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Checked October 16, 2026
Each figure below is copied from a CMS, Medicare.gov, White House, manufacturer, or KFF page, with the date that source stated and the date this site checked the link. Named private-plan copays are omitted when those sources do not publish them.
Information only, not medical advice. Talk to your doctor or pharmacist.
Rows are grouped by the channel that published the number. They are not ranked, and a lower number is not a recommendation.
$50 copay · Jul 1, 2026–Dec 31, 2027
Medicare GLP-1 Bridge
CMS describes the Medicare GLP-1 Bridge as a short-term demonstration for eligible Medicare Part D beneficiaries, running from July 1, 2026 through December 31, 2027. It operates outside the Part D benefit’s coverage and payment flow. Part D sponsors do not carry risk for these drugs and do not have to opt in.
Stated July 1, 2026. CMS: Medicare GLP-1 Bridge. Checked October 16, 2026.
$50 for a one-month supply
Medicare GLP-1 Bridge
Medicare.gov says people pay a $50 copayment to the pharmacy for a one-month supply (28 or 30 days, depending on the drug). Because a separate Medicare program covers the drug, the copayment does not count toward the yearly Part D deductible or out-of-pocket limit, does not appear on the Part D Explanation of Benefits or a Medicare Summary Notice, cannot be lowered by Extra Help, and cannot be spread across months with the Medicare Prescription Payment Plan.
Stated July 1, 2026. Medicare.gov: Weight loss drugs. Checked October 16, 2026.
$245 net price per monthly supply
Medicare GLP-1 Bridge
A CMS memorandum dated June 10, 2026 says participating manufacturers will provide eligible GLP-1 drugs under the Bridge at a net price of $245 per monthly supply. No part of that $245 counts toward gross covered prescription drug costs, and no part of the $50 copay counts toward true out-of-pocket costs. The $50 copay stays the same in every Part D benefit phase. Low-income cost-sharing subsidies do not apply, and these fills are not eligible for the Medicare Prescription Payment Program.
Stated June 10, 2026. CMS: Medicare GLP-1 Bridge: Expectations and Frequently Asked Questions for Part D Sponsors. Checked October 16, 2026.
$149 / $199 / $299 per month by dose
NovoCare Pharmacy self-pay
NovoCare Pharmacy says self-pay patients pay $149 for each month of Wegovy pill 1.5 mg, $199 per month for 4 mg, and $299 per month for 9 mg and 25 mg. One month is one bottle of 30 tablets. Novo Nordisk says eligibility and restrictions apply and that it may modify or cancel the program.
Stated October 16, 2026. Novo Nordisk: NovoCare Pharmacy. Checked October 16, 2026.
$199 intro, then $349 or $399
NovoCare Pharmacy self-pay
NovoCare Pharmacy says patients new to the Wegovy Savings Offer and NovoCare Pharmacy pay $199 for each month of 0.25 mg and 0.5 mg. The offer is for two monthly fills through December 31, 2026, then $349 per month for Wegovy 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg, and $399 per month for Wegovy HD (semaglutide) injection 7.2 mg. One month is one box of four pens. A separate offer says pay as little as $25, with maximum savings of $100 per month, and excludes government beneficiaries.
Stated October 16, 2026. Novo Nordisk: NovoCare Pharmacy. Checked October 16, 2026.
$199 intro, then $349 or $499
NovoCare Pharmacy self-pay
NovoCare Pharmacy says patients new to the Ozempic Savings Offer and NovoCare Pharmacy pay $199 for each month of 0.25 mg and 0.5 mg, for two monthly fills through December 31, 2026, then $349 per month for Ozempic 0.25 mg, 0.5 mg, or 1 mg, and $499 per month for Ozempic 2 mg. One month is one box of one Ozempic pen.
Stated October 16, 2026. Novo Nordisk: NovoCare Pharmacy. Checked October 16, 2026.
$299 to $449 on the Self Pay Journey Program
LillyDirect self-pay, as announced
On December 1, 2025, Eli Lilly announced lower Zepbound single-dose vial prices on LillyDirect. With a valid prescription, the 2.5 mg starting dose is as low as $299 per month (previously $349) and the 5 mg dose is $399 per month (previously $499). Other approved doses are $449 per month on the Zepbound Self Pay Journey Program (previously $499). Lilly lists regular monthly prices outside that program as $599 for 7.5 mg, $699 for 10 mg, $849 for 12.5 mg, and $1,049 for 15 mg. Lilly says the Journey price for 7.5 mg, 10 mg, 12.5 mg, and 15 mg applies on the first fill and when the prescription is refilled within 45 days of the previous delivery, and that the 12.5 mg and 15 mg vials are $849 and $1,049 if refilled outside that window. This row is the December 1, 2025 announcement. LillyDirect did not return a price page on the October 16, 2026 check.
