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PlainMedicare

Is Wegovy (semaglutide) covered by Medicare Part D?

44 of 5,052 Medicare Part D plan offerings (0.9%) list Wegovy on their 2026 formulary, most often on tier 5; 100% of the formularies that cover it require prior authorization. Part D spending on it was $301 million in 2024 for 52,961 people: what plans and patients paid at the pharmacy, before manufacturer rebates (CMS Part D Spending by Drug).

Plans that cover it
0.9%
44 of 5,052 offerings; the median drug: 76%
Usual tier
Tier 5
from tier 1 to tier 5
Prior authorization
100%
of formularies that cover it; the median drug: 1%
Quantity limits
100%
of formularies that cover it; the median drug: 30%

Source: CMS Part D formulary file, 2026 second quarter: the formularies in use in 2026. A plan's 2027 formulary can differ; check your own plan's coverage in Medicare Plan Finder.

What does it cost under Part D in 2027?

A negotiated price
Medicare negotiated a lower price for Wegovy, in effect from January 1, 2027: $274 for a 30-day supply, against a list price of $959 (2024); CMS gives one figure for Ozempic, Rybelsus and Wegovy together. Where your share is a percentage of the drug's price, it is a percentage of the lower price; a flat copay stays as your plan sets it.
Your yearly cap in 2027
Out-of-pocket spending on covered Part D drugs stops at $2,400 in 2027 ($2,100 in 2026); after that, you pay nothing for covered drugs for the rest of the year.
The deductible
A plan's drug deductible is at most $700 in 2027 ($615 in 2026); many plans charge less or none.

Source: CMS, Announcement of calendar year 2027 Part D parameters; Medicare.gov, “How much does Medicare drug coverage cost?”; CMS, “Selected drugs and negotiated prices” (read Oct. 7, 2026).

How much does Medicare spend on it?

Part D spending by year

2023$200 thousand
2024 (latest)$301 million

52,961 people filled it under Part D in 2024, in 211,575 claims. The amounts are what plans and patients paid at the pharmacy, before manufacturer rebates.

Source: CMS Medicare Part D Spending by Drug, 2020 to 2024 (published June 2026). Row used: Wegovy (Semaglutide).

Which forms and strengths are counted?

  • 0.5 ml semaglutide 0.5 mg/ml auto-injector
  • 0.5 ml semaglutide 1 mg/ml auto-injector
  • 0.5 ml semaglutide 2 mg/ml auto-injector
  • 0.75 ml semaglutide 2.27 mg/ml auto-injector
  • 0.75 ml semaglutide 3.2 mg/ml auto-injector
  • semaglutide 1.5 mg oral tablet
  • semaglutide 25 mg oral tablet
  • semaglutide 4 mg oral tablet
  • semaglutide 9 mg oral tablet

Which other versions are listed?

The same ingredients under other names, each with its own coverage and spending.

What else should you check?

Data, not medical advice. Coverage is the share of plan formularies listing the drug; your plan's formulary, tier and pharmacy decide what you pay.