Medicare Open Enrollment 2027: Picking a Part D Plan on a GLP-1

If you take a GLP-1 on Medicare, the 2027 plan that costs you least is the one that covers your exact drug and dose at the lowest yearly total, not the one with the lowest premium. You have from October 15 to December 7, 2026 to pick it, and the choice matters most if you use Ozempic, Mounjaro, Rybelsus or Trulicity for diabetes, or Wegovy or Zepbound for a covered non-weight condition. If you use Wegovy, Zepbound or Foundayo for weight loss alone, your cost runs through the separate Medicare GLP-1 Bridge, and your Part D plan choice matters less.

Figures checked October 19, 2026 against Medicare.gov, CMS and the sources linked below. Plans can change terms, so verify anything that matters in writing with the plan before you enroll.

The 2027 numbers that shape your GLP-1 cost

Four figures do most of the work for a GLP-1 user this year. Medicare.gov says no Medicare drug plan may have a deductible above $700 in 2027 ($615 in 2026), and that you pay nothing more for covered Part D drugs once your out-of-pocket spending reaches $2,400 in 2027 ($2,100 in 2026) (Medicare.gov, costs for drug coverage).

Source: Medicare & You 2027; Medicare.gov; CMS negotiated price fact sheet; CMS Medicare GLP-1 Bridge. Checked October 19, 2026.

The 2027 edition of Medicare & You confirms the window: you can change coverage for 2027 from "October 15 to December 7, 2026" (Medicare & You 2027). If you end up in a Medicare Advantage plan, the same handbook lists a second window from January 1 to March 31, 2027, when Medicare Advantage enrollees can switch plans or return to Original Medicare.

First, figure out which route pays for your GLP-1

Part D is barred by law from covering drugs used specifically for weight loss. It covers GLP-1s for other medically accepted uses, such as type 2 diabetes, cardiovascular risk reduction or sleep apnea (KFF). That split decides how much your plan choice matters.

Route 1: Your Part D plan covers it

This is the route for Ozempic, Mounjaro, Rybelsus and Trulicity used for type 2 diabetes. Medicare.gov also says people with type 2 diabetes, moderate-to-severe sleep apnea or fatty liver disease are not eligible for the Bridge, "but your Part D plan might cover your GLP-1s" (Medicare.gov). On this route, the plan's formulary, tier and restrictions set your price, so comparing plans carefully pays off.

Route 2: The Medicare GLP-1 Bridge

For weight loss without one of those conditions, Medicare.gov lists Foundayo tablets, Wegovy (injection or tablet) and Zepbound KwikPen as covered under the Bridge, at a $50 copay for a one-month supply. That copay does not count toward your Part D deductible or out-of-pocket limit (Medicare.gov). CMS says the program runs "between July 1, 2026, and December 31, 2027," extended because the BALANCE model will not launch in Part D in 2027 (CMS).

We cover eligibility and enrollment in our Bridge enrollment checklist. For plan shopping, three Bridge facts matter:

• You still need drug coverage. Medicare.gov says the Bridge is for people with Medicare drug coverage, including standalone drug plans (PDPs) and Medicare Advantage plans with drug coverage (MA-PDs) (Medicare.gov).
• The Bridge runs outside the Part D benefit, so your plan's formulary does not set your $50 copay (CMS).
• Medicare.gov says a Bridge prior authorization is valid through December 31, 2027, including refills and dose changes, unless you change GLP-1 drugs. It does not say how switching Part D plans affects it, so confirm with 1-800-MEDICARE before you switch.

How to use Plan Finder with a GLP-1

Medicare's Plan Finder estimates your yearly drug costs plan by plan, but only if you give it accurate inputs. Generic inputs give you a generic answer.

1. Enter the exact product and strength. Ozempic pens, Rybelsus tablets and Wegovy pens are priced differently even though they all contain semaglutide. CMS's negotiated price list shows an Ozempic 4 mg/3 mL pen and a 30-count bottle of Rybelsus 7 mg at $276.78 each, and a four-pen box of Wegovy 2.4 mg at $385.63 (CMS fact sheet).
2. Enter the right quantity and frequency. One box or bottle a month is typical, but use what your prescription actually says.
3. Add the pharmacy you will really use. Your estimate is only as good as the pharmacy you enter, so pick the one where you actually plan to fill, and ask the plan whether your cost differs at other pharmacies in its network.
4. Sort by total estimated yearly cost (premiums plus drug costs), not by premium.
5. Open the drug details for your top three plans and read the tier, the cost per fill in each phase and any restriction flags.

Reading the restriction flags

Plan Finder marks GLP-1s with letters such as PA, ST and QL. Each one is a hurdle that can delay or block your first fill in January.

