If you’re a diabetic patient and have eligibility for original Medicare benefits, you must be curious to know does Medicare cover Ozempic.
Millions of Americans have diabetes and get prescription medications for treatment. These medications are usually expensive and not affordable for the patients, and Medicare helps such patients lower their costs.
The best part?
Medicare covers test strips because they cost too much for a patient who needs to check blood sugar levels countless times a day. But the question is, why is the Medicare concern only related to Ozempic?
Let’s uncover the answer together with understanding does insurance cover Ozempic for weight loss.
What Is Ozempic?
Prescription medication for controlling blood sugar in type 2 diabetes patients. Ozempic is given to the patient with a pen-like device with a small needle. Patients can carry this device with them to use it wherever needed.
Ozempic should not be used in type 1 diabetic patients because of higher complications. People with pancreatitis are also at higher risk of complications with using Ozempic. Before searching for the answer to ‘is Ozempic covered under medicare,’ make sure you’re a safe candidate for Ozempic
The manufacturers of Ozempic claim if the medicine is used as per rules, it will effectively reduce blood sugar to healthy levels. Ultimately the patient’s life is improved over time.
Cost of Ozempic
If Ozempic had been a cheaper medicine, we wouldn’t discuss getting it free through Medicare. The high quality and effectiveness of Ozempic make it more expensive and unaffordable for most people with diabetes.
On average, the demonstrated monthly cost of Ozempic for a diabetic patient is approximately $500. Even a single dose costs above 70$.
The price is incredibly high.
The worst thing? If you’ve been searching for ‘does insurance cover Ozempic for weight loss.’ You need to know the Ozempic cost for weight loss is even higher, above $1,250 per month.
Does Medicare Cover Ozempic?
With higher medicine prices, you should work on tips to prevent diabetes. But you’ll need medication until your blood sugar levels fluctuate. Another option is getting Ozempic through Medicare without paying or paying significantly less.
But does Medicare cover Ozempic?
Original Medicare doesn’t assist Ozempic. The Medicare plan and be does not cover prescription drugs. The Medicare supplement insurance also doesn’t support medicines other than the original Medicare prescriptions.
Yet you can get your Ozempic the word by Medicare If you have a Medicare Advantage plan or a party prescription drug plan.
What’s Medicare Part D Plan?
Seniors with Original Medicare coverage or employer-sponsored health insurance can access the Medicare Part D plan.
The four standards include:
- Tier 1: Allowance for generic medication with specific brands
- Tier 2: More brand names are allowed in this standard, with a higher copayment.
- Tier 3: Includes costly drugs with frequent administration.
- Tier 4: Injectables and infusion medicines used for chronic conditions are included in this standard.
What Comes Under Medicare Advantage Plans?
Medicare Advantage plans are an alternative to Medicare parts A and B benefits. These plans are only offered through private insurance companies approved by Medicare.
Being an overall coverage, it includes coverage for seniors, prescription drugs coverage, dental care, hearing aid, and vision care coverage.
You may get the approval of Ozempic for weight loss, but it depends on whether you fall under plan A, B, or D. Because plan A and B don’t allows aid with prescription medicines. So identify your plan and rules, and then, you might be able to get your answer to ‘does Medicare cover Ozempic for weight loss?
Sign up for the Patient Assistance Program to get approved for no-cost medication. You’ll get free medicines without any registration fee or monthly charges if you qualify for the program.
- You’re a type 2 diabetes patient.
- You have uncontrolled A1C levels
- You’re a cardiovascular patient
- Have kidney or heart disease.
What’s The Catch
So, does Medicare cover Ozempic? Yes, it does, but it depends on the conditions. Original Medicare doesn’t cover prescription drugs or any other supplement. According to Medicare part D plans, some prescription medicines are covered, including Ozempic.
Whether your Medicare plan covers Ozempic or not, you must ask about your plan’s formulary. It will help you see which diabetes and hyperglycemia medicines Medicare covers.