Does Medicare cover Ozempic?

It’s hard to turn on the TV or surf the internet without coming across advertisements for the latest weight loss drug semaglutide. Ozempic is just one brand-name version of semaglutide, a medication prescribed to treat type 2 diabetes. (Others common brands include Rybelsus and Wegovy.) Ozempic helps reduce blood sugar, which can reach dangerously high levels in people with diabetes. It’s been FDA-approved for this use since 2017. But over time, healthcare professionals and their patients have reported a welcome side effect to this drug—weight loss.¹ And drug companies are taking note. 

If you check the drug formulary on Medicare Part D prescription drug plans, you may see Ozempic listed. While it may be covered, it may only be covered for specific uses. 

Does Medicare Part D cover Ozempic for type 2 diabetes? 

Yes. Ozempic is a common and accepted drug prescribed to treat type 2 diabetes.  

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.²

The list price of Ozempic (the original price determined by the manufacturer, NovoNordisk) is $968.52 per monthly injection,³ although most people don’t pay list price if they have insurance. To see what you would pay for an approved prescription for Ozempic, check your Medicare Part D plan’s formulary.  

Current law doesn’t allow Medicare to cover drugs prescribed solely for weight loss. New CMS rules do allow Medicare Part D coverage for weight loss medications that have also been FDA approved to treat other health conditions (for example, heart disease that’s made worse by obesity).

Bottom line? Talk to your doctor if you have concerns about your weight. Healthy changes to your diet and lifestyle may provide what your pharmacist can’t—and with no out-of-pocket cost.