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Federal program for 65+ and qualifying disabled adults
Medicare is the federal health insurance program for adults 65+ and eligible disabled individuals. Part D (prescription drug benefit) statutorily excludes weight-loss medications, but the 2024 OSA + obesity dual indication for Zepbound created the first Medicare-covered weight-loss GLP-1 pathway.
Medicare Part D covers GLP-1s only for type 2 diabetes (Ozempic, Mounjaro) and OSA with obesity (Zepbound, 2024 indication). Wegovy is not covered for weight loss alone. The Inflation Reduction Act capped Part D out-of-pocket at $2,000/year (2025), making covered GLP-1s more affordable for seniors.
Sample copays based on a representative Medicare plan. Your specific plan may differ.
| Product | Status | Sample copay |
|---|---|---|
| Hims & Hers Weight Loss Compounded drugs not covered by Medicare Part D | Not covered | — |
| Mounjaro T2D diagnosis | Covered | $45/mo |
| Ozempic T2D diagnosis | Covered | $45/mo |
| Zepbound OSA + obesity dual indication only. Documented sleep study required. | PA required | $45/mo |
| Wegovy Excluded by Part D statute (weight-loss drugs). Coverage change pending CMS rule. | Excluded | — |
Look up your specific plan ID for plan-level accuracy. Open formulary tool
Coverage shown is a sample plan and not a guarantee for your specific Medicare plan. Always verify with member services or your benefits administrator. We update this page when formulary changes are detected — last verified May 16, 2026.
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