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Does Medicare cover Ozempic?

Reviewed by the glpzoom Editorial Team against primary clinical sources — FDA labeling, peer-reviewed trials, and specialty-society guidelines.
Content current as of June 2026; updated when guidance or availability changes.
Yes — Medicare Part D covers Ozempic for its FDA-approved indication: type 2 diabetes with adequate glycemic control documentation. Coverage typically requires prior authorization with documented T2D diagnosis (A1c values, prior diabetes medications tried). Copay varies by plan tier — typically $30-100/month for Ozempic, with some plans placing it on a higher specialty tier. Medicare Part D does NOT cover Ozempic when prescribed off-label for weight loss in patients without diabetes (Medicare excludes anti-obesity medications by federal statute, even when prescribed off-label). Medicare Advantage plans sometimes offer slightly more permissive coverage; check your specific plan. The Treat and Reduce Obesity Act, introduced in Congress, would change weight-loss medication coverage rules for Medicare — as of 2026 it has not become law.

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Drugs referenced

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