Prediabetes , or borderline diabetes , occur when a person has eminent line sugar level but not to the extent required for a type 2 diabetes diagnosing .
Semaglutide is an injectable glucagon - like peptide-1 ( GLP-1 ) receptor agonist sold under several brands . TheFood and Drug Administration ( FDA)has only O.K. the brand Ozempic for contend blood bread levels and reducing tortuousness in people with type 2 diabetes .
This means that Original Medicare does not hatch Ozempic to handle prediabetes . likewise , Medicare Part D , which covers prescription drug , typically onlycoversthe prescription for the FDA - okay indication . Medicare Advantage ( Part C ) design with drug reporting must do the same .
How do I get prescribed Ozempic for prediabetes?
doc can decide to order Ozempicoff - labelfor prediabetes or , in some cases , also for weighting loss .
A person can speak with their doctor about whether injecting semaglutide to boil down their prospect of developing prediabetes is correct for them .
In this face , Medicare Part D may not insure their prescription , which means they may involve to pay the full price of the drug .
How much does Ozempic cost?
Semaglutide brand can cost more than$1,000per prescription without insurance policy , depending on the dish out chemist’s shop .
The architectural plan type determines how much a soul who ask Ozempic to treat diabetes may pay out of pouch under Medicare Part D or a Part C plan with drug coverage . Private insurance underwriter deal these plans . Each one expend aformulary listto classify their covered drugs into level . Generally , the higher the tier , the higher the out - of - pocket cost .
Typically , these plans also have a deductible and monthly premium , which also depend on the plan . The national nucleotide donee agiotage for Part D is$36.78 in 2025 . concord to the Centers for Medicare & Medicaid Services ( CMS ) , the average monthly agio for Part C plans is$17.00 in 2025 .
What does Medicare cover for prediabetes?
Medicare Part Bcovers one - clock time participationin a diabetes prevention plan for masses who do not have a diagnosis of diabetes but touch sealed standard , admit blood sugar heighten to certain tier .
Part C plans must offer the same welfare as Original Medicare ( portion A and B ) , though some may offer additional benefits .
