Medicare prescription drug plans generally cover semaglutide in pill form. These plans include Part D and Medicare Advantage plans with drug benefits.
Semaglutide is a type of drug called a glucagon-like peptide-1 (GLP-1) receptor agonist. Manufacturers sell it in different forms under various brand names, and doctors may prescribe it to treat type 2 diabetes, cardiovascular disease, and obesity.
The oral pill form of semaglutide is called Rybelsus.
Rybelsus has Food and Drug Administration (FDA) approval for treating type 2 diabetes when people combine it with regular exercise and a balanced diet.
Sometimes, doctors may prescribe Rybelsus off-label to assist with weight loss.
Medicare prescription drug plans generally cover Rybelsus when prescribed to help lower blood sugar in people with type 2 diabetes. However, Medicare does not cover Rybelsus for its off-label uses, such as weight loss.
Medicare drug plans only cover drugs for uses approved by the FDA.
Since private insurance companies offer Part D and Medicare Advantage plans, their coverage and costs vary. Given this, oral semaglutide costs depend on the details of a person’s specific plan.
Potential costs include copayments, coinsurance, or deductibles.
In 2025, Part D plans have an annual deductible of no more than $590. There is also a $2,000 cap on annual out-of-pocket spending on covered drugs.
To find a Medicare plan that includes coverage of Rybelsus and learn the estimated cost, use the coverage finder tool on Medicare.gov.
Injectable forms of semaglutide include Ozempic and Wegovy. Wegovy has FDA approval for treating overweight or obesity. However, despite Wegovy having FDA approval for this indication, Medicare does not currently cover Wegovy as a treatment for obesity alone.
Medicare rules prohibit the coverage of drugs used solely for obesity.
Medicare may cover Wegovy to help prevent serious cardiovascular events in people with obesity and cardiovascular disease. This is a newly approved use for the drug as of