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Medicare open enrollment 2026: how do you check a Part D plan covers Ozempic, Wegovy or Zepbound?

The dates, Medicare’s Plan Finder step by step, what 2027 plans actually showed for these medicines, and where the $50 Bridge fits. From CMS and Medicare.gov, and our own Plan Finder checks.

GLP Guidebook teamPublished Oct 14, 202611 min read20 sourcesWritten from published sources
What we checked20 sources, each one opened and linked to the sentence it supportsLast checked Oct 14, 2026 · Next review due Apr 14, 2027 · How we write

Written for the United States, from US sources.

The short answer

Open enrollment runs October 15 to December 7, 2026, for coverage from January 1, 2027. In Medicare’s Plan Finder, add your exact drug and dose, then open each plan’s details to see its tier, prior authorization, quantity limits and yearly cost. Part D plans still can’t pay for weight loss alone; the $50 Bridge sits outside them.

Key takeaways

  • Medicare open enrollment runs from October 15 to December 7, 2026, and a drug plan you choose then starts on January 1, 2027.1
  • Medicare’s Plan Finder shows each plan’s tier for your drug and whether it needs prior authorization, has a quantity limit or uses step therapy.2
  • In two 2027 Chicago drug plans we checked on October 14, 2026, Ozempic and Wegovy were covered with prior authorization and quantity limits, and Zepbound was not.2
  • Part D plans still can’t pay for a GLP‑1 used for weight loss alone; the $50-a-month Medicare GLP‑1 Bridge does, outside any plan, through December 31, 2027.6,7,8
  • In 2027 the most you pay for covered Part D drugs in a year is $2,400, and no plan’s deductible can be above $700.4,5
Before you go further
  • Plans differ. Our Plan Finder figures are examples from two plans in one ZIP code, not your plan’s costs. Your plan’s drug list decides.
  • This post explains Medicare’s rules. It doesn’t tell you whether you qualify for anything: Medicare, your plan and your prescriber decide that. We don’t name or rank plans.
  • These medicines need a prescription and carry real risks: see our side effects guide.
On this page
  1. When can you change your Medicare drug plan for 2027?
  2. Why does the reason for your prescription decide what a plan pays?
  3. How do you check a plan in Medicare’s Plan Finder, step by step?
  4. What did 2027 Plan Finder show for Ozempic, Wegovy and Zepbound?
  5. What can make Plan Finder’s yearly total misleading?
  6. Where does the $50 Bridge fit when you choose a plan?
  7. What changes if you choose a Medicare Advantage plan?
  8. What limits your costs, and what help is there?
  9. Questions people ask
  10. How we researched this
  11. Sources

When can you change your Medicare drug plan for 2027?

Between October 15 and December 7, 2026, you can join, switch or drop a drug plan or Medicare Advantage plan; changes start January 1, 2027.1

Your new plan must get your enrollment by December 7. If you do nothing, your current plan carries on with its 2027 costs and drug list. Its Annual Notice of Change letter sets out what changes.1

After December 7, the chances are narrower:

  • Medicare Advantage members: one change between January 1 and March 31, to another Advantage plan or to Original Medicare.1,10
  • Extra Help or Medicaid: you can change drug plans once a calendar month.10
  • A 5-star plan: you can join one once between December 8 and November 30.10

One more reason to look now. The Medicare GLP‑1 Bridge needs Part D drug coverage, from a drug plan or an Advantage plan that includes drugs.8 Joining Part D late can bring a penalty that lasts as long as you have Medicare drug coverage.12

Why does the reason for your prescription decide what a plan pays?

