How much does Ozempic cost with Medicare in New Jersey?

Ozempic (semaglutide) is a GLP-1 receptor agonist, a once-weekly injection approved for type 2 diabetes. Part D plans cover it for that use; drugs used only for weight loss sit outside Part D. In 2024, 47,299 New Jersey Part D members filled Ozempic and paid an average of $55.77 per 30-day fill.

Ozempic under Medicare: New Jersey 2024 figures and the 2027 negotiated price

Ozempic	Amount
New Jersey Part D members who filled Ozempic (2024)	47,299
New Jersey gross cost per 30-day fill (2024)	$907.11
New Jersey patient share per 30-day fill (2024)	$55.77
Medicare negotiated price, 30 days (from Jan 1, 2027)	$274
2024 list price, 30 days, and discount	$959 (71% off)
People with Part D using Ozempic, Rybelsus or Wegovy (2024)	2,282,000
A full 2027 year, standard design	$1,347
Most common tier on renewing Part D plans for 2027 (national)	Tier 3 (4,289 of 4,748 plans)

Source: CMS fact sheet: negotiated prices for initial price applicability year 2027.

Diabetes coverage versus weight loss

If you have type 2 diabetes, your Medicare drug plan can pay for Ozempic as it would any listed medicine, though some plans ask for prior authorization first. If you want a GLP-1 for weight management, Ozempic is not the route.

That gap is what the Medicare GLP-1 Bridge addresses. From July 1, 2026 to December 31, 2027, eligible people with Medicare drug coverage can get Wegovy, the Zepbound KwikPen or Foundayo for a $50 copay for a month. Ozempic is not on that list, people with type 2 diabetes are not eligible for the Bridge, and the $50 does not count toward your Part D totals. Our post on the GLP-1 Bridge explains the BMI rules and how to start.

The 2027 negotiated price for semaglutide

CMS negotiated $274 for a 30-day supply of the semaglutide group (Ozempic, Rybelsus and Wegovy), 71% below the 2024 list price of $959. The group drew $15.2 billion in Part D gross costs in 2024. The exact price varies by strength. No generic semaglutide appears on the FDA first generic approval lists through October 2026.

How the cap changes the math

In 2026, at the New Jersey 2024 gross cost of $907.11 a fill, the $615 deductible is used up in January, which costs $688.03. Each later fill is 25%, $226.78, until spending reaches $2,100 in August. After that, covered Part D drugs cost $0 through December.

In 2027, at the $274 negotiated price with a $700 deductible, two full-price months and a $182.50 March fill clear the deductible, then fills run $68.50. The year comes to $1,347, under the $2,400 limit. Your plan's copay design will move these numbers.

Help with a front-loaded year

Because 2026 costs land early, the Medicare Prescription Payment Plan suits Ozempic users: a January cost of $688.03 becomes a first bill of about $57.34. Novo Nordisk's 2026 rules say Medicare beneficiaries with prescription drug coverage are no longer eligible to get Ozempic through its patient assistance program. Extra Help remains open to people under the 2026 limit of $23,940 income for one person. In New Jersey, Senior Gold members pay $15 plus 50% of each covered drug until their out-of-pocket spending passes $2,000 single or $3,000 married, then a flat $15 a prescription; PAAD members pay $7 for a covered brand.

Ozempic, Rybelsus and Wegovy: one price group

All three brands contain semaglutide. Ozempic is the weekly pen for type 2 diabetes, Rybelsus is a daily tablet for the same condition, and Wegovy is the higher-dose version used for weight management and heart risk. CMS negotiated them together, so the 2027 price covers whichever of the three your plan lists for a covered use.

Ozempic also carried the steepest gross bill of any drug on these pages: $907.11 per month-equivalent in New Jersey during 2024, and $1,387.09 per national claim in early 2026, so prices have not dropped the way they did for the 2026 group.

Questions for an Ozempic plan review

Bring the pen you use, because Ozempic pens deliver different weekly doses and plans can set quantity limits per pen. Ask whether prior authorization needs a diabetes diagnosis code or a recent A1C result from your doctor, whether pen needles are covered as Part D supplies, and what the plan does if your prescriber later moves you to Rybelsus tablets or to tirzepatide (Mounjaro), a different GLP-1 based medicine with its own spot on each plan list.

Nationally, 4,289 of the 4,748 renewing Part D plans list semaglutide on tier 3 for 2027, and 367 moved it lower than in 2026, per CMS formulary files.

Related questions

Sources

1. CMS Medicare Part D Prescribers by Geography and Drug, 2024 (New Jersey) Centers for Medicare & Medicaid Services
2. CMS fact sheet: negotiated prices for initial price applicability year 2027 Centers for Medicare & Medicaid Services
3. CMS Medicare Quarterly Part D Spending by Drug Centers for Medicare & Medicaid Services
4. Medicare.gov: How much does Medicare drug coverage cost? Centers for Medicare & Medicaid Services
5. CMS: Medicare GLP-1 Bridge Centers for Medicare & Medicaid Services
6. FDA: First Generic Drug Approvals (2026) U.S. Food and Drug Administration
7. NovoCare: Patient Assistance Program 2026 eligibility Novo Nordisk
8. Medicare.gov: Medicare Prescription Payment Plan, before using this payment option Centers for Medicare & Medicaid Services
9. CMS Monthly Prescription Drug Plan Formulary and Pharmacy Network Information (CY2026 and CY2027 basic drugs formulary), with the CMS 2027 plan crosswalk Centers for Medicare & Medicaid Services
10. New Jersey Division of Aging Services: Senior Gold Prescription Discount Program New Jersey Department of Human Services, Division of Aging Services
11. New Jersey Division of Aging Services: Pharmaceutical Assistance to the Aged and Disabled (PAAD) New Jersey Department of Human Services, Division of Aging Services

Please note: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.Garden State Medicare Solutions is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.