Medicare's answer on a GLP-1 drug depends on two things: the brand, and the reason it is prescribed. Part D plans can pay for these medicines when they are prescribed for type 2 diabetes, heart risk, kidney disease, sleep apnoea or fatty liver disease. They cannot pay when the use is weight loss — a rule written into federal law in 1990. Since 1 July 2026 a separate, temporary programme, the Medicare GLP-1 Bridge, has filled part of that gap at $50 a month, for three products only.
This page is the brand-by-brand record. The law, the labels and Medicare's own pages were read on 15 October 2026. Why the law is written this way is explained on GLP-1 insurance coverage; the Bridge's eligibility rules and traps are on the Medicare GLP-1 Bridge. This page does not repeat either.
Every brand, by use
| Brand | Labelled use (current US label) | Through a Part D plan? | Through the $50 Bridge? |
|---|---|---|---|
| Ozempic (injection) | Type 2 diabetes: blood sugar; cardiovascular risk with heart disease; kidney risk with chronic kidney disease | Yes, plan formulary permitting | No |
| Ozempic tablets · Rybelsus | Type 2 diabetes: blood sugar; cardiovascular risk | Yes, plan formulary permitting | No |
| Mounjaro | Type 2 diabetes (adults and children 10+) | Yes, plan formulary permitting | No |
| Trulicity · Victoza | Type 2 diabetes; cardiovascular risk | Yes, plan formulary permitting | No |
| Wegovy (injection) | Weight management | No — excluded use | Yes |
| Cardiovascular risk reduction (established heart disease plus obesity or overweight) | Not an excluded use; plan formulary decides | — | |
| MASH (fatty liver disease with fibrosis) | Not an excluded use; plan formulary decides | Not eligible with this diagnosis | |
| Wegovy tablets | Weight management (as listed for the Bridge on Medicare.gov) | No — excluded use | Yes |
| Zepbound | Weight management | No — excluded use | KwikPen only |
| Moderate-to-severe obstructive sleep apnoea with obesity | Not an excluded use; plan formulary decides | Not eligible with this diagnosis | |
| Foundayo | Weight management | No — excluded use | Yes |
| Saxenda | Weight management (adults and 12+) | No — excluded use | No |
Sources: labelled uses from each manufacturer's current label (Ozempic July 2026, Rybelsus/Ozempic tablets January 2026, Mounjaro August 2026, Trulicity June 2026, Victoza October 2025, Wegovy June 2026, Zepbound August 2026, Foundayo July 2026, Saxenda February 2026); Part D rule from 42 U.S.C. 1395w-102(e)(2)(A); Bridge list and eligibility from Medicare.gov. "Plan formulary permitting" means the law allows coverage; each plan's drug list, tier and prior-authorisation rules decide whether and how it pays.
Reading the table: three rules do all the work
Rule 1 — the exclusion is about the use, not the drug. The Part D statute says a covered drug "does not include drugs or classes of drugs, or their medical uses" that Medicaid law lets programmes exclude, and the first item on that list is agents "when used for anorexia, weight loss, or weight gain". So semaglutide prescribed as Ozempic for diabetes is coverable, and semaglutide prescribed as Wegovy for weight is not — same molecule, different use.
Rule 2 — a second labelled use opens the Part D door. Wegovy's heart-risk and liver indications and Zepbound's sleep apnoea indication are not weight-loss uses. Medicare.gov says so in plain terms for three of them: someone with "type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease" is told their "Part D plan might cover your GLP-1s." Might is the operative word — the statute permits coverage; it does not require any plan to list the drug.
Rule 3 — the Bridge covers what Part D cannot, and only that. Medicare.gov lists the Bridge drugs as Foundayo tablets, Wegovy injection or tablet, and Zepbound "KwikPen only", and states the programme "doesn't cover single-dose Zepbound vials or pens". The same page makes anyone with diabetes, sleep apnoea or fatty liver disease ineligible, because those uses belong to the plan. The result is two separate routes that do not overlap: the plan for the medical indications, the Bridge for weight.
