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Does Medicare cover Rybelsus?

Short answer: Yes. Rybelsus (oral semaglutide) is covered on about 97.4% of Medicare Part D plans, typically on Tier 3 and usually requires prior authorization. It is prescribed for type 2 diabetes (the oral form of semaglutide, the same molecule as Ozempic).
~97.4%
of Part D plans cover Rybelsus
Tier 3
most common tier · prior authorization common

What this means for you

Coverage this broad means the question is usually not whether Rybelsus is covered, but what it will cost, which comes down to your plan's tier and whether prior authorization or step therapy applies.

It is also broadly covered on ACA marketplace plans (on 5 of the 6 major carriers we track). Your exact tier, prior-auth, and cost can vary by plan; the lookup shows you where your plan lands.

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See how Rybelsus — or any drug — lands across all Medicare Part D plans and major marketplace plans.

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Frequently asked questions

Does Rybelsus need prior authorization on Medicare?

Often yes. Plans use prior authorization to confirm Rybelsus is being used for an approved condition. Your prescriber submits it; once approved, it is covered at the plan's tier.

How much will Rybelsus cost on Medicare?

It depends on your plan's Tier 3 cost-share and the time of year. Use the lookup to confirm your plan's tier, then check that tier's copay in your plan documents.

Is there a cheaper alternative to Rybelsus?

Sometimes a generic or a same-class drug is preferred on your plan at a lower tier. The drug lookup flags covered alternatives when it can.

Does my specific plan cover it?

Coverage and tier vary by plan. The free drug lookup checks Rybelsus against all Medicare Part D plans and major marketplace plans in a few seconds.