You may be able to find Medicare plan options in your area that cover Ozempic (semaglutide). Learn more about Ozempic and find Medicare Advantage plans in your area that may cover prescription drugs.
Chemical name: Semaglutide
Ozempic typically comes in a prefilled pen and is used to help people with type 2 diabetes better control their blood sugar. As of 2023, there isn't a generic alternative for Ozempic.1
Ozempic is a drug used to lower blood sugar and A1C in people with type 2 diabetes. Ozempic is one of several types of drugs that can help lower the risk of major cardiovascular events such as strokes, heart attacks and death.1
Medicare beneficiaries with type 2 diabetes may want to find out if Ozempic is covered by Medicare. In this review, we outline Medicare drug coverage options and how Ozempic may be covered by a Medicare drug plan.
Medicare drug plan availability and coverage may vary, so it’s important to speak with a licensed insurance agent or compare plans online to find out which Medicare plans near you may cover Ozempic.
How much does Ozempic cost with Medicare?
Ozempic coverage and costs may vary based on the specific plan you have, as well as what coverage stage you're in.
Contact your plan carrier or consult your plan formulary for more cost information.
Does Medicare cover Ozempic?
According to GoodRx, 94% of Medicare Advantage plans and Medicare Part D plans covered Ozempic in 2023.1
Medicare Advantage plans or Part D plans that cover Ozempic include copay amounts that can range widely from one plan to another. Plan members may also be responsible for meeting a deductible before the plan’s drug coverage kicks in.
Medicare Advantage plans that offer prescription drug coverage are called Medicare Advantage Prescription Drug Plans (MA-PD). 89% of 2023 Medicare Advantage plans included prescription drug coverage.2
Medicare prescription drugs plans each have their own formulary, or drug list, that details what prescription drugs are covered by the plan and how they are covered.
Drug coverage may vary based on plan availability. You may be able to find Medicare Advantage plan options in your area that cover Ozempic. We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.
This article is for informational purposes only. It is not healthcare advice, treatment, or diagnosis. It is not an endorsement of or recommendation for this medication. Speak to your doctor or healthcare provider about your specific healthcare needs, including your prescription medications. Only take medication as directed by your doctor.
Coverage and costs of prescription medications will vary by Medicare plan. Not all plans are available in all areas.
Written by Hayden Gharibyar, Pharm.D.
1 GoodRx. Ozempic. Retrieved October 2023, from www.goodrx.com/Ozempic/medicare-coverage.
A formulary for Medicare is the list of drugs a given Medicare Part D prescription drug plan or Medicare Advantage Prescription Drug (MA-PD) plan will cover. A Medicare plan formulary details information such as how drugs are covered, their relative costs, limitations and/or restrictions. Read more