Medicare Part D and GLP-1 costs

A drug name alone cannot tell you whether Part D covers a particular prescription.

Check the plan first

Coverage depends on the plan, product, medically accepted indication and any authorization rules. Ask the plan for the exact 2026 cost for your prescription. Some weight management situations may involve special federal programs with distinct eligibility, so verify directly with Medicare or the plan.

Annual limit

Medicare states that 2026 out-of-pocket spending on Part D-covered drugs is limited to $2,100. This is a combined plan-year rule for covered Part D drugs. A single-drug cash price multiplied by 12 cannot predict when you reach it, and purchases outside Part D may not count.

Example

If a plan quotes $85 for a covered fill, use $85 as a one-fill input. The calculator's $1,020 annual figure assumes 12 equal fills and does not apply the benefit-phase rules.

Sources: Medicare Part D costs, CMS GLP-1 Bridge information. Estimate one fill →