Yes, for its labeled uses. Ozempic is approved for blood sugar control in adults with type 2 diabetes, and for lowering heart and kidney risks in adults with type 2 diabetes[1]. Those are uses a Part D plan can cover, and Novo Nordisk says most Part D plans cover Ozempic[2]. The harder questions are weight loss and cost.
| Why it is prescribed | What Medicare does | What decides it |
|---|---|---|
| Type 2 diabetes, or its labeled heart and kidney uses | A Part D drug; most plans cover it | Your plan's formulary, tier and any prior authorization |
| Weight loss alone | Excluded from Part D | The statute's weight-loss exclusion |
| Weight management, meeting CMS criteria | Not Ozempic: the GLP-1 Bridge covers other products at $50 a month | The Bridge's product list and criteria |
Type 2 diabetes: a covered Part D drug
Part D covers drugs for a medically accepted indication[3]. For Ozempic, that means the uses on its label[1]. What you pay depends on where your plan puts it on its formulary, and on any prior authorization or step therapy it requires[2].
Medicare sets outer limits on that cost. A plan’s deductible cannot exceed $615 in 2026[4]. After it, you pay 25% coinsurance until your out-of-pocket spending on covered drugs reaches $2,100[4].
| Limit | 2026 | 2027 |
|---|---|---|
| Most a plan may charge as a deductible | $615 | $700 |
| Your share after the deductible | 25% coinsurance | Set by the plan within Medicare's rules |
| Yearly out-of-pocket cap on covered Part D drugs | $2,100 | $2,400 |
Novo Nordisk points Part D enrollees to the Medicare Prescription Payment Plan, which spreads those costs across the year[2]. It does not lower the total; it changes when you pay it.
Weight loss alone: excluded
The Part D statute excludes drugs, or their uses, that Medicaid may exclude[3]. That list includes agents used for weight loss[5]. So an Ozempic prescription written only for weight, without type 2 diabetes, is outside the Part D benefit.
Ozempic is not labeled for weight loss[1]. The semaglutide product labeled for weight is Wegovy, and Medicare treats it differently. Does Medicare cover Wegovy covers its heart-risk route and the Bridge.
The GLP-1 Bridge does not include Ozempic
Since July 2026, CMS’s Medicare GLP-1 Bridge has charged $50 a month for certain GLP-1 drugs used for weight management[6]. It covers Foundayo, Wegovy and the Zepbound KwikPen[6]. Ozempic is not on that list.
The Bridge also excludes anyone with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease[6]. CMS tells those enrollees to contact their own drug plan, which may already cover a GLP-1 drug for them[6]. If you already get a GLP-1 through your plan, you must keep getting it there[6].
Negotiated prices from 2027
Ozempic, Rybelsus and Wegovy were negotiated together as one selected drug in Medicare’s drug price negotiation program[7]. The negotiated price takes effect on January 2027[7]. The maker must make that price available to eligible people with Medicare and to the pharmacies that fill their prescriptions[7]. By law, Part D plans must also include a drug with a negotiated price on their formularies[7]. Your own share still runs through your plan’s deductible and coinsurance, up to the yearly cap.
Coupons, free-drug programs and cash
The Ozempic copay card is closed to Part D enrollees, and so is the patient assistance program for Ozempic[2]. The Novo Nordisk patient assistance program guide explains who can still use it.
Part D enrollees can use Novo Nordisk’s self-pay offer[2]. New self-pay patients pay $199 a month for the first 2 fills at the lowest doses, then $349 a month through 1 mg and $499 at 2 mg[2]. That purchase sits outside your plan: it cannot be reimbursed and does not count toward your deductible or out-of-pocket limit[2].
Compounded semaglutide is outside Medicare too: it is not FDA approved and is sold for cash. Its prices are on the semaglutide price board, and the all-in monthly calculator adds each seller’s fees. The compounding guide explains what those products are. For the brand’s cash price in full, see Ozempic cost.