Medicare to Cover Weight-Loss Drugs at $50 Monthly Starting July 1

Medicare coverage for weight-loss drugs will begin July 1, allowing millions of seniors to obtain the medications at an out-of-pocket cost of $50 per month.

Seniors must meet clinical criteria established by their plan and prescribing physician. Plans may still require prior authorization or step therapy before approving coverage. The $50 monthly cap applies after any deductible and until the beneficiary reaches the coverage gap, after which standard cost-sharing rules resume.

Not all Part D plans are required to add the drugs.

Insurers decide whether to include them on formularies and at what tier. Beneficiaries can review plan documents or contact their insurer to confirm whether a specific medication is covered under the new terms.