By law, Part D plans can’t pay for drugs used for weight loss, but they can pay for other approved uses, like diabetes.6,7

Medicare’s rule book lists weight-loss drugs as excluded “even if used for a non-cosmetic purpose”.6 KFF is a health-policy research group. It says Part D can cover GLP‑1s for uses other than obesity, “like type 2 diabetes, cardiovascular disease risk reduction, or sleep apnea”.7

A label is the FDA-approved document that lists what a medicine is for. Here is what each label allows besides weight loss:

  • Ozempic and Rybelsus (semaglutide): type 2 diabetes; Ozempic also lowers heart and kidney risks in people with diabetes.17 Neither is approved for weight.
  • Wegovy (semaglutide): lowering heart risk in people with heart disease, and MASH, a scarring fatty liver disease.15 For weight alone: the $50 Bridge.8
  • Zepbound (tirzepatide): moderate-to-severe obstructive sleep apnea in adults with obesity.16 For weight alone: the Bridge, KwikPen only.8
  • Foundayo (orforglipron): weight management only.18 For weight: the Bridge.8

People with type 2 diabetes, moderate-to-severe sleep apnea or MASH can’t use the Bridge. Medicare says their drug plan may already cover a GLP‑1.8 Heart and sleep apnea coverage is explained in Wegovy for heart and liver and Zepbound for sleep apnea.

From January 1, 2027, every Part D plan must put Ozempic, Rybelsus and Wegovy on its drug list, because Medicare negotiated their price.14 Being on the list doesn’t change the law: a plan still can’t pay for them for weight loss alone.6,7 For what the new price means for your bill, see Ozempic’s $274 Medicare price. The whole picture is in how Medicare covers GLP‑1 medicines.

How do you check a plan in Medicare’s Plan Finder, step by step?

Enter your exact drugs, doses and pharmacies, then open each plan’s details; the results list shows totals, not each drug’s tier or rules.2

  1. Open Medicare.gov/plan-compare. Choose 2027 plans, your ZIP code, and a drug plan (Part D) or a Medicare Advantage plan. You don’t have to log in.2
  2. Add each drug at your dose. Plan Finder asks for the dosage, the package, the quantity and how often you fill it. Zepbound appears as vials, single-dose pens and the KwikPen, so pick the form you use.2
  3. Add your pharmacies. Your usual one and up to 4 others, including mail order. Prices can differ by pharmacy, and some plans have lower-priced “preferred” pharmacies.2
  4. Sort the list. “Lowest drug + premium cost” ranks plans by their estimated yearly total. Check that total before trusting it (next section).2
  5. Open “Plan details”. The drug coverage section shows each drug’s tier, prior authorization, quantity limits and step therapy. It also shows your cost before the deductible, after it and after the yearly cap.2
  6. Check the month-by-month estimate and the line “When you’ll meet your deductible”.2
  7. Read the plan’s own drug list, then call the plan. Plan Finder links the list when the plan provides it; one plan we opened hadn’t. Ask what its prior authorization needs for your drug and your use.2
  8. Enroll by December 7, through Plan Finder, the plan’s website or phone line, or a paper form.1

Free help: call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, or your State Health Insurance Assistance Program (SHIP), listed at shiphelp.org.1

What did 2027 Plan Finder show for Ozempic, Wegovy and Zepbound?

In two Chicago drug plans we checked on October 14, 2026, Ozempic and Wegovy were covered with prior authorization; Zepbound was not covered.2

We entered three drugs for ZIP code 60601. Ten standalone drug plans came up, with deductibles from $300 to $700 and monthly premiums from $5.30 to $178.30.2

One 2027 drug plan’s estimate, per monthly fill
What Plan Finder showed for each phase of the year
Drug and packBefore the deductibleAfter the deductibleAfter the $2,400 cap
Ozempic 2 mg pen (one pen)$277.29$69.32$0
Wegovy 2.4 mg (box of 4 pens)$386.13$96.53$0
Zepbound 5 mg (box of 4 single-dose pens)Not covered: $1,304.14Not covered: $1,304.14Not covered: $1,304.14
Source: Medicare Plan Finder, a standalone drug plan in Cook County, Illinois, at a standard in-network pharmacy, checked October 14, 2026. This plan charges 25% coinsurance on brand-name tiers like these, which is why $277.29 becomes $69.32. Your plan’s figures will differ.2

