Type two diabetes affects many Medicare recipients across the country. People living with type two diabetes are afforded more freedom to improve quality of life through medications like Ozempic. Medications for type two diabetes are meant to lower blood sugar levels in the event of a sudden spike or when the body is not producing or processing insulin properly. Left untreated, type two diabetes can inflame the pancreas and lead to other serious and potentially life-threatening health conditions, so addressing type two diabetes and its symptoms is extremely important.
What is Ozempic?
Ozempic (semaglutide) is a prescription medication that is used to control blood sugar in people with type two diabetes. It is injected into the body through a small needle that is housed in a pen-like device that can be transported in a pocket, purse or other small container. This medication is not for use in people with type one diabetes due to the risk of complications, and Ozempic should not be considered a first-line treatment for type two diabetes.
In addition, side effects of Ozempic may affect people with certain conditions like pancreatitis in more impactful ways, so it’s important to understand the risk of side effects and complications when taking this medication. When used as prescribed, however, Novo Nordisk, the manufacturer of Ozempic, claims that the drug can reduce blood sugar to healthy levels and allow more freedom for those with type two diabetes.
Does Medicare Cover Ozempic?
Many Medicare Part D plans provide coverage for Ozempic. The medication is covered under Medicare Part D prescription drug coverage because it is a medication that can be purchased from a retail pharmacy. This means that Medicare Advantage plans with prescription drug coverage (MA-PDs) may also include coverage for Ozempic. In order to know for sure whether or not your plan covers Ozempic, check the plan’s formulary, or list of covered drugs, that governs your options for prescription drug coverage.
There may be exceptions to traditional Part D coverage in cases where the medication is administered in a doctor’s office or in a skilled nursing facility. Part B provides coverage for outpatient treatment and procedures, so if you receive an injection of Ozempic in a doctor’s office, it may fall under this section. If you are admitted to a hospital or a skilled nursing facility and you receive Ozempic as part of your treatment, Medicare Part A will likely apply.
If you have type two diabetes, you have likely discussed lifestyle changes with your physician. People who face health challenges due to diabetes may find it beneficial to reduce sugar intake and to regularly test their blood to ensure that glucose is at healthy levels. Additionally, regular exercise that encourages weight loss in those who are considered overweight is usually recommended in controlling the symptoms of type two diabetes.
Prior to making any type of changes to your exercise routine or diet, you need to discuss your plan with your doctor. Making sudden or extreme changes in lifestyle, even if they sound like they will have a positive impact on your health, can alter the way that medications and glucose are processed in the body. Making such changes without your doctor’s approval comes with potential serious risks to both short-term and long-term health and should be avoided.
Does Medicare Cover Prescription Painkillers? (Opens in a new browser tab)
Does Medicare Cover 24-Hour Home Health Care?(Opens in a new browser tab)