Does Medicare Cover Saxenda for weight loss?
Doctors usually prescribe it as part of a comprehensive weight management plan that includes dietary changes and regular exercise.
Does Medicare cover Saxenda for older adults?
Medicare drug plans don't cover Saxenda because Medicare doesn't cover GLP-1 agonists when prescribed for weight loss.
Medicare may cover some GLP-1 agonists when prescribed to treat another health condition, like diabetes. However, the Food and Drug Administration (FDA) only approves prescribing Saxenda for weight loss, meaning Medicare doesn't cover the drug.
How much is a 30-day supply of Saxenda?
Without insurance coverage, Saxenda isn't cheap. One injection package costs around $1,400.
You may be able to afford Saxenda via the manufacturer's savings program, which reduces the price to $25 per box. Contact the manufacturer to verify your eligibility.
According to the manufacturer, this drug's availability is currently limited due to significant demand. So, you may, in some cases, have difficulty filling your prescription.
Is there a weight loss drug covered by Medicare?
The government set a goal to broaden Medicare and Medicaid coverage of GLP-1 drugs for weight loss alone by 2026. But the current administration abandoned the initiative.
However, if you have diabetes, you can get alternative GLP-1 agonists covered through Medicare if prescribed to treat your disease rather than for weight loss. These include Mounjaro (tirzepatide) and Ozempic (semaglutide).
If you have obesity, you can get Wegovy (semaglutide) if you're at a high risk of heart attack or stroke.
How do I know if my insurance covers an alternative to Saxenda?
If you're eligible for coverage of one of the aforementioned GLP-1 agonists based on your health, your Medicare drug plan should generally cover some of these drugs.
The GLP-1 drugs you can get through Medicare Part D or a Medicare Advantage prescription drug (MAPD) plan, and how much you may pay out of pocket after coverage, will depend on your specific plan.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
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