Does Medicare cover Wegovy?
Jump to section
Part D still excludes Wegovy used only for weight loss, but from July 1, 2026 through December 31, 2027 the Medicare GLP-1 Bridge covers Wegovy injections and tablets for $50 a month for eligible enrollees. Part D plans can also cover Wegovy for MASH and for cardiovascular risk reduction.
What Medicare specifically requires
- Enrolled in a standalone Part D plan or a Medicare health plan with drug coverage (not private fee-for-service, cost plans or PACE)
- Age 18 or older
- BMI of 35 or more; or 30 or more with heart failure with preserved ejection fraction, uncontrolled high blood pressure or chronic kidney disease stage 3a or higher; or 27 or more with prediabetes, a prior heart attack, prior stroke or symptomatic peripheral artery disease
- No type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease (those go through your Part D plan)
- Your prescriber submits an approval form to Medicare; refills on the same drug need no new approval, even when the dose changes
Sources: Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge (Jun 2026); CMS: Medicare GLP-1 Bridge information for providers (Aug 6, 2026); Humana: Does Medicare cover weight loss drugs? (Jun 8, 2026)
About Medicare coverage
- Medicare GLP-1 Bridge: $50 per month for Wegovy (injection or tablet), Zepbound KwikPen or Foundayo, from July 1, 2026 through December 31, 2027. Zepbound single-dose pens and vials are not covered. Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge, Jun 2026
- Bridge eligibility: age 18 or older and BMI 35 or more; or BMI 30 or more with HFpEF, uncontrolled high blood pressure or chronic kidney disease stage 3a or higher; or BMI 27 or more with prediabetes, a prior heart attack, stroke or peripheral artery disease. Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge, Jun 2026
- The $50 Bridge copay does not count toward the Part D deductible or the yearly out-of-pocket limit. Medicare.gov fact sheet 12234: Medicare GLP-1 Bridge, Jun 2026
- People with type 2 diabetes, moderate-to-severe sleep apnea or noncirrhotic MASH get GLP-1s through their Part D plan, not the Bridge. CMS: Medicare GLP-1 Bridge information for providers, Aug 6, 2026
- Federal law lets drug plans exclude agents used for weight loss, hair growth, or erectile dysfunction (42 U.S.C. 1396r-8(d)(2)). 42 U.S.C. 1396r-8(d)(2): drugs that may be excluded or restricted, Current code
Typical out-of-pocket
$50 per month through the Medicare GLP-1 Bridge (July 1, 2026 to December 31, 2027); it does not count toward the Part D deductible or out-of-pocket limit. Actual copay depends on your specific plan's pharmacy benefit tier.
If you're denied
A Part D denial for weight-loss use follows federal law, so check Bridge eligibility instead, or ask whether a covered use such as MASH or cardiovascular risk reduction applies to you.
Where to get Wegovy
Telehealth services that handle Wegovy, useful while prior auth processes or as a cash-pay alternative. We may earn a commission. See disclosure.
Ro
from $149/mo- Best for insured patients
- Best for clinical oversight
Ro Body, branded GLP-1 weight care program
Hims
from $149/mo- Best for cash-pay
- Best for speed
Hims Weight Loss, branded GLP-1 on a monthly membership
Medicare not the right plan?
Coverage varies between carriers and even between plans at the same carrier. Compare GLP-1 coverage across 20 US insurers and programs, or run the insurance pre-check to estimate your specific plan's odds.
More Medicare coverage
People also ask
Frequently asked
Does Medicare cover Wegovy?+
Part D still excludes Wegovy used only for weight loss, but from July 1, 2026 through December 31, 2027 the Medicare GLP-1 Bridge covers Wegovy injections and tablets for $50 a month for eligible enrollees. Part D plans can also cover Wegovy for MASH and for cardiovascular risk reduction.
Does Medicare require prior authorization for Wegovy?+
Yes. Medicare requires prior authorization for Wegovy. Your prescriber submits the request with the documentation listed in the Medicare criteria on this page.
What if Medicare denies my Wegovy prescription?+
A Part D denial for weight-loss use follows federal law, so check Bridge eligibility instead, or ask whether a covered use such as MASH or cardiovascular risk reduction applies to you.
What is the Wegovy copay with Medicare?+
$50 per month through the Medicare GLP-1 Bridge (July 1, 2026 to December 31, 2027); it does not count toward the Part D deductible or out-of-pocket limit. Actual copay depends on your specific plan tier and any pharmacy benefit manager carve-outs.