Does Medicare Cover Ozempic in 2027? Negotiated Price, Part D Cap and the GLP-1 Bridge

Does Medicare cover Ozempic?

Yes, for type 2 diabetes. Part D, Medicare's prescription drug coverage, pays for it through a stand-alone drug plan or a Medicare Advantage plan with drug coverage. For how those plans change next year, see what's changing in Medicare Advantage for 2027.

Part D doesn't pay for Ozempic used for weight loss. Original Medicare (Parts A and B) covers hospital and medical care, not most drugs you fill at a pharmacy.

Each plan has a formulary, its list of covered drugs sorted into cost tiers. Your plan's formulary sets Ozempic's tier and any approval rules. Many plans need prior authorization (the plan's approval before it pays). Some use step therapy, which means trying a lower-cost diabetes drug first.

The negotiated price from January 1, 2027

Ozempic gets a lower Medicare price on January 1, 2027. CMS negotiated it with the drugmaker under the Medicare Drug Price Negotiation Program. The price covers Ozempic, Rybelsus and Wegovy, which share one active ingredient, semaglutide.

That's 71% below the 2024 list price, CMS says. The $274 is CMS's figure for a 30-day supply across all three drugs. Prices differ by package: one Ozempic 4 mg/3 mL pen has a negotiated price of $276.78.

The negotiated price is what Medicare drug plans pay for the drug. It isn't your copay. Semaglutide is one of 15 drugs whose negotiated prices start in 2027. Our guide to Medicare drug price negotiation has the full list.

What you might pay with the $2,400 cap

What you pay for Ozempic depends on your plan's tier, your copay or coinsurance, and how much you've spent this year. Part D costs in 2027 work in three stages.

If you pay coinsurance (a percentage of the drug's price), the lower negotiated price may lower your share. If you pay a flat copay, your cost may stay the same. Premiums and drugs your plan doesn't cover don't count toward the $2,400 cap.

Extra Help, Medicare's program for people with limited income and resources, can lower Part D premiums, deductibles and copays.

To check your own cost, look up Ozempic and your dose in your plan's 2027 drug list. The Medicare Plan Finder on Medicare.gov shows each plan's tier and estimated yearly cost. For help comparing plans, call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP). Open enrollment runs through December 7, 2026.

Ozempic isn't in the GLP-1 Bridge

The Medicare GLP-1 Bridge is a temporary program for weight loss, and Ozempic isn't in it. It covers only Wegovy (injection or tablet), Foundayo and Zepbound KwikPen, for a $50 copay a month. It runs from July 1, 2026, through December 31, 2027.

The Bridge is for weight loss. For type 2 diabetes, your Part D plan may cover a GLP-1. To use the Bridge, you also need prior authorization and a BMI that meets its criteria.

Wegovy has the same active ingredient as Ozempic and is approved for weight management. Our guide to Medicare GLP-1 coverage compares the GLP-1s Medicare covers.

Getting an Ozempic prescription by telehealth

A renewal is a new prescription for a medicine you already take. Is it worth a morning off and a waiting room to get one for a drug you've taken for years? A licensed doctor on Doctronic can see you by video, check that Ozempic still fits your diabetes care, and renew it if appropriate. Doctronic accepts Medicare.

Many people can have video visits from home under Medicare's expanded telehealth rules, which run through December 31, 2027.

Our guide to Ozempic online prescriptions explains how a telehealth prescription works. For dosing and side effects, see our Ozempic medication guide.

Frequently Asked Questions

Does Medicare cover Ozempic for weight loss?

No. Part D covers Ozempic for type 2 diabetes only. For weight loss, the GLP-1 Bridge covers Wegovy, Foundayo and Zepbound KwikPen, not Ozempic, if you meet its criteria.

Will Ozempic cost me $274 a month in 2027?

Not necessarily. $274 is the negotiated price Medicare drug plans pay for a 30-day supply. Your cost depends on your plan's deductible, tier and copay or coinsurance.

Does Medicare Advantage cover Ozempic?

Yes, if your Medicare Advantage plan includes drug coverage. Each plan sets its own tier and approval rules, so check its 2027 drug list.

Can I get Ozempic for $50 a month?

No. Ozempic isn't in the GLP-1 Bridge. The $50 Bridge copay is for Wegovy, Foundayo and Zepbound KwikPen, and it doesn't count toward the Part D out-of-pocket cap.

Does Medicare cover Rybelsus too?

Yes, Part D covers Rybelsus for type 2 diabetes. It's a semaglutide pill and shares Ozempic's 2027 negotiated price.

The Bottom Line

Look up Ozempic and your dose on your plan's 2027 drug list. Check its tier, your copay or coinsurance, and any prior authorization rule. If you need a renewal, ask about it before your current prescription runs out.