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Does Humana Cover Ozempic? 2027 Medicare Part D Rules

By Brian Monahan Updated October 31, 2026

Reviewed October 31, 2026. Yes, Humana Medicare Advantage and Part D plans can cover Ozempic (semaglutide) when it’s prescribed for type 2 diabetes and is on your plan’s drug list. Humana Medicare plans can’t cover it for weight loss alone, because federal Part D rules exclude drugs “when used for anorexia, weight loss or gain.” What you pay depends on your plan’s 2027 drug tier, deductible and pharmacy.

Quick answer: In 2027, Medicare’s negotiated price for semaglutide (Ozempic, Rybelsus and Wegovy) takes effect on January 1, no Part D deductible can be higher than $700, and out-of-pocket drug costs are capped at $2,400 for the year. Check your Humana plan’s 2027 Drug List or Annual Notice of Change, then call Humana to confirm any prior authorization rules.

Does Humana cover Ozempic for type 2 diabetes?

Ozempic is approved for type 2 diabetes, and CMS says GLP-1 drugs used for type 2 diabetes “are eligible for Part D coverage.” Humana Medicare Advantage plans with drug coverage (MAPD) and Humana stand-alone Part D plans can include it on their formularies. Each plan sets its own drug list, tier and rules such as prior authorization or quantity limits, so look up Ozempic in your specific plan’s 2027 Drug List. CMS also lists moderate to severe obstructive sleep apnea and some fatty liver conditions as GLP-1 uses eligible for Part D coverage.

Call Humana at the Humana phone number to ask about Ozempic coverage : 1-800-720-8985

Does Humana cover Ozempic for weight loss?

Not under Medicare. CMS’s excluded drug guidance lists “agents when used for anorexia, weight loss or gain (even if used for non-cosmetic purposes, for example: morbid obesity)” as drugs Part D plans can’t cover. That rule applies to every Medicare drug plan, including Humana’s, so a prescription for Ozempic for weight loss alone usually isn’t covered.

There is one temporary exception for certain weight-loss GLP-1s. CMS’s Medicare GLP-1 Bridge runs from July 1, 2026, through December 31, 2027, with a “$50 copay” for Wegovy (injection and tablet), Zepbound KwikPen and Foundayo for people who meet BMI and health criteria. Ozempic isn’t on the Bridge list, and people with type 2 diabetes are excluded because their Part D plan should cover a GLP-1 for diabetes. See how UnitedHealthcare handles Ozempic and Wegovy for a comparison.

How much does Ozempic cost with Humana in 2027?

Your cost depends on your plan, but three Medicare changes shape 2027 prices:

Negotiated price: CMS’s negotiated “maximum fair price” for semaglutide is $274 for a 30-day supply starting January 1, 2027, compared with a 2024 list price of $959. That is the price plans and pharmacies work from, not your copay.
Deductible: Medicare.gov says “no Medicare drug plan may have a deductible more than $700 in 2027,” up from $615 in 2026. Many Humana MAPD plans have a lower drug deductible or none.
Out-of-pocket cap: once your covered drug costs reach $2,400 in 2027 ($2,100 in 2026), you pay $0 for covered Part D drugs for the rest of the year. Humana says “Part D annual out-of-pocket costs are capped at $2,400.”

If cost is still a problem, ask about the Medicare Prescription Payment Plan, which spreads drug costs across the year, or Extra Help if your income is limited. For other common drugs, see does Medicare cover common prescriptions.

How to check your Humana plan’s Ozempic coverage

Find your plan name and number (for example H1036-xxx) on your Humana ID card or Annual Notice of Change.
Open the plan’s 2027 Drug List on Humana.com or in your mailed plan documents and search for Ozempic or semaglutide. Note the tier and any letters such as PA (prior authorization) or QL (quantity limit).
Ask your doctor to send any needed prior authorization showing a covered use, such as type 2 diabetes.
Compare plans during Open Enrollment, October 15 to December 7, 2026, if your current plan moves Ozempic to a higher tier for 2027.

Humana Medicare Advantage plans also include extras that can help with diabetes care, such as an OTC allowance on many plans. See Humana Medicare Advantage plans for 2027, the Humana Spending Account Card and Humana gym membership with SilverSneakers.

Frequently asked questions

Does Humana Medicare cover Ozempic?

Yes, for covered uses such as type 2 diabetes when Ozempic is on your plan’s formulary. It can’t be covered for weight loss alone under Medicare Part D rules.

Does Humana require prior authorization for Ozempic?

Many plans use prior authorization for GLP-1 drugs to confirm a covered diagnosis. Check for “PA” next to Ozempic in your plan’s 2027 Drug List or call Humana.

Is Ozempic part of the $50 Medicare GLP-1 Bridge?

No. CMS lists Wegovy, Zepbound KwikPen and Foundayo for the Bridge, which runs through December 31, 2027. Ozempic for diabetes is covered through your regular Part D benefit instead.

Will Ozempic be cheaper with Medicare in 2027?

The negotiated price of $274 for a 30-day supply starts January 1, 2027, and the $2,400 out-of-pocket cap limits what you pay for covered drugs in a year. Your copay still depends on your plan.

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