Original Medicare Part D GLP-1 Coverage

Coverage details, copay estimates, and tips for getting GLP-1 medications approved through Medicare.

Last verified: 2026-04-01

Medication Coverage

Wegovy

Not Covered

Zepbound

Not Covered

Foundayo

Pending

Mounjaro

CoveredPA Required

Ozempic

CoveredPA Required

Estimated Copay

$0-35/mo under Part D; GLP-1 Bridge expansion in July 2026

Key Facts

•Wegovy and Zepbound are not covered under current Part D rules.
•Mounjaro and Ozempic are covered for diabetes management.
•The GLP-1 Bridge program will expand coverage starting July 2026.
•Foundayo is under review and may be added in future updates.

Prior Authorization Tips

1.Check your Part D plan's formulary for GLP-1 coverage via Medicare.gov.
2.The GLP-1 Bridge program will expand coverage starting July 2026.
3.Use the Medicare Part D Savings Program to reduce costs if eligible.

If Your Claim Is Denied

1.Appeal if denied due to lack of coverage — submit a letter from your doctor.
2.Request a redetermination if you believe you meet eligibility criteria.
3.Appeal through the Medicare Appeals process with clinical documentation.

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Medical Disclaimer: This page is for informational purposes only and does not constitute medical or insurance advice. Coverage details change frequently — always confirm with your insurance provider. MedSwitcher may earn a commission from affiliate links at no extra cost to you.

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