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Which GLP-1s does Oscar cover? 3 checked

By John Samaras, EditorPolicy verified August 28, 2026

Oscar publishes a policy on 3 GLP-1s we track. Of those, 3 are covered with prior approval. Each answer below names the conditions it covers and cites the document it came from.

Does Oscar cover Mounjaro?

Yes, with prior approval. Oscar pays for Mounjaro once your prescriber gets the plan to sign off.

Oscar covers Mounjaro for type 2 diabetes with prior authorization, and it sits on tier 2 of Oscar's 2026 formulary with a quantity limit of four pens every 28 days. Approval requires a documented type 2 diabetes diagnosis (for example an A1C of 6.5% or higher) plus either a failed 90-day trial of metformin at 1,500 mg daily or a documented need for combination therapy with an A1C of 7.5% or higher. Oscar does not cover Mounjaro for weight loss, because Mounjaro is FDA-approved for type 2 diabetes only. The weight-loss version of tirzepatide is Zepbound, which Oscar reviews under a separate weight-loss policy and which does not appear on this 2026 formulary.

Applies to commercial non-Medicare.

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 with prior authorization and a quantity limit of one pen per fill period. It sits on tier 2 of Oscar's 2026 standard formulary. Ozempic is not covered for weight loss. Wegovy is the semaglutide that is FDA-approved for weight loss, and Oscar's standard individual plans generally exclude weight-loss GLP-1 drugs.

Applies to commercial non-Medicare.

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 with prior authorization and a quantity limit of 30 tablets every 30 days. It sits on tier 2 of Oscar's 2026 standard formulary. Rybelsus is FDA-approved for type 2 diabetes only, not for weight loss. Wegovy is the semaglutide that is FDA-approved for weight loss, and Oscar's standard individual plans generally exclude weight-loss GLP-1 drugs.

Applies to commercial non-Medicare.

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.

If the answer above is no, or your employer did not buy the benefit, Strut Health is the cheapest cash route on the chart, from $149 a month. That price buys compounded semaglutide, a pharmacy-made version that is not FDA-approved and is not Wegovy, Ozempic, Zepbound or Mounjaro.

Visit Strut Health ↗

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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.

Checked by the GLP Chart coverage deskBuilt from GLP Chart's own policy records and checked against each plan's published document.
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