Quick answer
Yes for type 2 diabetes: Part D plans cover Ozempic when it’s on the plan’s formulary. Part D still can’t cover Ozempic or other GLP-1 drugs for weight loss alone. Since July 1, 2026, though, a separate Medicare GLP-1 Bridge lets people with a Part D plan who meet BMI and health criteria get Wegovy, Zepbound KwikPen or Foundayo for weight loss for a flat $50 a month, through December 31, 2027.
Medicare and GLP-1 drugs at a glance
| Use | How Medicare handles it |
|---|---|
| Type 2 diabetes (Ozempic, Mounjaro, Rybelsus) | Covered by Part D if on your plan’s formulary; plan cost-sharing applies and counts toward the $2,100 cap (2026) |
| Weight loss only | Not covered by regular Part D; may qualify for the GLP-1 Bridge |
| GLP-1 Bridge (July 1, 2026 – Dec 31, 2027) | $50 per 28- or 30-day fill for Wegovy, Zepbound KwikPen or Foundayo; doesn’t count toward the Part D deductible or out-of-pocket cap |
| Heart disease risk or sleep apnea | Part D plans may cover certain GLP-1 drugs for these FDA-approved uses; check your plan’s formulary |
Last reviewed October 26, 2026 by Greg Wilson. Sources: Medicare.gov, CMS.
Medicare Part D covers Ozempic (semaglutide) when it’s prescribed for type 2 diabetes. By law, though, regular Part D plans can’t cover drugs used only for weight loss. That has been the biggest gap in Medicare drug coverage, and in 2026 Medicare started a temporary program to fill part of it.
Ozempic for Diabetes: Covered
Ozempic is FDA-approved for type 2 diabetes and is covered by Part D plans and Medicare Advantage plans with drug coverage that list it on their formulary. Your cost depends on the plan’s tier and whether you’ve met your deductible. Most plans put it on a higher tier, and many require prior authorization showing you have diabetes.
What you pay counts toward the Part D out-of-pocket cap: $2,100 in 2026, rising to $2,400 in 2027. Once you hit the cap, you pay nothing more for covered drugs for the rest of the year. You can also spread costs over the year with the Medicare Prescription Payment Plan.
Weight Loss: The Medicare GLP-1 Bridge
From July 1, 2026 through December 31, 2027, Medicare is running the GLP-1 Bridge, a pilot that sits outside your regular Part D plan. If you qualify, you pay a flat $50 copay per 28- or 30-day fill, at any dose.
Who qualifies. You must be enrolled in Part D (a stand-alone drug plan or a Medicare Advantage plan with drug coverage) and meet one of these:
- A BMI of 35 or higher
- A BMI of 30 or higher with heart failure, uncontrolled high blood pressure, or stage 3a or higher kidney disease
- A BMI of 27 or higher with prediabetes, prior heart disease or heart attack, prior stroke, or symptomatic peripheral artery disease
Covered drugs. Wegovy (injection or pill), Zepbound (KwikPen only) and Foundayo (pill).
How to get it. Your doctor prescribes the drug and submits the approval request to Medicare’s central processor. Your Part D plan doesn’t run the Bridge, so call your doctor first, not your plan.
Fine print. The $50 copay doesn’t count toward your Part D deductible or the $2,100 cap, and Extra Help can’t be applied to it. If you take Ozempic or Mounjaro for diabetes, you stay on your regular Part D coverage instead.
Other Covered Uses
Part D plans may also cover some GLP-1 drugs for other FDA-approved uses, such as Wegovy to lower the risk of heart attack and stroke in people with heart disease and excess weight, or Zepbound for obstructive sleep apnea. Coverage depends on your plan’s formulary and usually requires prior authorization.
What Happens After 2027
The Bridge is scheduled to end December 31, 2027. Whether a longer-term program replaces it hasn’t been decided. If you start a GLP-1 through the Bridge, talk to your doctor about a plan for when it ends, since many people regain weight after stopping these drugs.
How to Check Your Coverage
- Look up the drug in your plan’s formulary or in the Medicare Plan Finder.
- Ask your doctor whether you meet the GLP-1 Bridge criteria.
- During Open Enrollment (October 15 – December 7), compare plans if your diabetes drug is on a costly tier.
Part of our Medicare Guide. Costs, enrollment deadlines, Medicare Advantage vs. Medigap, Part D and what Medicare covers, all in one place. See the full guide →
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