Stated December 1, 2025. Eli Lilly and Company: Lilly lowers the price of Zepbound (tirzepatide) single-dose vials. Checked October 16, 2026.
TrumpRx prices and a $245 Medicare price, as stated that day
White House most-favored-nation fact sheet
The November 6, 2025 White House fact sheet says agreements with Eli Lilly and Novo Nordisk would move Ozempic from $1,000 and Wegovy from $1,350 per month to $350 when purchased through TrumpRx, and Zepbound and orforglipron, if approved, from $1,086 per month to an average of $346. It says that if the FDA later approved a Wegovy pill or similar oral GLP-1s, the initial dose would be $150 per month through TrumpRx. It also says the Medicare prices of Ozempic, Wegovy, Mounjaro, and Zepbound will be $245, and that Medicare beneficiaries will pay a copay of $50 per month.
Stated November 6, 2025. The White House: Fact Sheet: President Donald J. Trump Announces Major Developments in Bringing Most-Favored-Nation Pricing to American Patients. Checked October 16, 2026.
Average and as-low-as monthly prices, as stated that day
White House TrumpRx fact sheet
The February 5, 2026 White House fact sheet says the monthly price of Ozempic will fall from $1,028, and injectable Wegovy from $1,349, to an average of $350 and as low as $199, depending on dosage strength. It says the Wegovy pill will fall from $1,349 to as low as $149, depending on dosage strength, and Zepbound from $1,088 to an average of $346 and as low as $299, depending on dosage strength. The fact sheet says patients with valid prescriptions reach the discounts through coupons or manufacturer channels integrated into TrumpRx.gov.
Stated February 5, 2026. The White House: Fact Sheet: President Donald J. Trump Launches TrumpRx.gov to Bring Lower Drug Prices to American Patients. Checked October 16, 2026.
$274 for a 30-day supply in 2027
Medicare drug price negotiation
The CMS fact sheet on negotiated prices for initial price applicability year 2027 lists one negotiated price of $274 for a 30-day supply of Ozempic, Rybelsus, and Wegovy, against a 2024 list price of $959 for a 30-day supply. Prices take effect beginning January 1, 2027. For three example packages, CMS lists a maximum fair price of $276.78 for one Ozempic 4 mg/3 mL pen (NDC 00169-4130-13), $276.78 for 30 Rybelsus 7 mg tablets (NDC 00169-4307-30), and $385.63 for four Wegovy 2.4 mg/0.75 mL pens (NDC 00169-4524-14). The PDF file was created November 25, 2025. The fact sheet says the negotiation period ended November 1, 2025. This negotiated price is separate from the Bridge $50 copay and the $245 Bridge net price.
Stated November 25, 2025. CMS: Medicare Drug Price Negotiation Program: Negotiated Prices for Initial Price Applicability Year 2027. Checked October 16, 2026.
Medicare, employer plans, and Medicaid are separated because the sources describe different rules. A commercial insurer is listed only when one of those sources names its price or coverage rule. None did, on the check date, for a current Wegovy or Zepbound copay.
$50 copay · Jul 1, 2026–Dec 31, 2027
Medicare GLP-1 Bridge
CMS describes the Medicare GLP-1 Bridge as a short-term demonstration for eligible Medicare Part D beneficiaries, running from July 1, 2026 through December 31, 2027. It operates outside the Part D benefit’s coverage and payment flow. Part D sponsors do not carry risk for these drugs and do not have to opt in.
Stated July 1, 2026. CMS: Medicare GLP-1 Bridge. Checked October 16, 2026.
$50 for a one-month supply
Medicare GLP-1 Bridge
Medicare.gov says people pay a $50 copayment to the pharmacy for a one-month supply (28 or 30 days, depending on the drug). Because a separate Medicare program covers the drug, the copayment does not count toward the yearly Part D deductible or out-of-pocket limit, does not appear on the Part D Explanation of Benefits or a Medicare Summary Notice, cannot be lowered by Extra Help, and cannot be spread across months with the Medicare Prescription Payment Plan.
