Health Insurance State: What Covers IVF, Weight Loss Drugs, and More in India

When it comes to health insurance state, the rules vary by region and insurer, determining what medical treatments are covered and what you pay out of pocket. In India, there’s no single national health insurance policy—each state sets its own guidelines, and private plans add more layers. This means one person in Maharashtra might get IVF covered, while someone in Uttar Pradesh pays the full ₹3 lakh out of pocket. The same goes for weight loss drugs like Ozempic or Wegovy: some insurers approve them, others don’t, and many require months of paperwork just to get a yes or no. It’s not about being sick—it’s about understanding what your plan actually includes.

Many people assume health insurance means everything is covered, but that’s not true. IVF insurance, coverage for in vitro fertilization, is only mandatory in a few states like Maharashtra and Tamil Nadu, and even then, it’s often limited to one cycle. In most places, you’re on your own. Meanwhile, weight loss medication insurance, coverage for drugs like Ozempic, Wegovy, or Mounjaro, is still rare in India. Even if your doctor says it’s medically necessary, insurers often label it as "cosmetic" or "non-essential." Some employers offer it as a voluntary benefit, but it’s not standard. And if you’re using Express Scripts or another pharmacy partner, prior authorization is almost always required—and denials are common. You can’t just show up with a prescription and expect it to be paid. You have to fight for it.

What’s worse? Even when coverage exists, hidden costs pile up. IVF might be listed as covered, but medications, lab tests, and consultations often aren’t. Weight loss drugs might be approved, but only after you’ve tried and failed at three other treatments—sometimes including therapy or diet plans you can’t afford. And if you’re in a rural area, finding a pharmacy that stocks these drugs or a doctor who knows how to file the paperwork is another hurdle. The system isn’t broken—it’s just not built for people who need it most.

That’s why the posts below matter. They don’t just tell you what’s covered—they show you how to get it covered. You’ll find real guides on how to appeal an IVF denial, how to get Express Scripts to approve Wegovy, and what alternatives exist if your state won’t pay. There’s no fluff. Just clear steps, real examples, and the exact questions to ask your insurer. Whether you’re trying to afford IVF, manage diabetes with a new drug, or fight a denied claim for Ozempic, you’ll find what you need here. No theory. No guesswork. Just what works in India today.