Will insurance pay?

Ask which medicine is being considered, and have the person treating you explain their reason. Request the amount you would pay and any permission needed from the plan in advance.

Prior authorization is the plan's agreement to pay before coverage starts.

A plan calls its covered-drug list a formulary.

Keep the answer in writing. Ask whether the visit, tests and medicine follow separate coverage rules.

As of September 2026, Medicare's Part D drug benefit still excludes medicines when they are used solely for weight loss.

Eligible people can get certain weight-care drugs through Medicare's temporary GLP-1 Bridge program for a monthly payment of $50.

This program uses a separate route from ordinary Part D payment. Its start date is July 1, 2026, and its end date is December 31, 2027.

Eligibility depends on age, health conditions and plan type, and needs a prescription plus approval in advance.

Ordinary Part D is the route for people with type 2 diabetes; they do not use this Bridge.

The $50 Bridge payments do not bring you closer to Part D's yearly limit on covered drug costs you pay yourself. After you reach that limit through payments that count, Part D pays your covered drug costs for the rest of the year. You cannot add coupons to the Bridge payment.

For Ozempic and Wegovy (semaglutide) or Mounjaro and Zepbound (tirzepatide), manufacturer savings cards exclude Medicare, Medicaid and military coverage.

Those savings cards require private or workplace health insurance.

A maker's cash-payment offer is a price you pay yourself without using insurance. People with government insurance can generally use that offer; a savings card is a separate discount with different rules.

Before paying, ask whether the price is a self-pay cash offer or a savings-card discount used with insurance. Ask for the terms for that exact offer.

Ask about eligibility and the exact price. Avoid treating a card's lowest advertised payment as your confirmed cost.