How much is Ozempic with Medicare in Arizona in 2026?
Ozempic has no Medicare negotiated price in 2026, when its average gross Part D cost was $1,387.09 per claim in the first quarter, but your own 2026 cost is capped at $2,100 for all covered Part D drugs, and a $274 negotiated price for a 30-day supply starts January 1, 2027.
These are national Medicare figures from CMS, not Arizona-only prices. Ozempic is used for type 2 diabetes, including to lower heart and kidney risks in some patients. What you pay at a pharmacy in Chandler or anywhere in Arizona depends on your plan's deductible, the tier Ozempic sits on, and whether you have reached the yearly cap.
| Measure | Figure |
|---|---|
| Medicare negotiated price, 30-day supply (from Jan 1, 2027) | $274 |
| List price CMS reported before negotiation, 30-day supply | $959 |
| Average gross Part D cost per claim, 2025 (national) | $1,302.82 |
| Average gross Part D cost per claim, Q1 2026 (national, preliminary) | $1,387.09 |
| People with Part D who used it in 2025 (national) | 2,044,798 |
| Part D out-of-pocket cap, 2026 / 2027 | $2,100 / $2,400 |
How Part D pricing works for this drug
Your plan pays the pharmacy a negotiated price, and your share comes in three steps, in this order:
Step 1, the deductible: you pay the full negotiated price until your plan's deductible is met. The highest Part D deductible in the CMS landscape for Maricopa County is $615 for 2026 and $700 for 2027. Some plans have a lower deductible or none on certain tiers.
Step 2, your tier: after the deductible you pay the copay (a flat dollar amount) or coinsurance (a percentage of the price) set by the tier Ozempic sits on in your plan.
Step 3, the yearly cap: once your out-of-pocket drug spending reaches $2,100 in 2026 ($2,400 in 2027), you pay $0 for covered Part D drugs for the rest of the year.
In 2025, 2,044,798 people with Part D filled Ozempic, at an average gross cost of $1,302.82 per claim. A claim can be a 30-day or 90-day fill, so treat that as a guide to scale, not a monthly bill.
What changes the answer
The $274 figure is the CMS negotiated price for the semaglutide group (Ozempic, Rybelsus and Wegovy) for a 30-day supply, against a $959 list price; the exact price varies by strength. Part D covers Ozempic for type 2 diabetes; by law Part D does not cover drugs used only for weight loss, and plans may require prior authorization to confirm the diagnosis.
Formularies are set plan by plan. The 2027 drug lists are published by each plan for Annual Enrollment, and CMS has not yet released its 2027 formulary files, so check your own plan's 2027 list and tier. People with limited income can apply for Extra Help through Social Security, which lowers drug copays.
What to do next
Bring your prescription list to a plan review. During Annual Enrollment, October 15 to December 7, 2026, we compare how Ozempic is covered on the 2027 plans we offer in Maricopa and Pinal counties, including tier, deductible and pharmacy, and show you the yearly total rather than one copay.
Related questions
How much is Ozempic with Medicare in Arizona in 2026?
Ozempic has no Medicare negotiated price in 2026, when its average gross Part D cost was $1,387.09 per claim in the first quarter, but your own 2026 cost is capped at $2,100 for all covered Part D drugs, and a $274 negotiated price for a 30-day supply starts January 1, 2027.
Is Ozempic covered by Medicare?
Ozempic is covered under Medicare Part D drug plans and Medicare Advantage plans with drug coverage when it is on the plan's formulary. Coverage, tier and any prior authorization vary by plan.
What is the most I can pay for Part D drugs in a year?
$2,100 in 2026 and $2,400 in 2027 for covered Part D drugs. After that you pay $0 for covered drugs for the rest of the year.
Does the Part D deductible apply to Ozempic?
It can. Until your plan's deductible is met, you may pay the full negotiated price for Ozempic. Deductibles are set plan by plan, and some plans have a lower deductible or none on certain tiers, so compare where Ozempic sits on each plan's 2027 drug list, not just the premium.
Can Extra Help lower what I pay for Ozempic?
Yes, if you qualify. Extra Help is a federal program, applied for through Social Security, that lowers Part D premiums, deductibles and copays for people with limited income and resources. In Arizona, people with full AHCCCS coverage or a Medicare Savings Program usually get it automatically. We can help you check.
Can I spread my Ozempic costs over the year?
Yes. The Medicare Prescription Payment Plan lets you pay your out-of-pocket Part D drug costs in monthly amounts across the calendar year instead of all at once at the pharmacy. It does not lower the total you pay, but it can help when a deductible or high copay lands early in the year. Ask your plan to sign you up.
How do I check whether my 2027 plan covers Ozempic?
Look up Ozempic on each plan's 2027 drug list, called the formulary, and note the tier and any prior authorization or quantity limits. During Annual Enrollment, October 15 to December 7, 2026, we can compare it across the 2027 plans we offer in Maricopa and Pinal counties and show you the yearly total.
Will I pay the Medicare negotiated price for Ozempic at the pharmacy?
Not exactly. The negotiated price is what your plan's cost for Ozempic is based on from January 1, 2027. You pay that price only while you are in your deductible; after that you pay your tier's copay or coinsurance, until the yearly out-of-pocket cap stops your costs for covered drugs.
Will Ozempic be cheaper with Medicare in 2027?
CMS set a negotiated price of $274 for a 30-day supply of semaglutide products starting January 1, 2027. Your copay still depends on your 2027 plan.
Sources
- CMS Medicare Quarterly Part D Spending by Drug Centers for Medicare & Medicaid Services
- CMS fact sheet: negotiated prices for initial price applicability year 2027 Centers for Medicare & Medicaid Services
- CMS: Selected drugs and negotiated prices Centers for Medicare & Medicaid Services
- CMS Medicare Advantage and Part D Landscape, Contract Year 2027 Centers for Medicare & Medicaid Services
Please note: We do not offer every plan available in your area. Currently we represent 34 organizations which offer 64 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.Rise Up Benefits Group is not connected with or endorsed by the United States government or the federal Medicare program. Medicare has neither endorsed nor reviewed this information.
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