Stated July 1, 2026. Medicare.gov: Weight loss drugs. Checked October 16, 2026.
$245 net price per monthly supply
Medicare GLP-1 Bridge
A CMS memorandum dated June 10, 2026 says participating manufacturers will provide eligible GLP-1 drugs under the Bridge at a net price of $245 per monthly supply. No part of that $245 counts toward gross covered prescription drug costs, and no part of the $50 copay counts toward true out-of-pocket costs. The $50 copay stays the same in every Part D benefit phase. Low-income cost-sharing subsidies do not apply, and these fills are not eligible for the Medicare Prescription Payment Program.
Stated June 10, 2026. CMS: Medicare GLP-1 Bridge: Expectations and Frequently Asked Questions for Part D Sponsors. Checked October 16, 2026.
Three products; Zepbound vials and single-dose pens excluded
Medicare GLP-1 Bridge
CMS tells pharmacies that eligible products, when used to reduce excess body weight and maintain weight reduction, are Foundayo, Wegovy (injection and tablets), and Zepbound KwikPen. The single-dose vial and single-dose pen formulations of Zepbound are not available through the Bridge. CMS says this list was updated on April 6, 2026 to include Foundayo after FDA approval and to limit Zepbound to the KwikPen. A fill is one monthly supply (28 or 30 days). Sixty- and ninety-day fills are not available. Pen needles for the KwikPen are not covered.
Stated April 6, 2026. CMS: Medicare GLP-1 Bridge: Information for Pharmacies. Checked October 16, 2026.
Part D enrollment plus age and BMI rules
Medicare
Medicare.gov lists Foundayo (tablet), Wegovy (injection or tablet), and Zepbound (KwikPen only) starting July 1, 2026. The person must be 18 or older and, at the start of GLP-1 therapy, have a BMI of 35 or higher; or a BMI of 30 or higher with diastolic heart failure, uncontrolled high blood pressure, or chronic kidney disease at stage 3a or higher; or a BMI of 27 or higher with prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease. Medicare.gov says someone is not eligible if they already get GLP-1 drugs through their Part D plan, or if they have type 2 diabetes, moderate-to-severe sleep apnea, or fatty liver disease (the Part D plan might cover GLP-1s for those). The provider must certify use as part of a lifestyle program that focuses on diet and exercise. Prior authorization is valid, including refills and dose changes, through December 31, 2027, unless the person changes GLP-1s.
Stated July 1, 2026. Medicare.gov: Weight loss drugs. Checked October 16, 2026.
Nationwide, including employer group waiver plans
Medicare Part D plans
Medicare.gov says the temporary program is available nationwide, including U.S. territories, to people in a standalone Medicare drug plan, a Medicare Advantage coordinated care plan with drug coverage (HMO, HMOPOS, and local and regional PPO), a Special Needs Plan, an employer or union group waiver plan, or the Limited Income Newly Eligible Transition program. CMS tells pharmacies that private fee-for-service plans, section 1876 cost plans, section 1833 health care prepayment plans, PACE organizations, fallback plans, and religious fraternal benefit plans are not eligible unless the person is also in a standalone drug plan. In 2026 CMS uses one central processor. CMS names Humana, the LI NET administrator, as that processor. Pharmacies collect the $50 copay. CMS says they are reimbursed at wholesale acquisition cost minus the copay, plus a dispensing fee ($3, or $5 for a beneficiary in long-term care) and sales tax if applicable. Coupons and discount programs may not be applied.
Stated July 1, 2026. CMS: Medicare GLP-1 Bridge: Information for Pharmacies. Checked October 16, 2026.
Weight-loss use is outside ordinary Part D
Medicare Part D
KFF writes that, from the outset, Medicare has been prohibited by law from covering medications when used specifically for weight loss. People on Medicare can get GLP-1s covered by Part D plans only for a medically accepted FDA-approved indication other than obesity, such as type 2 diabetes, cardiovascular disease risk reduction, or sleep apnea.
Stated May 11, 2026. KFF: What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge. Checked October 16, 2026.
