Key Points
Medicare beneficiaries are reaping the benefits of negotiated rates on 10 popular prescription drugs this year, but there are some notable absences on that list, specifically GLP-1 medications. Though these drugs have become extremely popular for weight loss, Medicare doesn’t currently cover them for this purpose.
Fortunately, we’re only a few months away from a shift that will make these medications a lot more accessible to you if you’re on Medicare. Here’s what you need to know.
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Medicare doesn’t currently cover GLP-1s for weight loss
Medicare currently covers drugs like Ozempic and Wegovy for specific purposes, like managing Type 2 diabetes. If you have a condition like this, you may be able to get one of these medications under your Medicare Part D plan right away.
But if you just want a GLP-1 to help you lose weight, you’re out of luck for the moment. Medicare doesn’t cover these drugs for weight loss purposes, so you’ll either need to cover them out of pocket — which can cost almost $1,000 per month — or use another health insurance plan if you have one available.
Fortunately, all that will change in a few months. Medicare is changing its rules for GLP-1 coverage, and this could give some beneficiaries access to the drugs for weight loss as soon as July 2026.
Medicare will start covering GLP-1s for weight loss later this year
Medicare is launching the Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) model in January 2027. Under this model, you’ll be able to get coverage for GLP-1s on some Medicare Part D plans next year. However, it’ll be up to each private health insurer offering the Part D plans to decide whether to include this coverage.
Beginning in July 2026, Medicare will begin offering a GLP-1 bridge to give beneficiaries earlier access to these medications. To be eligible, you must have a Medicare Part D plan or a Medicare Advantage plan that includes prescription drug coverage. You’ll also need your healthcare provider to submit a prior authorization form to Medicare.
If you have any questions, consider reaching out to the Center for Medicare & Medicaid Services or your Part D plan administrator for clarification. You’ll also want to pay careful attention to which Part D plan you choose during the next Open Enrollment Period. If you opt for a plan without GLP-1 coverage, your retirement healthcare costs could skyrocket in 2027.
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