Which weight loss drug is covered by Medicare?
Asked by: Henri Kuhn | Last update: July 11, 2025Score: 4.4/5 (58 votes)
What weight loss drug will Medicare pay for?
While Medicare is forbidden to cover weight loss drugs, it can cover certain medications, including Ozempic and Wegovy, when they're prescribed to treat conditions other than weight loss.
Will Medicare pay for Ozempic?
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.
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 are the requirements for Medicare to cover Wegovy?
Summary. Wegovy is a type of GLP-1 agonist, doctors primarily prescribe it as a weight loss medication. However, Medicare only covers Wegovy for the prevention of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and either obesity or overweight.
Biden proposes covering weight loss drugs with Medicaid and Medicare
How do you get Wegovy for $25 a month?
You may be able to get Wegovy for $25 (or less!) with the Wegovy Savings Card—that is, however, as long as you have a valid prescription for the drug, have private or commercial insurance, and meet the other eligibility requirements.
Will Medicare cover Mounjaro for weight loss?
GLP-1 agonists like Ozempic, Mounjaro, and Wegovy have become a popular method of weight loss. While Medicare Part D prescription drug plans and Medicare Advantage plans don't cover medications specifically for weight loss, they can choose to cover these drugs when prescribed for a medical reason.
Which is cheaper, Ozempic or Wegovy?
Wegovy and Ozempic, both forms of semaglutide, are used for different medical conditions but come at similar costs. Typically, these medications are priced at: Weekly: $50 to $87.50 per week. Monthly: $200 to $350 per month.
How much does a one month supply of Wegovy cost?
The cost of Wegovy without insurance is $1,349.02 per month (28-day) supply, but insurance, coupons, and manufacturer savings cards can reduce the price. With insurance, Wegovy can cost as little as $0, but the exact price depends on factors such as level of coverage.
Which insurance covers 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.
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®.
How to get approved for Wegovy?
Prior authorizations (PAs) are required by some prescription insurance plans to cover certain medications. Your health care provider will need to submit a form to your insurance company to seek approval for Wegovy®. You can reach out to your health care provider's office and request that they initiate a PA.
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 I get a discount on Ozempic if I am on Medicare?
Fortunately, the Medicare Part D and Medicare Advantage plans that include prescription drugs help cover the cost of Ozempic. Various programs are also available to help alleviate your out-of-pocket costs if you're uninsured or have limited income.
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)
Does Medicare pay for belly fat removal?
In summary, Medicare does not cover most cosmetic fat removal procedures like CoolSculpting and liposuction, as these are not considered medically necessary. However, Medicare does cover certain weight loss treatments, such as bariatric surgery, if you meet specific medical criteria.
How much does CVS charge for Wegovy?
Pay $ 1,388 chevron_right at Walgreens with a GoodRx discount. That's 14% off the retail price of $1619. Pay $ 1,352 chevron_right at CVS Pharmacy with a GoodRx discount. That's 15% off the retail price of $1590.
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.
Do you lose weight faster on Ozempic or Wegovy?
Ozempic has not been directly compared with Wegovy for helping weight loss. But based on a review of studies, Wegovy may lead to more weight loss than Ozempic. This is likely because doctors typically prescribe Wegovy at a higher maintenance (long-term) dosage than Ozempic.
Is there a generic for Wegovy?
No. There is currently no therapeutically equivalent version of Wegovy available in the United States. Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of Wegovy. These medications may be counterfeit and potentially unsafe.
What weight loss will Medicare pay for?
Medicare will pay for medically necessary bariatric surgery, including adjustable gastric banding, biliopancreatic diversion with duodenal switch, Roux-en-Y gastric bypass, sleeve gastrectomy, and vertical gastric banding.
How long do you stay on Mounjaro for weight loss?
How long can I take Mounjaro for? You can take Mounjaro for as long as your doctor prescribes it. This is usually until you've reached your weight loss goal. Studies have shown people can lose up to 22.5% of their starting weight while taking the highest maintenance dose of 15 mg after 72 weeks.