior authorization requirements to ensure medical necessity, and adoption of step therapy protocols.
Here’s what the union is claiming:
The company has chosen to bypass these alternatives and pursue outright exclusion for all employees, even with the growing recognition of obesity as a chronic disease.
This decision was made unilaterally by American Airlines. This change reduces the value of your healthcare coverage and strips treatment options Members rely on for prevention and quality of life. Your Union will continue to fight to have these medications covered for weight management.
We are urging all affected Members and those who stand in solidarity to contact company representatives directly. Voice your concerns about this decision. Share how this change impacts you, your family, or your ability to manage your health. Every message matters.
This is going to anger a lot of flight attendants
People of course have varying takes on drugs like Ozempic being used for weight loss. It does seem to be a “miracle” drug for weight loss, though I guess it remains to be seen if there are any long term health side effects (it’s beyond my area of expertise, of course, and I haven’t really looked much into Ozempic, other than what I’ve come across online).
One thing is for sure — Ozempic has made a huge difference in many peoples’ lives, though the retail cost is outrageously expensive, at around $1,000 per month. For most people that’s unaffordable, and for that matter, it sure seems like a medication shouldn’t cost five figures per year.
President Trump has been highlighting how he plans to lower the cost of Ozempic to $150 per month, but there’s no deal there yet, so it remains to be seen if that becomes a reality.
For those flight attendants who have found success with Ozempic, I certainly feel bad for them in the context of this coverage change. There’s a big health benefit to being a healthy weight, and if Ozempic is what helps people accomplish that, then it seems like a positive.
I also can’t say that I’m surprised to see American trying to cut costs with healthcare coverage. The company has very high labor costs, and is sort of struggling financially, as it’s significantly less profitable than Delta and United. The company has to find cost savings somewhere, and I guess this is the latest place it’s trying to do so.
Bottom line
As of 2026, American Airlines flight attendants will no longer have Ozempic covered as part of their healthcare plan, unless they have type 2 diabetes. The flight attendant union isn’t happy about this, given how many people rely on Ozempic for weight loss.
That certainly puts many flight attendants in a tough spot, given that the retail cost of Ozempic is around $1,000 per month.
What do you make of this American flight attendant healthcare coverage change?
GLP-1s, ideally, should be covered for anyone who is overweight (not just obese) and has any kind of comorbidity (even if something like high blood pressure).
There is still a lot of misinformation about them - putting an overweight on obese person on GLP-1s, and simultaneously getting them in the gym on a strenuous cardio and weightlifting program, can help transform's people health (and physiques) within several months. Not just diabetes can get better, but...
GLP-1s, ideally, should be covered for anyone who is overweight (not just obese) and has any kind of comorbidity (even if something like high blood pressure).
There is still a lot of misinformation about them - putting an overweight on obese person on GLP-1s, and simultaneously getting them in the gym on a strenuous cardio and weightlifting program, can help transform's people health (and physiques) within several months. Not just diabetes can get better, but blood pressure, general blood work, sleep, all kinds of issues people have. Insurance and the healthcare system should be going the other way and getting them into the hands of more people with minimal co-pay. I know a few people that are on them, just for weight loss, that pay $25 a month with insurance.
In terms of this particular post, American isn't alone in doing this, but I am guessing more insurance companies will get with the program and just start approving them for as many people as possible with a couple of years.
My employer, a medical school, did the same. We get free statins but only get GLP-1 inhibitors after we develop diabetes. $$$$ rule.
Airline health insurance costs are high in large part because the average age of airline employees tends to be high. People start their careers in the industry at a relatively young age, and they tend to hang around more so than in other industries. I recall back in the 90's the average age of an employee at one legacy carrier was 46. For an average, that's pretty high.
A few takeaways on this:
1. Ozempic is, while essentially the same, specifically for Type 2 Diabetes. Wegovy is the version for weight loss. If they are removing Ozempic specifically from the insurance plan that is affecting those with Diabetes for which the drug is, for sure, essential. So I guess while I can see perhaps taking Wegovy out of the plan (though it has amazing benefits for obesity and/or with high cholesterol and blood...
A few takeaways on this:
1. Ozempic is, while essentially the same, specifically for Type 2 Diabetes. Wegovy is the version for weight loss. If they are removing Ozempic specifically from the insurance plan that is affecting those with Diabetes for which the drug is, for sure, essential. So I guess while I can see perhaps taking Wegovy out of the plan (though it has amazing benefits for obesity and/or with high cholesterol and blood pressure) taking Ozempic off is not a good look.
