Does Medicare Pay for Weight Loss Drugs?
Explore how Medicare covers weight loss drugs, like Wegovy, Ozempic, Zepbound, and Mounjaro
More than 42% of adults over 60 are considered obese due to having a body mass index (BMI) of 30 or higher. Being obese increases your risk of heart attacks, strokes, diabetes, and joint problems. While lifestyle changes are important, weight loss medications have become more common in recent years as a way to help some people manage their weight more effectively.
These treatments can be expensive. So, many people wonder if Medicare will pay for weight loss drugs.
Original Medicare (Part A & Part B) generally doesn’t cover prescriptions. Medicare Part D provides prescription coverage and can be obtained through either a standalone Part D plan or as part of a Medicare Advantage plan. Medicare Part D coverage may cover the costs of GLP-1 (weight loss) drugs, but there are different criteria for different prescriptions. Let’s dig into the details.
What are weight loss drugs, and how do they work?
Sometimes known as anti-obesity drugs, weight loss medications can help you manage your weight in different ways. Some reduce your appetite. Others limit how much fat your body absorbs or adjust hormones that control hunger. Combined with healthy eating and exercise, these medications can help you lose weight, even after 60, when losing weight is more challenging. They can also lower your risk of heart disease, diabetes, and other weight-related health conditions.
What are some popular weight loss drugs?
While these drugs are relatively new, there are several FDA-approved weight loss drugs on the market. Each weight loss medication works in a slightly different way, and some popular options include:
Semaglutides (e.g., Wegovy, Ozempic): These drugs mimic a hormone called GLP-1, which helps regulate blood sugar and appetite. It is also used to control type 2 diabetes.
Liraglutide (e.g., Saxenda): Also a GLP-1 receptor agonist, liraglutide drugs cause a cell reaction to lower blood sugar levels and promote weight loss. It is used for diabetes, too.
Phentermine-topiramate (e.g., Qsymia): Combines an appetite suppressant (phentermine) with a drug used to treat seizures and migraines (topiramate). It is often used for people who are overweight and also have diabetes, high blood pressure, high cholesterol, or heart disease.
Naltrexone-bupropion (e.g., Contrave): Combines naltrexone, an opioid antagonist used to fight substance abuse, with bupropion, an antidepressant. Together, they influence the brain's appetite regulation centers and reduce food cravings.
Orlistat (e.g., Alli, Xenical): Reduces fat absorption in the intestines so that it is not absorbed as calories but rather passes as waste. Alli, an over-the-counter version of Orlistat, has been an effective weight loss aid for dieters, but Xenical contains more Orlinstat for greater effectiveness.
Setmelanotide (e.g., Imcivree): Reduces your appetite, makes you feel fuller, and may help you burn calories while your body is at rest. However, the FDA has approved setmelanotide only for people who have obesity due to one of these rare inherited conditions: Pro-opiomelanocortin deficiency, proprotein subtilisin-kexin type 1 deficiency, or leptin receptor deficiency.
Why is there no coverage for weight loss drugs in Original Medicare?
Original Medicare doesn’t actually cover most medications. Medicare Part D was introduced later to address older adults’ prescription needs.
Medicare Part D and weight loss drugs
While common weight loss drugs, like Ozempic, Wegovy, and Mounjaro are often covered by Medicare Part D, they are usually only covered if prescribed to treat health conditions. Weight loss drugs are most commonly prescribed to treat diabetes, but may also be prescribed to reduce the risk of heart attack and stroke or help patients with sleep apnea. These drugs are generally not covered if prescribed simply for weight loss. Medicare Part D will cover Ozempic when it’s used to manage diabetes.
Learn more about how Medicare covers common weight loss drugs:
Possible updates to Medicare weight loss drug coverage
Ozempic, Wegovy, and other weight loss drugs only recently became popular. During the Biden administration, it was proposed that Medicare prescription drug benefits cover weight loss drugs for obesity treatment.
The Treat and Reduce Obesity Act of 2023 was introduced in Congress to allow Medicare prescription drug plans to cover drugs that aid weight management and anti-obesity for those who are overweight. With the change in government in 2025 and the Trump administration now in power, it is unknown if the Treat and Reduce Obesity Act will be moved forward and written into health policy.
How much do weight loss drugs cost?
Currently, brand-name prescription drugs are still under patent. As a result, there are no generic versions approved by the FDA.
Here are a few sample prices for some of the most commonly used weight loss drugs:
Wegovy (semaglutide): The list price is around $1,350 for a 28-day injectable supply. This results in a total of over $16,000 per year without insurance or discounts.
Ozempic (semaglutide): While primarily used for diabetes, it's sometimes prescribed for weight loss. The list price is similar to Wegovy—around $900-$1,000 per month.
Saxenda (liraglutide): Another injectable medication, can cost around $1,300 per month.
Imcivree (setmelanotide): It will only be prescribed for those with genetic conditions and costs over $34,000 without insurance.
Does medical insurance cover weight loss medication?
Some private insurance plans cover weight loss medications, but coverage varies. It's essential to check with your specific insurance provider to see what is covered by your specific plan.
Are there other ways to cut the cost of weight loss drugs?
Some manufacturers offer programs to reduce out-of-pocket costs for eligible patients. Prices can also vary between pharmacies, so shopping around to find a pharmacy with lower costs can save you money.
Want to discuss Medicare’s coverage of weight loss drugs?
Speak with one of our independent Medicare Advisors, who are eager to help you understand your coverage and how to get the most out of Medicare. Get in touch by calling us at (855) 900-2427 or picking a time to chat.