About 9 percent of adults 65 and older are now using GLP-1s, a lower rate than the 22 percent of adults age 50 to 64, according to a KFF poll released Nov. 14. The lower usage is likely because Medicare doesn’t cover prescriptions specifically for weight loss, the nonpartisan health policy nonprofit says.
Administration officials expect that percentage to rise to 10 percent, about 7 million people, with the GLP-1 discounts.
What if I don’t have Medicare Part D yet?
If you’re still working or have prescription coverage outside of Medicare or other government programs, you have the option to buy through TrumpRx. The site’s lowest prices for GLP-1s in early February included $149 a month for the Wegovy pill, $199 for the Wegovy and Ozempic pens, and $299 a month for Zepbound; higher doses cost more.
The site lists 43 brand-name drugs and says more will be added. Consumers can get the prices at local pharmacies using the TrumpRx coupons, but other prescriptions are available only through the manufacturer’s website.
If the FDA approves a different GLP-1 called orforglipron that’s now being studied to treat type 2 diabetes and obesity, it will be about $350 a month.
How they work. GLP-1s are a class of medications created to treat type 2 diabetes by helping the pancreas release the right amount of insulin when blood sugar levels are high. The FDA approved the first GLP-1 drug in 2005.
These medications also can help with weight loss because they make you feel fuller faster. On average, the trendy GLP-1 medications have helped people lose 12 percent of their total weight.
Nearly 40 percent of Americans age 60 and older are considered obese — defined as having a body mass index (BMI) of 30 or higher based on height and weight — according to the Centers for Disease Control and Prevention (CDC). Obesity increases the risk of heart disease, stroke, type 2 diabetes and other conditions.
Extra health benefits. Doctors have been prescribing GLP-1s for weight loss because studies have found that losing 5 percent to 10 percent of your weight can have positive effects on your health. In drug trials sponsored by manufacturer Novo Nordisk, the Wegovy pill resulted in an average weight loss of more than 16 percent for those who took it as directed.
In addition to helping with weight loss, GLP-1s, or glucagon-like peptide-1 receptor agonists, have been found to improve heart and liver health and treat sleep apnea in overweight adults. They’ve also been shown to reduce complications from kidney disease and even protect the brain.
Isn’t Medicare banned from covering weight-loss drugs?
Yes, the Medicare Prescription Drug, Improvement and Modernization Act of 2003 prohibits Part D plans from covering anti-obesity medications as part of the standard prescription drug benefit. The restriction followed a late 1990s scandal involving the diet pill known as fen-phen, an appetite suppressant that combined fenfluramine and phentermine and later was linked to heart disease.
Drugs prescribed for weight gain, cosmetic purposes, fertility, hair growth and treatment of sexual or erectile dysfunction also aren’t allowed to be covered. Medicare now covers GLP-1s for diabetes and other approved ailments, such as obesity in conjunction with heart disease.
“There was skepticism of weight loss medications that existed at the time, and a sense that obesity was more of a behavioral problem than a medical condition,” says Juliette Cubanski, deputy director of the program on Medicare policy for KFF.
What uses of GLP-1 medications have been covered?
In January 2025, CMS selected Ozempic, Rybelsus and Wegovy, all GLP-1s manufactured by Novo Nordisk, for its second round of Medicare drug price negotiations. The Medicare-negotiated prices, effective in 2027, will be $274 for a 30-day supply.
But Medicare has been covering five medications for several years, just not for weight loss.
1. Mounjaro (tirzepatide) is an FDA-approved diabetes drug that isn’t approved for weight loss. More than 90 percent of commercial and Part D plans cover Mounjaro for people with type 2 diabetes, according to an Eli Lilly spokesperson. It contains the same active ingredient in the same doses as Zepbound.
2. Ozempic (semaglutide) was approved in 2017 by the FDA for treating diabetes, and approval was expanded to cardiovascular disease and kidney disease but not weight loss, even though some people use it off-label for that purpose.
3. Rybelsus (semaglutide) was the first-ever GLP-1 pill to be given the FDA’s OK. The once-a-day tablet is prescribed for type 2 diabetes to help control blood sugar levels along with diet and exercise and reduce the risk of heart attack or stroke, but in medical trials Rybelsus’ lower doses have resulted in fewer pounds lost compared to the other, higher-dose GLP-1s that are injected once a week.
4. Wegovy (semaglutide) received approval from the FDA for adults with cardiovascular disease who are also overweight in March 2024, which opened the door for Medicare Part D plans to cover it. In mid-August 2025, the FDA also OK’d Wegovy to treat a serious liver disease called metabolic-associated steatohepatitis (MASH) that develops when fat buildup in the liver causes inflammation and scarring.
5. Zepbound (tirzepatide) is FDA-approved for weight loss, so Medicare had not been covering it. However, the FDA approved it in late 2024 to treat moderate to severe sleep apnea in adults with obesity, so that opens the door for its use in weight loss.
When deciding what medication to prescribe, Shauna Levy, M.D., medical director of the Tulane Bariatric and Weight Loss Center in New Orleans, says insurance is her number one limiting factor.
“With obesity, every insurance and every employer follow their own plan,” she says. “We actually have to employ a person in our clinic whose job it is to call the insurance company for every single patient we see to figure out what are the criteria for medical weight loss, surgical weight loss and what medications are approved.”
Medicare beneficiaries who will be eligible for lower-cost GLP-1 medications include those with a body mass index (BMI) of:
Outside of Medicare, typical requirements include a BMI of 30 or higher or 27 or higher when combined with another health condition. Employers may stipulate that employees participate in a lifestyle modification program.
“You can get your doctor to write you a prescription for off-label use as a weight loss drug. But that definitely does not mean it will be covered by your plan as a weight loss medication, even if it’s covered for diabetes” or sleep apnea, Cubanski says.
Can I get Ozempic, Wegovy, Zepbound covered now?
If your doctor prescribes Ozempic for type 2 diabetes or kidney disease rather than weight loss, Medicare Part D can cover it. Rybelsus also can be prescribed for diabetes and Wegovy for cardiovascular disease and MASH.
Together, Medicare spent $15.2 billion on these drugs in 2024, making them the top medications the agency spends the most on. But plans often decide on prior authorization requirements showing that people meet the risks for particular diseases
Some plans require you to try other less expensive medications first. Similar rules apply to Mounjaro and Zepbound.
Even though the Medicare Plan Finder may identify the brand-name drugs as covered, that doesn’t mean you’ll qualify. You’ll need to share documentation of your diagnosis with your Part D plan.
“Ozempic is a medication for diabetes,” Levy said before its approval for kidney disease. “People call their insurance and ask if Ozempic is covered, and they say it is, but if you don’t have diabetes, it’s not covered.”
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