Does Medicare Cover Ozempic? Part D Rules for 2027

Let's set the stage. Ozempic (semaglutide) is approved for type 2 diabetes, and that is how Medicare drug plans cover it. Medicare drug plans are generally not allowed to cover drugs used only for weight loss, which is why Ozempic is not covered when it is prescribed just to lose weight. Ozempic is also not part of the Medicare GLP-1 Bridge, the temporary program for weight loss drugs.

Ozempic coverage at a glance

What Ozempic costs under Medicare in 2027

Ozempic, Rybelsus and Wegovy were negotiated together as one selected drug in the second round of Medicare drug price negotiation. Per CMS:

• Negotiated price: $274 for a 30 day supply, versus a 2024 list price of $959, a 71% discount. It takes effect January 1, 2027.
• Per package: one 4 mg/3 mL Ozempic pen is $276.78, and 30 Rybelsus 7 mg tablets are $276.78.
• Use: 2,282,000 Part D enrollees used these drugs in 2024, with $15.2 billion in gross Part D costs, the most of any drug in that round.

Here's the thing. The negotiated price is what the plan and pharmacy work from. It is not your copay. What you pay depends on your plan's tier for Ozempic, its deductible (the 2027 standard maximum is $700) and whether it uses a copay or coinsurance. In every case, your covered Part D drug costs stop at $2,400 for 2027.

What to check before you pick a 2027 plan

1. Is Ozempic on the 2027 formulary? CMS requires drug plans to include negotiated drugs on their formularies, but tier and prior authorization rules still vary. 2027 formularies are being added to our data now, and we do not claim plan by plan coverage until they are.
2. What tier, and does the deductible apply? This is where two plans with the same premium can cost very different amounts.
3. Prior authorization. Many plans ask your doctor to confirm the diabetes diagnosis. Have that done early in January so your first fill is not delayed.
4. Your other drugs. Price the whole list together against the $2,400 cap.

What about Rybelsus, the pill?

Rybelsus is the tablet form of semaglutide for type 2 diabetes. CMS negotiated it together with Ozempic and Wegovy, and 30 tablets of the 7 mg strength have a 2027 negotiated price of $276.78, the same as one 4 mg Ozempic pen. Coverage works the same way: your plan's formulary, tier and prior authorization rules decide what you pay.

Already on Ozempic and turning 65?

Your employer or individual plan's approval does not carry over to Medicare. When you pick your first Medicare drug plan, confirm Ozempic is on its formulary and ask your doctor to send a new prior authorization if the plan requires one, so you do not have a gap at the pharmacy.

If you are trying to get a GLP-1 for weight loss rather than diabetes, read Does Medicare cover Wegovy for weight loss?

Everything Senior Insurance is a licensed insurance agency and is not connected with or endorsed by the U.S. government or the federal Medicare program.

Updated October 13, 2026 by the Everything Senior Insurance Data Desk.