Does Oscar cover GLP-1s in 2026?
Yes for type 2 diabetes. Oscar covers Ozempic, Mounjaro and Rybelsus with prior approval, and its standard individual plans usually leave the weight-loss GLP-1s out.
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Does Oscar cover Mounjaro?
Yes, with prior approval. Oscar pays for Mounjaro once your prescriber gets the plan to sign off.
Oscar does cover Mounjaro for type 2 diabetes, once the plan signs off. It sits on tier 2 of Oscar's 2026 drug list, with a quantity limit of four pens every 28 days. Approval needs a documented type 2 diabetes diagnosis, for example an A1C of 6.5% or higher. On top of that you need either a 90-day trial of metformin at 1,500 mg a day that failed, or a documented need for combination therapy with an A1C of 7.5% or higher. Oscar does not cover Mounjaro for weight loss, because the FDA approved it for type 2 diabetes only. Zepbound is the tirzepatide for weight loss. Oscar reviews that one under a separate weight-loss policy, and it is not on this 2026 drug list.
Source: Oscar Clinical Guideline: Antidiabetic Agents - Glucagon-like Peptide-1 (GLP-1) Receptor Agonists (PG152, Ver. 4), policy PG152 (Ver. 4). Read August 27, 2026.
The full Oscar policy on Mounjaro has the BMI bar, the step-therapy rule and what happens at renewal.
Does Oscar cover Ozempic?
Yes, with prior approval. Oscar pays for Ozempic once your prescriber gets the plan to sign off.
Oscar covers Ozempic for type 2 diabetes, once the plan signs off. A quantity limit of one pen per fill period applies. It sits on tier 2 of Oscar's 2026 standard drug list. Ozempic is not covered for weight loss. Wegovy is the semaglutide the FDA approved for weight loss, and Oscar's standard individual plans usually leave weight-loss GLP-1 drugs out.
Source: Oscar 2026 Formulary: List of Covered Drugs, policy PG152 v9. Read August 27, 2026.
The full Oscar policy on Ozempic has the BMI bar, the step-therapy rule and what happens at renewal.
Does Oscar cover Rybelsus?
Yes, with prior approval. Oscar pays for Rybelsus once your prescriber gets the plan to sign off.
Oscar covers Rybelsus for type 2 diabetes, once the plan signs off. A quantity limit of 30 tablets every 30 days applies. It sits on tier 2 of Oscar's 2026 standard drug list. The FDA approved Rybelsus for type 2 diabetes only, not for weight loss. Wegovy is the semaglutide the FDA approved for weight loss, and Oscar's standard individual plans usually leave weight-loss GLP-1 drugs out.
Source: Oscar 2026 Formulary: List of Covered Drugs, policy PG152 v9. Read August 28, 2026.
The full Oscar policy on Rybelsus has the BMI bar, the step-therapy rule and what happens at renewal.
Every insurer we have read
This is reference information, not medical or legal advice, and not a guarantee of coverage. GLP-1 coverage policies change often. Always confirm the current policy with your insurer using the number on your card before you rely on this page. If your experience differs from what is shown here, email hello@glpchart.com with the details and we will re-verify.