• Prior authorization (PA): Medicare.gov describes it as "approval based on a plan's specific requirements" (Medicare.gov coverage rules). For a GLP-1, expect the plan to check that you have a covered diagnosis, not weight loss alone.
• Step therapy (ST): You may have to try a "less expensive drug on the plan's drug list" first (Medicare.gov). If you have already tried the other drug, your prescriber can document that.
• Quantity limits (QL): Plans may cap how much you get over a period. Your prescriber can request an exception if the limit is not medically appropriate for you.

A new plan generally applies its own rules. If you are switching plans and already take a GLP-1, ask the new plan before December 7 whether it will need a fresh prior authorization in January and what your prescriber must send.

Where the $274 negotiated price fits

CMS lists semaglutide (Ozempic, Rybelsus, Wegovy) at a negotiated price of $274 for a 30-day supply, versus a 2024 list price of $959, effective January 1, 2027 (CMS fact sheet). It is the price Medicare uses for the drug, not a flat copay you will see at the counter. KFF explains that enrollees who pay coinsurance could see savings, while those with flat copays depend on how their plan sets cost-sharing (KFF negotiation FAQ).

In practice, when you compare plans for Ozempic or Rybelsus, look at whether the plan charges a flat copay or a percentage. A percentage of a lower price can fall noticeably in 2027. It does not help Mounjaro, Trulicity or Zepbound, which are not among the 15 drugs whose negotiated prices start in 2027 (AP via 6abc). We break down the copay math in our post on Medicare's $274 semaglutide price.

MA-PD or standalone PDP?

Both count as drug coverage for the Bridge, and both use formularies, tiers and restrictions for Part D-covered GLP-1s. The differences are structural.

Source: Medicare & You 2027; Medicare.gov, GLP-1 Bridge. Checked October 19, 2026.

If your endocrinologist or cardiologist is outside an MA plan's network, a lower drug cost may not be worth losing access to the prescriber who manages your GLP-1.

A quick worksheet for each plan you are considering

1. Is my GLP-1, at my dose, on the formulary? Which tier?
2. Is it a flat copay or a percentage, before and after the deductible?
3. Does the plan apply the full $700 deductible to my drug's tier, or a lower one?
4. Are there PA, ST or QL flags, and what does the plan need from my prescriber?
5. What is my cost at the pharmacy I actually use?
6. What is the premium, and what is the total estimated yearly cost?
7. If I use the Bridge, is this plan a PDP or MA-PD, so I keep the drug coverage the Bridge requires?

If your drug is expensive, the $2,400 cap limits what you pay for covered Part D drugs in 2027. The Medicare Prescription Payment Plan can spread those costs across the year, though Medicare.gov notes it "doesn't save you money or lower your drug costs." Bridge copays are not part of Part D, so they do not count toward that cap (CMS).

What to do before December 7

1. Read your current plan's Annual Notice of Change for any formulary, tier or restriction change to your GLP-1.
2. Run Plan Finder with your exact drug, dose, quantity and pharmacy.
3. Shortlist three plans by total yearly cost, then call each one to confirm coverage and PA requirements for your diagnosis. Write down the date, the representative's name and the answer.
4. If you use or want the Bridge, confirm your new plan is a PDP or MA-PD and call 1-800-MEDICARE about your existing Bridge approval.
5. Enroll by December 7 so your coverage starts January 1, 2027, and ask your prescriber to submit any new PA in December.

Questions to ask the plan

• "Is [drug, strength] covered for [my diagnosis] in 2027, and on which tier?"
• "Will I need a new prior authorization if I am switching from another plan?"
• "What do I pay per fill at [pharmacy] during the deductible and after it?"
• "Is there a step therapy requirement, and does my history count?"

Sources

1. Medicare & You 2027 (Medicare.gov)
2. A new Medicare season begins, but some shifts will arrive in 2027 (AP via 6abc, Oct. 15, 2026)
3. What to Know About the BALANCE Model and the Medicare GLP-1 Bridge (KFF, May 2026)
4. Weight loss drugs: Medicare GLP-1 Bridge (Medicare.gov)
5. Medicare GLP-1 Bridge (CMS)
6. Negotiated Prices for Initial Price Applicability Year 2027 fact sheet (CMS)
7. FAQs About the Medicare Drug Price Negotiation Program (KFF)
8. Drug plan coverage rules (Medicare.gov)
9. Find a Medicare plan / Plan Finder (Medicare.gov)
10. Medicare Prescription Payment Plan (Medicare.gov)
11. Ozempic Savings Offer terms (NovoCare)
12. Mounjaro Savings Card terms (Lilly)
13. Save on Ozempic (Novo Nordisk)
14. Medicare.gov: Costs for Medicare drug coverage

Medical disclaimer: This article is general information, not medical advice, and does not replace a licensed clinician who knows your history. Approvals, labels, coverage and prices change; check the linked sources and talk with your prescriber or pharmacist before making decisions about any medication.