Guide · Updated November 2026

Medicare’s Negotiated Price for Ozempic and Wegovy, Explained

In November 2025, CMS published negotiated prices for 15 drugs that take effect January 1, 2027. Semaglutide, the active ingredient in Ozempic, Rybelsus and Wegovy, is one of them: $274 for a 30-day supply, compared with a 2024 list price of $959. That headline number gets repeated a lot. What it actually means for your pharmacy copay is a different question, and the two most-searched follow-up questions, "is this the same as the $50 Bridge program" and "does this cover Mounjaro too," both have a no for an answer.

Here’s the mechanism, what it changes, and what it doesn’t.

What actually got negotiated

The Inflation Reduction Act created the Medicare Drug Price Negotiation Program, which lets CMS negotiate a Maximum Fair Price (MFP) directly with a manufacturer for a short list of high-spend drugs, once those drugs have been on the market long enough to qualify. Semaglutide, grouped as one selected drug covering Ozempic, Rybelsus, and Wegovy, was one of 15 drugs in the program’s second round. According to the CMS fact sheet, the negotiation period ended November 1, 2025 with agreements on all 15 drugs. CMS lists the $274 price as 71% below semaglutide’s 2024 list price of $959. CMS also estimated that if these prices had applied in 2024, Medicare would have saved about $12 billion, or about 44% of net spending on the 15 drugs combined. That is an aggregate estimate, not each drug’s individual discount.

The fact sheet also shows how the price applies per package: $276.78 for an Ozempic 4 mg/3 mL pen and $385.63 for a four-pen box of Wegovy 2.4 mg.

Our guide on why GLP-1 list prices run so high covers the patent and rebate mechanics behind that $959 starting number. This is the first time a GLP-1’s Medicare price has been set through the statutory negotiation program.

Mounjaro and Zepbound are not part of this round. Tirzepatide is not on the 2027 list, and it was not among the 15 drugs CMS selected in January 2026 for prices starting in 2028. Coverage of both drugs sometimes blurs this together with separate Eli Lilly pricing moves (its own direct-to-consumer cash prices, and a separate Most Favored Nation pricing agreement with the federal government), but those are different mechanisms from the statutory negotiation that produced the $274 semaglutide price.

$274 is not your copay

This is the part most headlines skip. The negotiated price is what Medicare pays inside the program, specifically the ceiling a Part D plan’s claim gets priced against. It is not automatically the number a pharmacist charges you at the counter.

Your Part D plan still controls:

Which formulary tier semaglutide sits on
Your copay or coinsurance percentage for that tier
Whether prior authorization or step therapy applies
Whether your plan covers Ozempic for diabetes, Wegovy for its approved indications, or both

The CMS fact sheet says Part D plans must include negotiated drugs on their formularies, and CMS will review formularies for practices that undermine access. Plans still set tiers and cost-sharing within Part D rules. Two people on the same negotiated-price drug, in different Part D plans, can end up with very different copays. If you’re on Medicare, the number that matters to your budget is your plan’s 2027 formulary and cost-sharing tier for semaglutide, not the $274 figure in the CMS announcement.

Not on Medicare yet, or paying cash?

See Current Cash-Pay Prices →

This is a different program than the GLP-1 Bridge

The negotiated MFP above and the Medicare GLP-1 Bridge program both get called “Medicare’s new GLP-1 price,” and conflating them is an easy mistake. They’re separate programs with separate mechanics.

	IRA negotiated price (this article)	Medicare GLP-1 Bridge
What it is	Statutory price negotiation under the Inflation Reduction Act	A short-term CMS demonstration
Applies to	Semaglutide (Ozempic, Rybelsus, Wegovy)	Certain GLP-1 drugs for eligible Part D enrollees
What changes	The price Medicare plans pay for the drug	A $50 copay, handled outside the Part D benefit
Who decides your copay	Your Part D plan’s formulary and cost-sharing design	Set by CMS at $50
Dates	January 1, 2027 onward	July 1, 2026 through December 31, 2027

Sources: CMS negotiated price fact sheet, CMS Medicare GLP-1 Bridge page.

Our Medicare coverage guide covers Bridge eligibility and the $50 copay in detail. The short version: per the CMS Bridge page, the Bridge runs outside the normal Part D benefit, Part D plans do not have to opt in, the Part D deductible does not apply, the $50 copay does not count toward your out-of-pocket total, and there is no low-income subsidy for it. You can be affected by one program, both or neither depending on why you are prescribed the drug and whether you meet the Bridge criteria. Medicare’s eligibility checker is at Medicare.gov/glp1bridge.