2. It does not cost over $1000 anymore as the article states. It has not for months, especially since the changes to allowing of compounded versions. Wegovy is now around $450 per month if you get on a plan system with companies like RO. As well, it is expected to drop even more next year. In the EU, as an example, it can be purchased for around $200.
3. It is a miracle drug. In fact, obesity rates had a slight drop for the first time in the U.S. the past year. This is thought to be directly related to the GLP-1's and with more accessibility it could change the landscape of obesity here by remarkable percentages.
4. Daily tablet versions are expected to be FDA approved next year.
Given that the airline is looking to count every ounce of unnecessary weight from flights, I'm surprised they wouldn't want to cut potentially dozens of pounds from each flight.
All these drugs loosen your bowels, often violently. Not good when you’re working on a plane.
They also make you feel shite and probably contribute to more sick days. No wonder AA won’t cover it.
@1990 did Ben and Gary and Greg the Frequent Miler all ask you to respond to every comment with your perspective?
Asking for a friend. Wink (who doesn't care what you think about every post)
Odd choice considering they would make the money back in fuel savings.
For those arguing about government healthcare, no government run healthcare covers GLP1s for a weight loss diagnosis and that includes US Medicare (if you can find one please share).
Look at the research on these drugs, yes they are a bit of a miracle drug they help you lose weight fast but as soon as you come off of them you gain it back, they are a revolving door money pit. They are not...
For those arguing about government healthcare, no government run healthcare covers GLP1s for a weight loss diagnosis and that includes US Medicare (if you can find one please share).
Look at the research on these drugs, yes they are a bit of a miracle drug they help you lose weight fast but as soon as you come off of them you gain it back, they are a revolving door money pit. They are not medically necessary for weight loss, they are a fashion drug. If you want it pay for it yourself. AA is making the right call here.
"President Trump has been highlighting how he plans to lower the cost of Ozempic to $150 per month..."
Would that be after infrastructure week?
That is common for most healthcare plans. My plan covers the M and O only for type 2 diabetes and if extreme obesity is the diagnosis. Nothing to see here, if you just want to drop 15 - 20 either pay for it yourself or diet and exercise.
Maybe they could walk up and down the aisle more then once a flight and provide an additional beverage or trash pick up service.
$500/mo @ Costco. Er, I was checking for a friend.
'for a friend' *wink*
Trulicity (Lilly’s version) goes generic in 2027. And that will change everything.
Trulicity is not a GLP1. Lilly’s GLP1 equivalent fir weight loss is named Zepbound.
If your employer rather than your doctor decides what medication you get, the problem isn't the employer, the problem is your health care system. It's time for US to join the first world.
100%. Healthcare is a human right. The USA is the only developed nation to not have universal healthcare, or even a 'public option.' Bernie... 'was right about everything.'
What European country covers Ozempic for solely weight loss?
Of course none of them cover it for weight loss purposes. But that doesn’t fit the narrative and requires a google search.
"Healthcare is a human right."
100% wrong! If something requires the action/labor of another individual, then it can't possibly be a human right.
so by your definition we also shouldn't have a right to a fair trial as that requires the labor of others, or right to education as it requires the labor of already underpaid teachers, or the right to public safety as that requires the labor of police officers, fire fighters, etc, Rights aren't these magical things that happen without effort, they are social contracts we have all greed to and that will cost money and...
so by your definition we also shouldn't have a right to a fair trial as that requires the labor of others, or right to education as it requires the labor of already underpaid teachers, or the right to public safety as that requires the labor of police officers, fire fighters, etc, Rights aren't these magical things that happen without effort, they are social contracts we have all greed to and that will cost money and someone's labor and effort, healthcare also belongs in that list of rights we have.
National health care systems ration health care too.
It's less "rationing", Brian W, than it is insisting that treatments are worth their cost. If a fancy new drug for metastatic cancer, for instance, improves survival by only a few months at a cost of $30K a month, no nationalised health system is going to subsidize that. The health budget is not bottomless.
Lol - Who would subsidize the rest of the world with medical breakthroughs?
American Airlines (and all airlines) should know better... they really should embrace GLP-1s... less weight on-board, more fuel efficient, perhaps, healthier crews, etc. (consult with your doctor.)
While AA removed Ozenpic coverage for weight loss, there's no mention of approval of another drug for weight loss to replace Ozempic, like Mounjaro, Zepbound or Saxenda.
AA is trying to please the Orange Turd, who has been bashing Ozempic’s maker, Novo Nordisk, over cost.
Oh noooo Trump is fighting drug makers to lower costs!!! STOPPPPP DONT LOWER COSTSSSSS!