Ozempic, a medication used to treat Type 2 diabetes, has gone viral as a weight loss drug.
The #ozempic hashtag has over a billion views on TikTok, and more people are searching the web for Ozempic than for insulin, Viagra or Tylenol, according to Google Trends data for May 2023.
Medicare beneficiaries interested in the drug might be surprised to see that it’s often covered by Medicare Part D. It’s one of the prescription drugs on which Medicare, the federal health care program for people age 65 and older and for younger people with certain disabilities, spends the most money each year.
But Medicare doesn’t cover Ozempic for weight loss — only for diabetes. Nor does Medicare cover Wegovy, a weight loss drug that uses the same active ingredient as Ozempic.
In fact, Medicare doesn’t cover any prescription drugs for weight loss. And because of legal barriers and cost concerns, that might not change any time soon.
Here’s what to know about Medicare coverage of Ozempic and other weight loss drugs.
What is Ozempic?
Ozempic is a brand name for semaglutide, a prescription medication manufactured and sold by Novo Nordisk. As an injection, it can help control blood sugar in people with Type 2 diabetes.
The Food and Drug Administration approved Ozempic to treat Type 2 diabetes in December 2017. Currently, there isn’t a generic version of the drug, and there might not be for some time — Novo Nordisk’s Ozempic patents expire as late as December 2031, according to data from the FDA.
In June 2021, the FDA approved a semaglutide product for another purpose: weight loss. Novo Nordisk sells semaglutide for weight loss under the brand name, Wegovy.
Medicare covers Ozempic for Type 2 diabetes
Medicare prescription drug plans might cover Ozempic, but only to treat diabetes. In 2021, Medicare spent over $2.6 billion to cover Ozempic prescriptions. Because it’s an outpatient prescription drug, Ozempic falls under Medicare Part D. Original Medicare (Part A…
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