Which Medicare plans cover Ozempic?
Asked by: Jevon White DVM | Last update: August 18, 2025Score: 4.9/5 (10 votes)
Which Medicare insurance covers Ozempic?
Medicare Part D covers Ozempic to treat diabetes, but not as a weight loss treatment.
Will Medicare cover Ozempic for weight loss in 2025?
The Centers for Medicare & Medicaid Services announced 15 new drugs it wants to lower the cost for, including popular, but expensive weight-loss drugs. When you purchase through links on our site, we may earn an affiliate commission.
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).
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®.
Does Your Health Plan Cover Ozempic?
Is there a weight loss drug covered by Medicare?
*Medicare Part D does not currently provide access to drugs to treat obesity alone; these enrollees may have been prescribed the medications for another condition such as type-2 diabetes or cardiovascular disease combined with obesity.
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 is the cost of a 30 day supply of Ozempic?
Each box of Ozempic contains 4 weekly doses of Ozempic, which is roughly a monthly supply. The cost of a 30-day supply of Ozempic is $968.52 without insurance. However, the amount you pay will depend on your insurance coverage, the pharmacy you use, and any Ozempic coupons you may be eligible for.
How do I get my Ozempic covered?
If you have health insurance, you may be able to get Ozempic covered if it's being used as a treatment for Type 2 diabetes. But you may not get coverage if you don't have diabetes and want to use the medication for weight loss.
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.
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).
What can I do if my insurance won't cover Ozempic?
- File an Appeal. If your claim was denied, you can appeal the decision. ...
- Request a Prior Authorization. ...
- Explore Drug Discounts and Coupons. ...
- Consider Compounded Semaglutide. ...
- Switch to a Covered Alternative.
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.
What is the full price of Ozempic without insurance?
Official answer. 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.
How much does Ozempic cost at Costco?
The $179 subscription fee does not include the cost of medications. Members will need to check their insurance to see what's covered. Without insurance, weight-loss medications like Wegovy, Ozempic and Saxenda can cost between $950 to $1,600 per month, Sesame said.
What is the downside of Ozempic?
Serious Side Effects
Symptoms include severe abdominal pain, nausea, and vomiting, and require immediate medical attention. Gallbladder Disease: Ozempic may increase the risk of gallbladder disease, including gallstones. Symptoms can include severe abdominal pain, fever, and jaundice.
Does Blue Cross Blue Shield cover Ozempic?
BCBS typically requires prior authorization for Ozempic. You can check if your specific plan does by reviewing your plan's drug formulary. If you see a “PA” next to Ozempic, that means prior authorization is required. It's worth noting that submitting the paperwork doesn't always result in approval.
How do I get Ozempic if I have Medicare?
- Research Part D plans. ...
- Ensure you qualify for Ozempic. ...
- Ensure you qualify for Medicare. ...
- Enroll in Original Medicare with Part D coverage or Medicare Advantage through the Medicare Plan Finder.
- Ask your provider to prescribe the drug.
What tier is Ozempic on Medicare?
Medicare prescription drug plans typically list Ozempic on Tier 3 of their formulary. Generally, the higher the tier, the more you have to pay for the medication. Most plans have 5 tiers.
What weight loss drugs are 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.
How long does Medicare cover Ozempic for weight loss?
Does Medicare pay for Ozempic? Yes, most Medicare prescription drug plans (Medicare Part D) cover Ozempic for the treatment of type 2 diabetes, but not for weight loss. Coverage can change yearly, so it's best to check directly with your plan.
What is the strongest weight loss prescription pill?
Some of the strongest weight loss pills available today include: Naltrexone/bupropion (brand name Contrave) Phentermine/topiramate (brand name Qsymia) Orlistat (brand names Xenical, Alli)
Will Medicare pay for Wegovy?
Wegovy (semaglutide) is used to help people lose weight and maintain weight loss. Wegovy is not covered by most Medicare and insurance plans, but manufacturer and pharmacy coupons can help offset the cost. Wegovy is a GLP-1 Agnonist, which works by increasing insulin release and reducing appetite.