Want the Medicaid side of this picture too?

Read the Medicaid GLP-1 Coverage Guide →

Why diabetes and weight-loss indications don’t get treated the same

Semaglutide’s negotiated price attaches to the drug, not to the reason it’s prescribed. But Medicare’s coverage rules still separate the uses. The Medicare Part D statute excludes certain drug classes, including drugs used for weight loss, from Part D coverage. Ozempic for type 2 diabetes has a more established Part D coverage path. Wegovy’s Part D coverage has relied on its other FDA-approved uses, such as cardiovascular risk reduction, a distinction our Zepbound sleep apnea coverage guide walks through for a similar non-weight-loss indication workaround on the tirzepatide side.

That means a lower negotiated ceiling price doesn’t by itself expand which beneficiaries get coverage. It can only lower what a plan pays, and potentially what it charges you, for a use the plan already covers.

What to actually do about this

If you’re on Medicare and take semaglutide, or are considering it:

Don’t budget around $274. Check your specific plan’s 2027 formulary and cost-sharing tier. Medicare open enrollment for 2027 coverage runs October 15 to December 7, 2026.
Ask your plan directly whether lower negotiated pricing changed your tier placement or copay for 2027, rather than assuming it did.
Check Bridge eligibility separately if you’re prescribed a GLP-1 specifically for weight management. It’s a different qualification path with its own $50 flat copay, covered in our Medicare guide above.
Compare against cash-pay options if your plan’s post-negotiation copay still runs high. Novo’s self-pay pricing (as of Nov 4, 2026, $199 a month for two months, then $349 a month for the Wegovy pen) is covered in our savings comparison guide. Note that Novo’s savings card excludes government beneficiaries, and self-pay purchases generally do not count toward Part D costs.

Bottom Line

Medicare negotiated semaglutide’s price down to $274 for a 30-day supply starting January 1, 2027, compared with a $959 list price in 2024. That number is the price plans pay, not a guaranteed copay. Your Part D plan still sets your actual cost-sharing. Tirzepatide (Mounjaro, Zepbound) isn’t part of this negotiation round, and the separate $50 GLP-1 Bridge runs on its own eligibility rules through December 31, 2027. If you’re on Medicare, the useful number to chase down is your specific plan’s 2027 formulary tier for semaglutide, not the headline figure.

FAQ

Does the $274 Medicare price mean my Ozempic copay drops to $274?

No. $274 is the Maximum Fair Price Medicare pays inside the negotiation program for a 30-day supply. Your Part D plan still sets its own formulary tier, copay, or coinsurance for that drug, so your actual cost can be higher or lower than $274.

Is Mounjaro or Zepbound included in this Medicare price negotiation?

No. This negotiation round covers semaglutide (Ozempic, Rybelsus, Wegovy) specifically. Tirzepatide was not selected for prices starting in 2027 or 2028, though Eli Lilly has made separate pricing moves on its own products.

When does the new Medicare price for Ozempic and Wegovy start?

January 1, 2027. CMS and Novo Nordisk reached agreement by November 1, 2025, as part of the program’s second negotiation cycle, and CMS published the price that November.

How is this different from the Medicare GLP-1 Bridge program?

The Bridge is a separate, short-term CMS demonstration running July 1, 2026 through December 31, 2027 that gives eligible Part D enrollees a $50 copay for certain GLP-1 drugs, outside the normal Part D benefit. This article covers the broader statutory negotiation that sets semaglutide’s price ceiling across Part D generally. You could qualify for one, both, or neither depending on your prescription and plan.

Does the negotiated price apply whether I take semaglutide for diabetes or weight loss?

The negotiated price attaches to the drug itself, not the diagnosis. But Medicare’s coverage rules still treat diabetes and weight-management indications differently, so a lower ceiling price doesn’t automatically mean your plan covers a use it didn’t cover before.

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What we checked

This AI-assisted public-source desk check reviewed the CMS fact sheet on 2027 negotiated prices, the CMS Medicare GLP-1 Bridge page, the Part D statute (42 U.S.C. 1395w-102) on Cornell LII, and Novo Nordisk’s Wegovy pricing page on November 4, 2026. This is not a clinical review and it is not medical advice. Prices and policies change, so confirm them with the provider or your prescriber before you act.