Do not assume a treatment offer is covered
MOTS-c was not a medicine approved by the US drug agency (FDA) as of September 30, 2026.
Ask your insurer about the exact proposed product. Ask about the care visit and any tests separately. Keep the response in writing.
Ask your insurance plan to confirm payment for that exact expense.
Translate the insurance plan’s words
A formulary is an insurance plan’s list of medicines it pays for. Prior authorisation means the insurance plan must agree to payment before it will cover the prescription.
As of September 26, 2026, Medicare’s prescription coverage could consider a weight-management medicine used to treat another condition, such as diabetes. Its use must be recognised as a medical treatment for that condition. Payment still depended on the insurance plan’s medicine list and required approval.
That rule does not establish that Medicare pays for unapproved MOTS-c. Ask your Medicare drug plan about MOTS-c by name, and request its answer in writing.
Health spending accounts have their own test
Health savings accounts and flexible spending accounts hold money for qualifying medical costs.
The Internal Revenue Service (IRS), the US tax agency, distinguishes treatment for a disease diagnosed by a doctor from spending just to improve general health, as of September 26, 2026.
That general rule does not establish whether a MOTS-c expense qualifies. Ask the people who manage your health spending account about the exact expense and required paperwork.
A doctor’s letter does not promise payment
Your health spending account’s managers may request a doctor’s written explanation of why the care is needed, called a “letter of medical necessity”.
As of September 26, 2026, IRS guidance did not require a document with that name. The account’s managers may still require one as paperwork supporting the expense.
Ask them what paperwork they need before relying on the account to pay a charge.
Keep this in mind
Get a written answer about the exact expense from your insurance plan or the people managing your health spending account before expecting payment.
A question to take
What will my insurance plan pay for, and what written approval is needed before a charge?
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