Weight loss injections — coverage 2026

Short answer: yes or no?

Coverage of weight loss injections in the Netherlands is not a yes/no question — it depends on: 1) which medicine, 2) your BMI, 3) whether you have a weight-related condition, and 4) whether you have already followed a lifestyle programme that did not work.

For most people who 'just want to lose weight' it is not covered — that is called off-label use and falls outside basic health insurance. But with obesity (BMI ≥35 or ≥40) and the right documentation, Wegovy or Saxenda can be covered via the GVS Annex 2 scheme.

Coverage per medicine (2026)

Not every GLP-1 medicine has the same coverage status. Below is the current overview for the Netherlands in 2026.

GVS Annex 2 conditions for obesity coverage

GVS Annex 2 is the scheme under which Saxenda and Wegovy are covered for obesity. The conditions are strict and must be documented by a doctor/dietitian.

• BMI ≥ 35 with at least one weight-related condition: type 2 diabetes (pre-diabetes does not count), hypertension, dyslipidaemia, sleep apnoea, non-alcoholic fatty liver disease (NAFLD/MASLD), joint problems due to excess weight, or polycystic ovary syndrome (PCOS) with a metabolic component;
• OR BMI ≥ 40 without a comorbidity being required;
• AND evidence of a previously followed combined lifestyle intervention (GLI) of at least 12 months without sufficient results (typically <5% weight loss);
• AND the prescription must come from an internist, endocrinologist or GP with demonstrable expertise in obesity treatment;
• AND periodic evaluation (every six months) of effect and side effects.

Type 2 diabetes — a different route

For people with type 2 diabetes things are different. Ozempic and Mounjaro are simply covered through basic health insurance when oral blood-glucose-lowering medicines (metformin, sulfonylurea derivatives) have insufficient effect. No GVS Annex 2 is needed here.

In practice this means: HbA1c stays too high despite the maximum dose of metformin + lifestyle → the doctor can prescribe a GLP-1 → covered on prescription. The €385 deductible (eigen risico) per calendar year is used, after which there are no further costs for the medicine itself.

Important: this route applies ONLY to people with formally documented type 2 diabetes. Pre-diabetes (HbA1c 39-47) does not count for regular coverage, only GVS Annex 2 for Wegovy/Saxenda if the BMI criteria are met.

Deductible and personal contribution — what will you really pay?

The Dutch deductible (eigen risico) is set at €385 per calendar year in 2026. That means: you pay the first €385 of healthcare costs under basic health insurance yourself, after which 100% is covered.

For medicines on GVS Annex 2 where the insurer applies a preference policy (some insurers designate 1 specific brand), a personal contribution of up to €250 per calendar year can apply if you choose a different brand within the same group. This can usually be avoided by sticking to the preferred brand.

At Go Leaner we also work with patients who do NOT qualify for coverage. For them the transparent Basic Programme of €199/month applies, including consultations with a BIG-registered doctor, lifestyle coaching and blood value monitoring. Medication is billed separately at cost price.

Off-label — what does it cost yourself?

When you do not receive coverage (e.g. BMI 28-34 without a serious comorbidity, or no type 2 diabetes), you pay for medication + supervision yourself. Below are the guide prices for 2026.

Application and prior authorisation in practice

For coverage via GVS Annex 2, the health insurer often requires a prior authorisation request from the prescribing doctor. This typically takes 1-2 weeks before the pharmacy may dispense.

The application includes: BMI documentation, weight history, evidence of a previously followed GLI (course + dietitian report), any comorbidity diagnosis codes (ICPC or ICD), and justification for the prescription.

Tip: apply for authorisation before you need the medication. It is a shame to go a week without an injection because the insurer still has to decide. At Go Leaner we handle the authorisation request for patients who qualify.