What the codes on a drug list mean:

  • Tier: the price band on the plan’s drug list. Medicare.gov’s example runs from tier 1, mostly generics, to a specialty tier.11 Ozempic and Wegovy sat on tier 3 in one plan and tier 2 in the other.2
  • PA (prior authorization): approval you or your prescriber must get before the plan pays.3 Both plans required it for Ozempic and Wegovy.2
  • QL (quantity limit): a cap on how much the plan covers over a set time.3 One plan’s 2026 limit for Ozempic was set per 28 days.2
  • ST (step therapy): a rule that you try a cheaper drug first.3 Neither plan used it for these drugs.2

How approvals and exceptions work is in reading your plan’s drug list and prior authorization, step by step.

What can make Plan Finder’s yearly total misleading?

Plan Finder adds the full price of drugs a plan doesn’t cover, and it never asks why a drug is prescribed, so read each line.2

  • Uncovered drugs swamp the total. In the two plans we opened, Zepbound added about $15,650 to the yearly estimate, and all 10 plans showed totals above $17,900.2 If one drug isn’t covered by any plan, compare the plans with and without it.
  • “Covered” means on the drug list. Wegovy showed as covered in both 2027 plans.2 For weight loss alone, a Part D plan still can’t pay for it.6
  • The Bridge isn’t in the sums. Plan Finder priced Wegovy at the plan’s own cost, not the Bridge’s $50.2,8 If you use the Bridge, leave that drug out when you compare plans.
  • One dose all year. The estimate repeats the dose you enter every month. These medicines start low and step up, so your real cost can differ.17,15
  • Lists change. Plans can change their drug list during the year.11 If a new plan doesn’t cover a drug you already take, you may get a one-time 30-day transition fill.3 It gives you and your prescriber time to sort it out.
Free toolWhat would it cost you?

Add up your copay, the $50 Bridge copay or the makers’ self-pay prices, month by month. No sign-up.

Work it out

Where does the $50 Bridge fit when you choose a plan?

The Bridge is a separate Medicare program, so its $50 price doesn’t depend on your plan, but you need Part D coverage to use it.8,9

It runs from July 1, 2026, to December 31, 2027. It covers Wegovy, Foundayo and the Zepbound KwikPen, used for weight, for adults who meet its BMI and health criteria.9,20 The rules are in the Medicare GLP‑1 Bridge explained and who qualifies.

  • Most Part D plans count: a standalone drug plan or an Advantage plan with drugs. Private fee-for-service, cost plans, PACE and a few other types don’t, unless you also have a standalone drug plan.9
  • If your drug plan has paid for a GLP‑1 for you, for any reason, Medicare says you keep getting it through your plan. That covers semaglutide, tirzepatide, orforglipron, dulaglutide and liraglutide.8
  • Separate money: the $50 is charged “no matter your income level” and doesn’t count toward your deductible or yearly cap.8,7
  • No payment plan: Bridge drugs can’t go on the Medicare Prescription Payment Plan.8
  • An end date: December 31, 2027. KFF says it is uncertain how people will keep coverage after that.7

So for weight-only use, your plan choice turns on your other drugs, the premium and your pharmacies.

What changes if you choose a Medicare Advantage plan?

Advantage plans with drug coverage include Part D, so the same drug-list checks apply, plus the plan’s network of doctors and pharmacies.1,12

Advantage plans bundle Part A, Part B and usually Part D, and Plan Finder can check whether your doctors are in network.1 If you join a separate drug plan, you’ll be disenrolled from your Advantage plan and switched to Original Medicare.12

If you have a Medigap policy and move to an Advantage plan, you may not get the same Medigap policy back later.1 Advantage members who change their mind get one change between January 1 and March 31.1

What limits your costs, and what help is there?

