Coverage at a glance
| Indication | Coverage |
|---|---|
| Type 2 diabetes | Covered with prior authorization |
Plan type: Medicare Part D. Each indication below lists the BMI and clinical thresholds, the prior-authorization documentation, and the published policy it comes from.
Coverage by indication
What the prior authorization needs:
- Prior authorization (PA) required
- Quantity limit (QL): 3 per 28 days
- Tier 3 on the Humana Premier Rx PDP; tier 2 on Humana's 2026 Medicare Employer comprehensive drug list
Policy Y0040_PDG26_FINAL_5C_C. Source: Prescription Drug guide, Humana Premier Rx Plan (PDP), 2026 (updated 08/01/2026). formulary. Verified August 27, 2026.
Recent change: Humana updates its 2026 Part D drug lists during the plan year. The Premier Rx PDP list cited here was current as of August 2026 (updated 08/01/2026). Tier and rules can change, so verify against the current formulary for your plan.
What to do next
If you qualify under one of the covered indications above, prior authorization is the path. Match the documentation in the requirements list then have your prescriber submit it. Plans that approve reassess at renewal, so know your long-term maintenance dose before you start.
- Browse the prior-authorization letter library for a template that matches your plan and indication.
- Read the full coverage picture, denial reasons, and the four appeal pathways at GLP-1 insurance coverage.
- If the prior-authorization request is denied, the appeal letter library has templates by denial reason, covering peer-to-peer review, Level 1 and Level 2 internal appeal, and external review.
- If your plan does not cover the indication you need, compare cash prices in the cost guide or check whether a clinical trial near you fits. Neither one goes through your insurer. Clinical trials cost nothing and many pay you for your time. Some participants get a placebo, decided at random.
What it costs without insurance
The programs below bill you directly. Prices checked every Monday.
Frequently asked questions
Does Humana cover Ozempic?
Humana's 2026 Medicare Part D drug lists cover Ozempic for type 2 diabetes, its only FDA-approved use. Prior authorization and a quantity limit of 3 per 28 days apply, and the tier depends on the plan, tier 3 on the Humana Premier Rx PDP that we cite here and lower on some other 2026 Humana lists. Neither list applies step therapy to Ozempic. Medicare does not cover weight-loss drugs, so Part D does not cover Ozempic for that use. Wegovy is the same semaglutide at a higher dose, approved for weight loss. This reflects the published policy verified August 2026.
What does Humana require to approve Ozempic?
For type 2 diabetes: Prior authorization is required, with the documentation listed in the requirements above.
Coverage for other payers
See the full payer coverage index for every plan we have sourced.
How we built this page
Each page is built from a published payer policy document, government statute, or independent formulary analysis (KFF). Every indication row carries the source URL and the date we verified it. Where a payer's policy PDF was confirmed at its public URL but served as an unreadable binary, the policy number and coverage framework were cross-checked against secondary sources; those rows are marked lower confidence. Commercial coverage often depends on whether an employer elected the weight-management benefit. Those rows say varies by plan rather than a flat yes.
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.
