Walmart will add a $0 prescription tier covering more than 250 medications, a rare conditions center of excellence and up to 12 weeks of paid NICU leave for associates, while raising its starting medical premium by $1.50 per pay period, the company announced Tuesday.
The retailer, which describes itself as the employer of the largest private workforce in the US, with about 1.6 million associates, outlined the changes in a letter from chief people officer Donna Morris. Annual enrollment runs through Nov. 6. The prescription tier and the new center take effect Jan. 1, 2027, and the NICU leave begins Nov. 17, 2026.
The zero-dollar tier includes generic, brand-name and specialty drugs, among them some insulin and inhalers. Walmart told Becker’s that some GLP-1 drugs will be available at $0 with prior authorization, but only for employees with Type 2 diabetes. Morris said Walmart is adding “even more ways for associates and their families to live better.”
Under the rare conditions center, associates and dependents enrolled in most Walmart medical plans who are being evaluated for, or have been diagnosed with, multiple sclerosis, Parkinson’s disease or ALS can see a specialist in person for an evaluation and treatment review at no cost. Walmart said it is working with facilities such as Mayo Clinic and Cleveland Clinic, and travel is covered for the patient and an adult caregiver.
The NICU leave provides up to 12 weeks for eligible associates whose children are admitted to a neonatal intensive care unit within 28 days of birth and are receiving inpatient care. Walmart said one in 10 births requires NICU admission. The leave can be combined with other time off, and frontline associates can receive up to 28 weeks of paid leave when a birth involves NICU admission. The retailer already offers 20 no-cost therapy sessions a year and up to $20,000 for fertility services, adoption or surrogacy, Reuters reported.
Walmart said its starting medical premium will rise to $39.80 per biweekly pay period, and it told Becker’s the increase is smaller than last year’s. A spokesperson said the changes allow improvements “without slashing benefits” or significantly raising premiums. Walmart also says its starting premiums run about one-third below the average at other national companies.
The announcement comes as employers weigh how to manage rising costs. Mercer projects employer health benefit costs will climb 8.2% per employee in 2027, the largest increase since 2003, after accounting for cost-control measures. Employers estimate costs would rise about 11% without those measures, and 59% plan cost-cutting changes such as higher deductibles. The Business Group on Health forecasts a median 9.2% increase before plan changes, while Aon has projected 9.5% and WTW 11.1%.
Prescription drugs are a leading pressure point. The Business Group on Health’s 2027 Employer Healthcare Strategy Survey found pharmacy accounts for a quarter of employer healthcare spending and is projected to rise 12% before plan changes. About 14% of employers have dropped GLP-1 coverage or plan to in 2027, and none of the surveyed employers plans to add it.
Starbucks and Deloitte are among the large employers that have removed or restricted weight-loss drug coverage, according to Insurance Business’s coverage of employers cutting GLP-1 coverage. That reporting described pharmacy benefit manager evaluation as a key area for brokers advising clients on those pressures.
For brokers benchmarking client plans, Walmart’s package offers a large-employer data point: targeted pharmacy and specialty-care additions paired with a $1.50 per-pay-period increase to its starting premium. Plan sizes and funding structures differ for mid-market employers. The company did not disclose what the zero-dollar tier or the new center is expected to cost.