The answers to the questions people actually search
"Will Medicare cover Zepbound in 2026?" For weight: yes since 1 July 2026, through the Bridge, at $50 a month — if the prescription is for the KwikPen, the person meets the BMI criteria at the start of therapy, and they have no sleep apnoea, diabetes or fatty liver diagnosis. For sleep apnoea: possibly, through their Part D plan, on that plan's terms. The vials sold through LillyDirect are outside the Bridge entirely (see Zepbound vials and the KwikPen).
"Does Medicare pay for Wegovy?" For weight: through the Bridge, injection or tablet. For cardiovascular risk reduction in someone with established heart disease: the use is not excluded, so a plan may cover it. The heart indication is not available to someone without established cardiovascular disease.
"Does Medicare cover Ozempic?" For type 2 diabetes and its labelled heart and kidney uses, the law allows Part D plans to cover it, on each plan's formulary terms. For weight loss, no — and it is not on the Bridge.
What sits outside both routes
- Manufacturer savings cards. The Ozempic, Wegovy, Mounjaro and Zepbound cards exclude Medicare enrollees (the terms are quoted on the Ozempic card page, Wegovy, Mounjaro and Zepbound), as each card's own terms state.
- Discount cards and cash prices. Medicare.gov points beneficiaries to TrumpRx.gov to compare cash prices, and states in the same passage that discount cards "aren't considered creditable coverage" — spending through them "doesn't count toward your Medicare deductible or out-of-pocket maximum."
- Saxenda, and every compounded product. Saxenda is weight-only and not on the Bridge list; compounded versions are not FDA-approved products and are not on any Medicare list.
Dates that change the answer
| Date | What changes | Source |
|---|---|---|
| 1 July 2026 | Bridge begins: $50 a month for listed drugs, weight use | Medicare.gov; CMS |
| 31 December 2027 | Bridge prior authorisations and the programme end | Medicare.gov; CMS |
| After 2027 | Not published. CMS's own FAQ says the Bridge was extended because the BALANCE model is not launching in 2027 | CMS (see the Bridge page) |
An announced change is not a current one. Each line above was read as written on 15 October 2026; the coverage of any individual depends on their plan's current formulary.
What this page cannot tell you
- Any one plan's formulary. Whether a specific Part D or Medicare Advantage plan lists a drug, at what tier, and with what prior authorisation, is on that plan's drug list.
- Medicaid. State Medicaid programmes set their own rules under the same statute; dual-eligible beneficiaries meet both systems.
- Costs at the counter. Part D cost-sharing varies by plan, phase of the benefit and low-income subsidy status; the Bridge's flat $50 is not always the lower figure, for reasons set out on the Bridge page.
Which route fits a particular person is a question for the plan, the prescriber and the pharmacist; 1-800-MEDICARE handles Bridge eligibility questions. Prior authorisation in general is covered on GLP-1 prior authorization, and sleep apnoea specifically on GLP-1 and sleep apnea.
Sources
- 42 U.S.C. §1395w-102(e)(2)(A) (Part D exclusions, incorporating §1396r-8(d)(2)), Cornell Legal Information Institute, law.cornell.edu/uscode/text/42/1395w-102, read 2026-10-15.
- Medicare.gov, Weight loss drugs: Bridge drug list, eligibility, exclusions for type 2 diabetes, sleep apnoea and fatty liver disease, prior-authorisation validity, TrumpRx and creditable-coverage passage, read 2026-10-15.
- CMS, Medicare GLP-1 Bridge: programme dates (1 July 2026 to 31 December 2027), the $50 copay outside the Part D benefit, and the BALANCE answer, read 2026-10-15.
- Current US prescribing information, section 1, via openFDA, read 2026-10-15: Ozempic injection (2026-07-30 listing), Rybelsus and Ozempic tablets (2026-01-30), Mounjaro (2026-08-27), Trulicity (2026-06-16), Victoza (2025-10-14), Wegovy injection (2026-06-18), Zepbound (2026-08-28), Foundayo (2026-07-29), Saxenda (2026-02-25).