Medicare Advantage and GLP-1 coverage

Medicare Advantage plans handle GLP-1 differently than original Medicare + Part D.

Original Medicare + Part D — July 2026 expansion

Wegovy now covered under SELECT-aligned CV pathway (BMI ≥27 + established CVD). T2D drugs (Ozempic, Mounjaro) covered.

Medicare Advantage variations

MA plans can have different formularies and supplemental benefits. Some MA plans cover weight management beyond the original Medicare scope.

How to evaluate plans

• Check formulary for Wegovy, Zepbound, Ozempic, Mounjaro.
• Review PA criteria.
• Calculate expected copay.
• Compare against cash-pay compounded ($1,428–$1,668/yr NexLife).