Medicare Out-of-Pocket Costs and New Drug Prices in 2027
Major pricing reforms taking effect on January 1, 2027, substantially lower semaglutide costs across the country through federal price negotiations and voluntary manufacturer price cuts.
Medicare Negotiated Prices for 2027
Under the Inflation Reduction Act of 2022, Medicare completed its second round of drug price negotiations, establishing a maximum fair price for semaglutide—the active chemical ingredient in Ozempic, Wegovy, and Rybelsus.
Starting January 1, 2027, the negotiated Medicare price for a 30-day supply of semaglutide drops to $274. This represents a 71% discount from the medication’s 2024 list price of $959.
This negotiated price applies specifically to beneficiaries who access semaglutide through standard Part D plans for approved medical indications.
Manufacturer List Price Reductions
Independent of federal negotiations, drug manufacturer Novo Nordisk announced wholesale price reductions taking effect January 1, 2027, lowering the official U.S. list price for Ozempic, Wegovy, and Rybelsus to $675 per month.
For Wegovy, this cuts the previous list price of $1,349 in half. For Ozempic, it represents an approximate 34% decrease from its prior list price of $1,028.
These lower prices benefit individuals paying out of pocket or experiencing coverage gaps outside federal programs.
Standard 2027 Part D Benefit Parameters
If you receive GLP-1 medications through standard Part D, you must budget around 2027 plan parameters. In 2027, the annual Part D out-of-pocket spending maximum increases to $2,400 from $2,100 in 2026.
Once qualifying out-of-pocket expenses hit $2,400, your plan covers 100% of covered prescription drug costs for the remainder of the calendar year.
The maximum allowable Part D deductible rises to $700 in 2027, up from $615 in 2026, while the estimated average monthly premium for stand-alone Part D plans is $36.
Individual plan premiums may vary more widely in 2027 because the federal Part D Premium Stabilization Demonstration expired at the end of 2026.
The following table compares your primary coverage pathways for GLP-1 medications during the 2027 calendar year.
| Coverage Pathway | Qualifying Medical Indications | Included Medications | 2027 Beneficiary Cost | Counts Toward $2,400 Cap? |
|---|---|---|---|---|
| Standard Part D | Type 2 diabetes, cardiovascular disease, sleep apnea, fatty liver | Ozempic, Wegovy, Zepbound | Plan tier copay (negotiated base $274/month) | Yes |
| GLP-1 Bridge Program | Weight loss alone (BMI ≥ 35, or ≥ 27 with complications) | Wegovy, Zepbound KwikPen, Foundayo | Flat $50 per 30-day supply | No |
| Self-Pay / Cash Option | Weight loss without qualifying Bridge criteria | Any prescribed GLP-1 | New manufacturer list price ($675/month) | No |