Part D coverage stays on the plan
Medicare Part D
The June 10, 2026 CMS memorandum says Part D sponsors must keep covering GLP-1s for indications that are coverable under Part D, consistent with 2026 bids, and must not deny or limit access in a way that pushes people onto the Bridge. CMS gives two examples that stay on the Part D plan: Zepbound for moderate to severe obstructive sleep apnea in adults with obesity, and Wegovy to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease and either obesity or overweight. Sponsors are not required to change existing Part D cost sharing to match the Bridge $50 copay. A person who has a Part D-coverable diagnosis such as type 2 diabetes, moderate to severe obstructive sleep apnea, or noncirrhotic MASH with moderate to advanced fibrosis is not eligible for the Bridge.
Stated June 10, 2026. CMS: Medicare GLP-1 Bridge: Expectations and Frequently Asked Questions for Part D Sponsors. Checked October 16, 2026.
CMS announcement dated April 21, 2026, as reported by KFF
Medicare Part D
KFF’s brief, updated May 11, 2026, says CMS announced on April 21, 2026 — the day after the Part D sponsor application deadline — that it would not move forward with BALANCE in Medicare in 2027 and would extend the Bridge through the end of 2027. KFF says the original Medicare design ran from January 2027 through December 2031 and that implementation in Part D is now uncertain. KFF also describes cost sharing in that original Part D design: $245 for a 30-day supply in the deductible phase, then $50 per month for enhanced plans and employer group plans and $125 per month for basic plans, and $0 after the out-of-pocket maximum ($2,100 in 2026, $2,400 in 2027). Those Part D BALANCE copays are not a benefit CMS says is in effect for 2027.
Stated April 21, 2026. KFF: What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge. Checked October 16, 2026.
Part D BALANCE is not launching in 2027; the Bridge runs through 2027
Medicare and Medicaid
The CMS BALANCE model page says state Medicaid agencies can join from May 2026 through January 1, 2027, and that eligible Part D beneficiaries have access through the separate Medicare GLP-1 Bridge from July 1, 2026 to December 31, 2027. CMS says the Bridge was extended through December 31, 2027 so the agency can collect GLP-1 utilization data to share with Part D sponsors ahead of potential BALANCE in Part D. CMS lists all formulations of Mounjaro, Ozempic, Rybelsus, and Wegovy, the KwikPen formulation of Zepbound, and Foundayo, for currently covered indications and for weight management. Participation is voluntary for manufacturers, state Medicaid agencies, and Part D plans. Coverage is not guaranteed for any individual.
Stated July 1, 2026. CMS: BALANCE Model. Checked October 16, 2026.
13 states as of January 2026, down from 16 in 2025
Medicaid
KFF writes that federal law gives states the option to cover drugs used for weight loss, and that only 13 states provided Medicaid coverage of GLP-1s for obesity as of January 2026, down from 16 states in 2025. KFF says the discounted net price for state Medicaid programs under BALANCE is not public, and that the model will not change out-of-pocket costs for Medicaid enrollees, which federal law limits to nominal amounts. KFF says Medicaid implementation is rolling from May 1, 2026 through January 1, 2027, and that the state request-for-applications deadline is July 31, 2026.
Stated January 1, 2026. KFF: What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge. Checked October 16, 2026.
19% of large firms say the largest plan covers them
Employer plans
KFF’s October 22, 2025 news release on the 2025 Employer Health Benefits Survey says about 19% of large firms (at least 200 workers) offering health benefits cover GLP-1 drugs such as Wegovy for weight loss in 2025. KFF says 57% do not, and about 24% are unsure whether their largest plan covers them. Among firms with at least 5,000 workers, 43% say they cover GLP-1 drugs for weight loss in their largest plan, up from 28% in 2024. The 2026 survey had not been released on the check date; KFF’s survey page says it will be released on October 22, 2026.
Stated October 22, 2025. KFF: Annual Family Premiums for Employer Coverage Rise 6% in 2025, Nearing $27,000. Checked October 16, 2026.
Coverage rises with firm size; many add a program requirement
Employer plans
On the 2025 Employer Health Benefits Survey page, KFF says that among firms offering health benefits, 16% of firms with 200 to 999 workers, 30% with 1,000 to 4,999 workers, and 43% with 5,000 or more workers cover GLP-1 agonists when used primarily for weight loss. Thirty-four percent of firms covering these drugs require enrollees to meet with a dietitian, case manager, or therapist, or to participate in a lifestyle program. Among firms that cover them, 44% with 1,000 to 4,999 workers and 59% with 5,000 or more say use was higher than expected. Forty-three percent and 66% of those same groups say covering the drugs had a significant impact on prescription-drug spending. Among firms with 200 or more workers that do not cover them, 1% say they are very likely to begin coverage within 12 months, 24% somewhat likely, 67% not likely, and 8% do not know. The survey includes 1,862 interviews with non-federal public and private firms.
