Does Medicare cover Ozempic or Wegovy?
Asked by: Orville Koelpin | Last update: January 2, 2026Score: 4.7/5 (69 votes)
What weight loss drug is covered by Medicare?
Medicare has been barred from paying for weight loss drugs, unless they're used to treat conditions like diabetes or to manage an increased risk of heart disease. States can decide whether to cover obesity drugs under Medicaid, but the majority don't.
Can I get Ozempic with Medicare?
Ozempic (semaglutide) is used to improve blood sugar control in adults with type 2 diabetes. Ozempic is covered by most Medicare and insurance plans, but some pharmacy coupons or cash prices could help offset the cost.
What diagnosis will cover Ozempic?
Most insurance companies will only cover Ozempic for its FDA-approved indication of treating type 2 diabetes. Some plans require additional criteria to be met, such as having tried other medications for diabetes first or having a certain severity of disease.
Can you really get Wegovy for $25?
Yes, you can really get Wegovy for $25 if you meet certain criteria. Offered by Novo Nordisk, the Wegovy Savings Card awards qualified individuals the opportunity to get the medication for $25 per month (i.e. 28-day supply).
Weight loss drugs like Wegovy access limited by insurance and Medicare coverage
How to get your insurance to cover Ozempic?
Obtain prior authorization, if needed.
If your insurance company requires prior authorization for Ozempic, your prescriber may need to provide confirmation that you have Type 2 diabetes and that the medication is medically necessary for treatment.
How do I get Ozempic for $25 a month?
With the Ozempic® Savings Card, you may PAY AS LITTLE AS $25b for a 1-month, 2-month, or 3-month supply for up to 48 months. To receive offer, prescription must be for a 1-, 2-, or 3-month supply. Savings card offer applies to eligible commercially insured patients with coverage for Ozempic®.
Why is Ozempic denied by insurance?
Ozempic use for weight loss is considered “off-label” and is not approved by the FDA. Insurance companies may not pay for “off-label” or unapproved uses of drugs.
How much does Wegovy cost?
The cost of Wegovy depends on your insurance coverage and pharmacy. A package of Wegovy contains four pens, each pre-filled with a single dose of Wegovy. Without insurance, the cost of Wegovy is $1,349.02 per month or 28-day package, which breaks down to $337.25 per week or $16,188.24 per year.
How to get Wegovy for free?
- Novo Nordisk's Wegovy Savings Card program. ...
- Prescription discount cards. ...
- Insurance coverage options for Wegovy. ...
- 90-day or mail-order refills. ...
- HSAs and FSAs. ...
- Government insurance programs for accessing Wegovy for free.
How do I get semaglutide from Medicare?
The only time that Medicare will offer to pay for semaglutide is if it's prescribed for type 2 diabetes treatment. The medication is part of the select anti-diabetes drugs that are covered under Medicare Part D (prescription drug coverage).
Is Medicare going to pay for Wegovy in 2024?
Do Medicare prescription drug plans cover Wegovy? No. In general, Medicare prescription drug plans (Part D) do not cover this drug.
What is the difference between Ozempic and Wegovy?
Ozempic and Wegovy have different FDA-approved uses, which is an important difference for many reasons. Both medicines contain the GLP-1 agonist semaglutide, but Ozempic is used to manage blood sugar in adults with type 2 diabetes, while Wegovy is prescribed for long-term weight loss in adults and children.
How much is Ozempic without insurance?
Ozempic costs $950 to $1,029 without insurance, depending on the pharmacy you use. The price is usually the same for all of the different strength pens.
Why won t Medicare pay for Ozempic?
Does Medicare Part D cover Ozempic for weight loss? No. At this time, the law doesn't allow Medicare to cover medications used solely for weight loss.
What insurance companies cover Wegovy?
Most major insurance plans cover Wegovy, including Blue Cross Blue Shield, Aetna, Cigna, and United Health Care, but coverage may vary with each plan. Benefits offered by employer plans also vary, and coverage is often based on what employers are willing to cover.
Who is not a good candidate for Ozempic?
Those with a personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia syndrome type 2 (MEN2), pancreatitis, or gallbladder disease are not suitable candidates for Ozempic. In addition, this treatment is not intended for pregnant or breastfeeding women.
How much is Ozempic at Walmart?
Walmart typically carries all available dosages of Ozempic, and prices can vary based on your location and whether you have insurance or use a discount card. If you're uninsured, the cost might range from $900 to $1,000 for a one-month supply.
How do I pay for Ozempic if insurance doesn't cover it?
Your insurance plan may cover Ozempic if you meet certain requirements. But if your insurance doesn't cover the medication or you don't have insurance, there are other ways to lower your out-of-pocket costs, including using an Ozempic copay savings card or GoodRx coupon.
Does Medicare cover weight loss drugs?
Under current law, people on Medicare can get anti-obesity drugs covered by Part D, Medicare's outpatient drug benefit, only if they are used for a medically accepted FDA-approved indication other than obesity, like diabetes or cardiovascular disease risk reduction.
Will Blue Cross Blue Shield cover Wegovy?
In most cases, your healthcare provider will initiate the prior authorization for Wegovy and will work with your BCBS plan to complete the request. If the prior authorization is approved, the medication will be covered. However, it may only be covered for a certain length of time.