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Does Medicare Cover Ozempic, Wegovy or Zepbound? (2026 and 2027)
When Medicare drug plans may cover Ozempic, Wegovy or Zepbound. Call or text 813-302-7151.
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Yes, in some cases. A Medicare drug plan (Part D) can cover Ozempic when it is prescribed for type 2 diabetes. For weight loss, Medicare’s temporary GLP-1 Bridge covers Wegovy, Zepbound (KwikPen only) and Foundayo from July 1, 2026 to December 31, 2027, for a $50 monthly copay, if you meet its rules.
Tell us the exact drug, the dose, why it was prescribed and your current plan. Your doctor sends the medical records; we help you understand what the plan or program requires.
Diabetes: Part D coverage for Ozempic
Part D plans can cover GLP-1 drugs such as Ozempic or Mounjaro for type 2 diabetes when you meet the plan’s rules. Check the plan’s drug list (formulary), its tier, and whether it needs prior authorization or step therapy (trying a lower-cost drug first). A prescription alone does not mean the plan will pay, and an agent can never supply or change a diagnosis.
If you also use insulin, Medicare limits what you pay for a one-month supply of each covered insulin product to $35, and no deductible applies to covered insulin.
Weight loss: the Medicare GLP-1 Bridge (July 2026 to December 2027)
The GLP-1 Bridge is a short-term Medicare program for weight loss. It works outside your Part D plan’s regular coverage and runs from July 1, 2026 to December 31, 2027. It covers three drugs: Wegovy (injection or tablet), Zepbound (KwikPen only, not single-dose vials or pens) and Foundayo (tablet).
You pay a $50 copay to the pharmacy for a one-month supply. Because the Bridge, not your drug plan, pays for the drug, the $50 does not count toward your plan’s deductible or the Part D out-of-pocket cap ($2,100 in 2026 and $2,400 in 2027), and Extra Help does not lower it. We update this page when new figures are published.
Who qualifies for the Bridge
You need Medicare drug coverage (a Part D plan or a Medicare Advantage plan with drug coverage), you must be 18 or older, and you must meet one of these weight rules, according to Medicare.gov:
- BMI of 35 or higher, or
- BMI of 30 to 34.9 with diastolic heart failure, uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher, or
- BMI of 27 to 29.9 with prediabetes, a previous heart attack or stroke, or peripheral artery disease with symptoms
You are not eligible if your Part D plan already covers your GLP-1, or if you have type 2 diabetes, moderate to severe sleep apnea or fatty liver disease; in those cases your Part D plan might cover the drug instead. Your doctor sends the prescription, completes a prior authorization and confirms you are also following a diet and exercise program.
Ozempic and Wegovy on the 2027 negotiated price list
The CMS list of negotiated prices for 2027 includes the semaglutide drugs Ozempic, Rybelsus and Wegovy. That is the price Medicare negotiated with the manufacturer, not your copay, and it does not change the diagnosis rules. Keep three questions separate: is the use covered, which program pays, and what do you owe under that program.
Choosing a Part D or Medicare Advantage plan if you take a GLP-1
Compare your entire medication list, not only the GLP-1. Check pharmacies, deductible treatment, authorization renewal and other prescriptions. If you already have an approval, ask the proposed plan how it handles new members and ongoing treatment. Do not assume an approval transfers unchanged. For Bridge access, confirm the current program process separately from the plan's regular formulary.
Call us to check your plan
Ask us to review the coverage route, formulary status and questions for your prescriber. Useful questions include: What use is being submitted? Who requests authorization? Is a preferred pharmacy required? What happens if the request is denied? Keep the denial letter so the prescriber can address the actual reason in an exception or appeal. We cannot promise approval or choose treatment.
Official resources: CMS: Medicare GLP-1 Bridge; medicare.gov: GLP-1 Bridge; CMS: negotiated drug prices; medicare.gov: Part D costs; medicare.gov: insulin.
We do not offer every plan available in your area. For information on all of your options, please contact Medicare.gov, call 1-800-MEDICARE, or contact your local State Health Insurance Assistance Program (SHIP).
Frequently Asked Questions
Is Medicare going to start paying for Ozempic?
It already can. Part D plans can cover Ozempic when it is prescribed for type 2 diabetes and you meet the plan’s rules. For weight loss, the separate GLP-1 Bridge covers Wegovy, Zepbound and Foundayo, not Ozempic.
Will Medicare cover GLP-1s in 2027?
Yes, for some uses. Part D plans can cover GLP-1s for type 2 diabetes, and the GLP-1 Bridge covers certain drugs for weight loss through December 31, 2027 for a $50 monthly copay.
Under what conditions will Medicare pay for Ozempic?
When it is prescribed for type 2 diabetes and you meet your plan’s rules, including any prior authorization. Your doctor documents the medical need.
Does Medicare cover Wegovy for weight loss?
Yes, if you qualify for the GLP-1 Bridge. From July 1, 2026 to December 31, 2027, it covers Wegovy for people who meet its BMI and health rules, and you pay $50 for a one-month supply. Your doctor must complete a prior authorization.
Does Medicare cover Zepbound?
It can. The GLP-1 Bridge covers the Zepbound KwikPen (not single-dose vials or pens) for weight loss if you qualify, for $50 a month. If you have moderate to severe obstructive sleep apnea, you can’t use the Bridge, but Medicare.gov says your Part D plan might cover the drug; ask your plan about its rules.
What will Ozempic cost with Medicare in 2027?
It depends on your plan. If Part D covers it for diabetes, your copay depends on the plan’s tier, deductible and any Extra Help, and your yearly out-of-pocket costs for all covered Part D drugs stop at $2,400 in 2027.
This guide is general information, not legal, tax or medical advice. Your plan documents, including the Summary of Benefits and Evidence of Coverage, control what is covered and what you pay.
About the Author
Raymundo Guzman
I am Raymundo Guzman, a licensed independent insurance agent and the owner of Covered by Guzman. On the health side, I help Florida individuals, families and small businesses compare ACA Marketplace plans, Medicare Advantage and Part D, and dental and vision coverage, checking doctors and medications before anything is submitted. I work in English and Spanish, and a member of our team speaks Arabic. We usually meet by phone or video, and I stay available after enrollment.
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