In 2027 you won’t pay more than $2,400 for covered Part D drugs, no plan’s deductible can exceed $700, and Extra Help lowers costs further.4,5

  • The yearly cap: $2,100 in 2026 and $2,400 in 2027. After it, Plan Finder showed $0 a fill for covered drugs.4,5,2
  • The deductible: at most $615 in 2026 and $700 in 2027; some plans charge less.4,5,2
  • Extra Help: it pays your premium, cuts your deductible to $0 and lowers copays.10 Brand-name copays are capped at $12.65 in 2026 and $14.40 in 2027, or less on the lowest incomes.4 Apply at SSA.gov/extrahelp.10
  • Medicare Prescription Payment Plan: spreads your costs over monthly bills, at no charge. It “doesn’t save you money or lower your drug costs.”5,13
  • Savings cards: the makers’ copay cards exclude Medicare. See does the savings card work with Medicare?

Prices, prescriptions and who pays are covered in our guide to getting a prescription.

RisksThe risks, in brief
  • Stomach effects. In the main trials, about 44 in 100 people on Wegovy 2.4 mg injection felt sick (nausea), against about 16 in 100 on a dummy injection (placebo);15 about 25 to 29 in 100 people on Zepbound did, against about 8 in 100 on a dummy injection.16 It mostly comes while the dose goes up.
  • Gallstones were reported in 16 in 1,000 people on Wegovy injection, against 7 in 1,000 on placebo;15 11 in 1,000 on Zepbound, against 10 in 1,000, with gallbladder inflammation in 7 in 1,000 against 2 in 1,000.16
  • Pancreatitis (an inflamed pancreas): severe stomach pain that won’t go away and may spread to the back. The labels say to stop the medicine if it is suspected.15,16
  • Thyroid warning. The labels carry a boxed warning: these medicines are not for people with a personal or family history of medullary thyroid cancer (MTC) or MEN 2, a rare inherited condition that causes gland tumors.15,16
  • Low blood sugar is more likely when Ozempic is taken with insulin or medicines that make the body release insulin.17
Full detail in our side effects guide →
Get help now: call 911 or go to the ER for severe stomach pain that won’t go away, with or without vomiting (it can be pancreatitis), or for swelling of the face or throat or trouble breathing. For a possible overdose, Poison Control is 1-800-222-1222.15,16,19

Questions people ask

How do I compare Part D plans for Ozempic or Wegovy?

We don’t rank plans, and no single plan suits everyone. Plans set their own tiers, deductibles and pharmacy prices, so compare your exact drugs and pharmacies in Medicare’s Plan Finder.2

Will a Part D plan cover Wegovy for weight loss in 2027?

No. Federal law bars Part D plans from paying for weight-loss drugs. The $50 Medicare GLP‑1 Bridge covers Wegovy for weight, for people who meet its criteria, through December 31, 2027.6,7,8

Do I need a Part D plan to use the GLP‑1 Bridge?

Yes. You need Medicare drug coverage, through a standalone drug plan or a Medicare Advantage plan with drug coverage. A few special plan types don’t qualify on their own.8,9

Is Zepbound covered by Medicare Part D in 2027?

Not for weight alone. Part D can cover it for sleep apnea, but in two 2027 Chicago plans we checked, the Zepbound single-dose pen wasn’t covered. Check your own plan’s drug list.7,2

Can I change plans after December 7?

In some cases. Medicare Advantage members get one change between January 1 and March 31. People with Extra Help or Medicaid can change drug plans once a month.1,10

How we researched this

We used Medicare’s own guides, CMS’s 2027 payment announcement, CMS’s Bridge documents and KFF’s analysis.1,4,8,9,7 We ran Medicare’s Plan Finder ourselves on October 14, 2026, for ZIP code 60601, without logging in.2

The plan figures come from two plans and show how Plan Finder works; they are not a price list. We don’t name, rank or recommend plans. All sources were checked on October 14, 2026.

