By the Kryder Cares data team · Reviewed by Kris Kryder, licensed agent · Last updated
Yes, for type 2 diabetes. Starting January 1, 2027, Medicare's negotiated price for Ozempic and the other semaglutide drugs is $274 for a 30-day supply, down from a $959 list price, under the Medicare Drug Price Negotiation Program. You pay your plan's copay or coinsurance, and what you pay out of pocket for covered Part D drugs is capped at $2,400 for 2027.
This applies to Ozempic (semaglutide) prescribed for type 2 diabetes through a Part D plan or a Medicare Advantage plan with drug coverage. Part D generally cannot cover a drug used only for weight loss, so plans may ask your doctor to confirm the diagnosis. Ozempic is not part of Medicare’s separate $50 GLP-1 weight-loss program (see the FAQ).
How it works: coverage and tiers for 2027
No renewing Medicare drug plan nationwide dropped Ozempic from its drug list (formulary) for 2027, and 41 added it, per our count from the CMS formulary files. About 9 in 10 put it on tier 3. A tier is the price level a plan puts a drug on; tier 3, "preferred brand", usually means a set copay or a percentage of the price (coinsurance).
| Measure | Figure |
|---|---|
| People with Part D who used Ozempic, 2025 | 2,044,798 |
| Average Part D spending per prescription, 2025 | $1,302.82 |
| Average Part D spending per prescription, January to March 2026 (quarterly release) | $1,387.09 |
| 2027 plans nationwide with Ozempic on tier 3 (preferred brand) | 4,289 of 4,748 (90%) |
| 2027 plans with Ozempic on tier 2 or tier 1 | 459 of 4,748 (10%) |
| Renewing plans that dropped Ozempic for 2027 | 0 (41 plans added it) |
Source: CMS Medicare Part D Spending by Drug (2025 and 2026 Q1); CMS Part D formulary files, CY2026 and CY2027, followed through the 2027 plan crosswalk. Pulled October 30, 2026. Negotiated price: CMS fact sheet, negotiated prices for 2027.
What it costs you in 2027
$274 is CMS's 30-day figure for the semaglutide drugs as a group (Ozempic, Rybelsus and Wegovy); the exact price varies by product and dose. It is what plans pay, not what you pay. Your share depends on the tier and your deductible (up to $700 in 2027). Once what you pay out of pocket for covered drugs reaches $2,400, you pay $0 for covered Part D drugs for the rest of the year.
If Ozempic is one of several brand drugs you take, you may reach the cap. The Medicare Prescription Payment Plan lets you spread your drug costs into monthly payments through your plan. Prior authorization (your doctor confirming to the plan why you need the drug) is common for Ozempic.
What to do next
Send Kris your full drug list with doses and your pharmacy. She checks the Ozempic tier, any prior authorization rule and your total yearly cost in each 2027 plan she represents, and enrolls you by December 7, 2026. You can also use the Rx drug lookup form.
Sources
- CMS fact sheet: Medicare Drug Price Negotiation Program, negotiated prices for 2027
- Medicare Rights Center: GLP-1 weight-loss drug demonstration (Medicare GLP-1 Bridge)
- CMS Innovation Center: BALANCE model
- CMS Medicare Part D Spending by Drug
- CMS Prescription Drug Plan formulary, pharmacy network and pricing files
- CMS CY2027 Rate Announcement (Part D deductible and out-of-pocket cap)
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This answer is general education, not a recommendation for any specific plan. Figures were current as of October 30, 2026.