Stated October 22, 2025. KFF: 2025 Employer Health Benefits Survey. Checked October 16, 2026.
$50 copay · Jul 1, 2026–Dec 31, 2027
Medicare GLP-1 Bridge
CMS describes the Medicare GLP-1 Bridge as a short-term demonstration for eligible Medicare Part D beneficiaries, running from July 1, 2026 through December 31, 2027. It operates outside the Part D benefit’s coverage and payment flow. Part D sponsors do not carry risk for these drugs and do not have to opt in.
Stated July 1, 2026. CMS: Medicare GLP-1 Bridge. Checked October 16, 2026.
Bridge open at $50 per month
Medicare GLP-1 Bridge
On July 1, 2026, CMS announced that eligible people enrolled in Medicare Part D can obtain certain GLP-1 medications to lose weight or maintain weight reduction for $50 per month through December 31, 2027. CMS said people who already receive GLP-1 medications through existing Medicare prescription drug coverage, or who are eligible for GLP-1 coverage through the Part D benefit, will not qualify.
Stated July 1, 2026. CMS: CMS Launches Medicare GLP-1 Bridge, Expanding Access to GLP-1 Medications. Checked October 16, 2026.
Part D BALANCE is not launching in 2027; the Bridge runs through 2027
Medicare and Medicaid
The CMS BALANCE model page says state Medicaid agencies can join from May 2026 through January 1, 2027, and that eligible Part D beneficiaries have access through the separate Medicare GLP-1 Bridge from July 1, 2026 to December 31, 2027. CMS says the Bridge was extended through December 31, 2027 so the agency can collect GLP-1 utilization data to share with Part D sponsors ahead of potential BALANCE in Part D. CMS lists all formulations of Mounjaro, Ozempic, Rybelsus, and Wegovy, the KwikPen formulation of Zepbound, and Foundayo, for currently covered indications and for weight management. Participation is voluntary for manufacturers, state Medicaid agencies, and Part D plans. Coverage is not guaranteed for any individual.
Stated July 1, 2026. CMS: BALANCE Model. Checked October 16, 2026.
CMS announcement dated April 21, 2026, as reported by KFF
Medicare Part D
KFF’s brief, updated May 11, 2026, says CMS announced on April 21, 2026 — the day after the Part D sponsor application deadline — that it would not move forward with BALANCE in Medicare in 2027 and would extend the Bridge through the end of 2027. KFF says the original Medicare design ran from January 2027 through December 2031 and that implementation in Part D is now uncertain. KFF also describes cost sharing in that original Part D design: $245 for a 30-day supply in the deductible phase, then $50 per month for enhanced plans and employer group plans and $125 per month for basic plans, and $0 after the out-of-pocket maximum ($2,100 in 2026, $2,400 in 2027). Those Part D BALANCE copays are not a benefit CMS says is in effect for 2027.
Stated April 21, 2026. KFF: What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge. Checked October 16, 2026.
Three products; Zepbound vials and single-dose pens excluded
Medicare GLP-1 Bridge
CMS tells pharmacies that eligible products, when used to reduce excess body weight and maintain weight reduction, are Foundayo, Wegovy (injection and tablets), and Zepbound KwikPen. The single-dose vial and single-dose pen formulations of Zepbound are not available through the Bridge. CMS says this list was updated on April 6, 2026 to include Foundayo after FDA approval and to limit Zepbound to the KwikPen. A fill is one monthly supply (28 or 30 days). Sixty- and ninety-day fills are not available. Pen needles for the KwikPen are not covered.
Stated April 6, 2026. CMS: Medicare GLP-1 Bridge: Information for Pharmacies. Checked October 16, 2026.
Approved April 1, 2026
FDA approval
FDA announced on April 1, 2026 that it approved Foundayo (orforglipron) for use with a reduced-calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in adults with obesity, or in adults with overweight and at least one weight-related comorbid condition. FDA granted the approval to Eli Lilly and Company.
Stated April 1, 2026. FDA: FDA Approves First New Molecular Entity Under National Priority Voucher Program. Checked October 16, 2026.