Medicare
What Ozempic and Wegovy Really Cost in 2026 — With Insurance, Medicare and Cash
The same pen has at least five different prices right now, and the one you pay depends on your coverage, your diagnosis and the calendar.
Margaret Linwood
Updated Sep 22, 2026 · 11 min read
Ozempic and Wegovy are one drug, semaglutide, sold under two brand names. Ozempic is approved for type 2 diabetes. Wegovy is approved for chronic weight management and, in certain adults with heart disease, for lowering the risk of heart attack and stroke. Same molecule, different label, and as of September 2026, at least five different prices.
The list price gets the headlines. Wegovy lists at about $1,349 a month and Ozempic at about $1,028. Hardly anyone hands over that amount at the counter, but it still matters, because deductibles and coinsurance are often figured from it.
Then there's everything else. The maker's own cash price for most pens is $349 a month. A temporary Medicare program that started July 1, 2026, charges a flat $50 copay for Wegovy to people who meet its rules. And on January 1, 2027, a price Medicare negotiated for Ozempic, Wegovy and Rybelsus kicks in: $274 for a 30-day supply, 71% below the 2024 list price.
This piece covers those prices and nothing else. Taking either drug is a medical decision for you and your doctor. What follows is what each route costs, who's allowed to use it, and when the numbers change.
Why does one drug have so many prices?
A brand-name drug starts with a list price the manufacturer sets. Insurers then negotiate rebates off that number, privately. Medicare now negotiates some prices in public, under the 2022 Inflation Reduction Act, and since 2025 drug makers have been selling straight to patients who pay cash, at prices well under list.
Each channel lets in different people. A commercial plan might cover Ozempic for diabetes and turn down Wegovy for weight loss. Medicare Part D is barred by law from covering drugs used only for weight loss, though it can pay for the same molecule when it's prescribed for another approved use. So two neighbors with nearly identical prescriptions can pay $25 and $349 for the same box.
Lots of households are sorting through this. In a KFF poll from late 2025, 12% of adults, about one in eight, said they were taking a GLP-1 drug at the time. Another way to see it: 18% said they'd taken one at some point.
The five prices, side by side
Every figure below carries a date. These numbers moved several times in 2025 and 2026, and they'll move again on January 1, 2027.
| Route | Who can use it | Monthly price | As of |
|---|
| List price | The starting point for deductibles and coinsurance | About $1,349 Wegovy, about $1,028 Ozempic. The maker says all doses drop to $675 on January 1, 2027 | February 2026 announcement |
| Commercial insurance plus maker's savings card | People whose private plan covers the drug | As little as $25, with the card covering up to $100 a month | April 2026 price guide |
| Maker's cash price (self-pay) | People with a prescription who pay without insurance | $349 for most pens. $499 for the 2 mg Ozempic pen. $399 for the 7.2 mg Wegovy pen. Pills from $149 | April 2026 price guide, still posted September 2026 |
| Medicare GLP-1 Bridge | People in a Part D or Medicare Advantage drug plan who meet the weight and health criteria | $50 copay for Wegovy | July 1, 2026, through December 31, 2027 |
| Medicare negotiated price | People whose Part D plan covers the drug for an approved use | Plan's cost is based on $274 per 30-day supply. You pay your plan's share of that | Starts January 1, 2027 |
$274 a month. That's the price Medicare negotiated for a 30-day supply of Ozempic, Rybelsus and Wegovy, effective January 1, 2027. CMS puts it 71% below the 2024 list price of $959. About 2.28 million people in Part D used one of these drugs in 2024.
So is $274 what you'll pay? No. It's the price your Part D plan's costs are built on. Your share at the counter depends on the plan's deductible, which tier it puts the drug on, and how close you are to the yearly out-of-pocket cap. That cap is $2,100 in 2026 and rises to $2,400 in 2027, when the standard deductible also goes from $615 to $700. A lower base price usually shrinks your share, and it helps most if your plan charges a percentage rather than a flat copay.
It's also a 30-day figure, not a price per pen. CMS lists $276.78 for a single 4 mg/3 mL Ozempic pen, the same $276.78 for a 30-tablet bottle of 7 mg Rybelsus, and $385.63 for a box of four 2.4 mg Wegovy pens. Part D plans have to carry negotiated drugs on their formularies.
Your price comes down to your coverage, the diagnosis on the prescription, and the calendar. The sections below take each situation in turn, starting with Medicare, where a new program comes with more strings than most people expect.
