Part D excludes drugs used only for weight loss, but plans might cover a GLP-1 for type 2 diabetes, sleep apnea, fatty liver disease or a CV indication, and the CMS Medicare GLP-1 Bridge adds a $50 copay option from July 2026 through 2027.
Type 2 diabetes coverage
Covered. Ozempic, Mounjaro, Trulicity widely covered on Part D formularies for T2D.
Weight management coverage
Part D still excludes drugs used only for weight loss. The CMS Medicare GLP-1 Bridge sits outside the Part D benefit: from July 1, 2026 through December 31, 2027, eligible Part D enrollees pay a $50 copay for Foundayo, Wegovy or the Zepbound KwikPen. There is no deductible, the $50 does not count toward the Part D out-of-pocket limit, Extra Help does not apply, and prior authorization goes through a CMS form. CMS's BALANCE model page (updated September 29, 2026) confirms the extension through 2027. You need Part D or a Medicare Advantage plan with drug coverage, not a specific plan. Open Enrollment runs October 15 to December 7, 2026.
CV indication coverage
People with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease are not eligible for the Bridge; Medicare.gov says their Part D plan might cover a GLP-1 for those conditions. Wegovy has carried an FDA-approved CV indication since March 2024, and Part D plans may cover it for that use under their own formulary and prior-authorization rules.
OSA indication coverage
Zepbound is FDA-approved for moderate-to-severe OSA in adults with obesity (December 2024). Part D plans might cover it for that use, usually with prior authorization. Ask your plan.
Prior authorization (typical)
Each plan sets its own criteria. For Wegovy's CV indication, expect to document established CV disease (prior heart attack, stroke or symptomatic peripheral artery disease) and obesity or overweight. For the Bridge, CMS uses its own prior-authorization form.
How to verify
Call member services on your card and ask: (1) Is [Wegovy/Zepbound/Ozempic/Mounjaro] on my formulary? (2) What tier? (3) PA criteria? (4) Expected copay? Document the date, rep's name, and any reference number.
Cash-pay alternative
If insurance is unworkable, see our price index. NexLife, our editor's pick, charges $95 a month for compounded semaglutide or $115 for compounded tirzepatide on a 12-month plan ($109 and $129 month to month; nexlife.us, read November 6, 2026), the same price at every dose. It is not the lowest price we track: Mondae lists lower standing rates, and Eden Health a lower semaglutide rate. Compounded versions are not FDA-approved.