Before you move on

  • Read your plan’s Annual Notice of Change.
  • Enter your exact drugs, doses and pharmacies in Plan Finder.
  • Open plan details: tier, PA, QL and ST for each drug.
  • Leave Bridge drugs out when you compare totals.
  • Enroll by December 7, 2026.
How Medicare covers GLP‑1sCost calculatorThe $50 Bridge

More from the US blog

USUnited StatesOzempic’s $274 Medicare price in 2027: what will you actually pay?USUnited StatesDoes Medicare cover Wegovy or Zepbound? The $50 Medicare GLP‑1 Bridge explainedUSUnited StatesHow do you get Zepbound or Wegovy covered by insurance? Prior authorization, step by step
About GLP Guidebook

The monthly US update

An independent guide to GLP‑1 medicines. We don’t sell medicines, take drug-company money, earn commissions or link to any provider. Once a month: FDA approvals and warnings, Medicare and Medicaid changes, and makers’ price changes. How we write

Was this post easy to understand?

Sources

  1. Medicare.gov. Your yearly Medicare review: Medicare Open Enrollment, October 15 – December 7. CMS Product No. 11220, September 2026. Link
  2. Medicare.gov. Medicare Plan Finder (plan-compare), 2027 and 2026 standalone drug plans for ZIP code 60601, Cook County, Illinois, with Ozempic 2 mg/3 mL pen, Wegovy 2.4 mg pens and Zepbound 5 mg single-dose pens entered. Checked Oct 14, 2026, without logging in. Link
  3. Medicare.gov. Drug plan rules: prior authorization, step therapy, quantity limits and transition fills. Checked Oct 14, 2026. Link
  4. Centers for Medicare & Medicaid Services (CMS). Announcement of calendar year 2027 Medicare Advantage capitation rates and Part C and Part D payment policies, Tables V-2 and V-6. April 6, 2026. Link
  5. Medicare.gov. How much does Medicare drug coverage cost? Checked Oct 14, 2026. Link
  6. CMS. Medicare Prescription Drug Benefit Manual, Chapter 6: Part D drugs and formulary requirements, sections 20.1 and 30.4.5 (Rev. 18). Link
  7. KFF. What to know about the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge. May 11, 2026. Link
  8. Medicare.gov. Medicare GLP-1 Bridge: GLP-1 drugs for $50 a month (fact sheet). CMS Product No. 12234, June 2026. Link
  9. CMS. Medicare GLP-1 Bridge: information for prescribers. CMS Product No. 12235, June 2026. Link
  10. Medicare.gov. Understanding Medicare Advantage and Medicare drug plan enrollment periods. CMS Product No. 11219, March 2026. Link
  11. Medicare.gov. How do drug plans work? Checked Oct 14, 2026. Link
  12. Medicare.gov. Choose how you get drug coverage. Checked Oct 14, 2026. Link
  13. Medicare.gov. Medicare Prescription Payment Plan. Checked Oct 14, 2026. Link
  14. CMS. Medicare Drug Price Negotiation Program: negotiated prices for initial price applicability year 2027 (fact sheet). November 2025. Link
  15. Novo Nordisk. Wegovy (semaglutide) injection and tablets: US prescribing information. Revised 06/2026. Link
  16. Eli Lilly. Zepbound (tirzepatide): US prescribing information. Revised 8/2026. Link
  17. Novo Nordisk. Ozempic (semaglutide) injection: US prescribing information. Revised 05/2026. Link
  18. Eli Lilly. Foundayo (orforglipron) tablets: US prescribing information. Revised 7/2026. Link
  19. Poison Control (National Capital Poison Center). Poison help line 1-800-222-1222. Link
  20. Medicare.gov. Weight loss drugs (Medicare GLP-1 Bridge). Checked Oct 14, 2026. Link

Last checked Oct 14, 2026 · Next review due Apr 14, 2027 · Report an error

How this post was made. Written by the GLP Guidebook team from the sources above. It’s general information, not medical advice. Talk to your doctor, pharmacist or prescriber before starting, stopping or changing any medicine. We don’t sell, prescribe or recommend any brand, plan or provider. How we write