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Does Medicare Cover Ozempic?

Does Medicare Cover Ozempic?


Published on 2025-02-14 13:23:11 - Forbes
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  • Over 40% of U.S. adults meet the medical classification for obesity, according to the Centers for Disease Control and Prevention (CDC)[1]. With this statistic in mind, it's no surprise that many people are curious about Ozempic,

The article from Forbes Advisor discusses whether Medicare covers Ozempic, a medication primarily used for managing type 2 diabetes and aiding in weight loss. Medicare Part D, which covers prescription drugs, might cover Ozempic if it's prescribed for diabetes management, but coverage isn't guaranteed as each Part D plan has its own formulary. For weight loss, coverage is less likely because Medicare typically does not cover medications solely for weight loss unless they are used for another covered condition. The article explains that even when Ozempic is covered, patients might face out-of-pocket costs like copayments or coinsurance, and there could be restrictions like prior authorization or step therapy requirements. Additionally, Medicare Advantage plans (Part C) might offer drug coverage similar to Part D, but specifics can vary by plan. The piece also touches on potential future changes in coverage policies and advises checking directly with Medicare or one's specific plan for the most current information.

Read the Full Forbes Article at:
[ https://www.forbes.com/advisor/health-insurance/medicare/does-medicare-cover-ozempic/ ]