Does the VA cover Ozempic?

If you get your healthcare through the Department of Veterans Affairs (VA), you may be wondering: Does the VA cover Ozempic? 

Short answer: It can in some cases. The VA covers injectable Ozempic (semaglutide) for some veterans with type 2 diabetes, though you’ll typically need to meet certain requirements first. 

Coverage gets a little more complicated for oral semaglutide tablets (originally sold as Rybelsus and now transitioning to the Ozempic pill), which aren’t on the VA formulary. And if you want to take either form for weight loss specifically, the VA generally won’t cover it since that’s not one of Ozempic’s approved uses (there are other possible options, though). 

Here’s what to know about when the VA covers Ozempic, what it may cost, and what your options are if you don’t qualify.

Yes, the VA covers Ozempic for some veterans with type 2 diabetes.However, coverage depends in part on which form you’re prescribed. 

Injectable Ozempic is on the VA National Formulary, which is the list of medications the VA generally covers. However, it requires prior authorization, meaning your provider must confirm you meet certain criteria before the VA will cover it. 

Those criteria typically include:

• Having type 2 diabetes

• Having blood sugar levels that remain above your target despite treatment with other diabetes medications

• Having certain heart or kidney conditions that make Ozempic a suitable treatment option

• Needing an alternative to certain diabetes medications because of concerns such as low blood sugar or weight gain 

The Ozempic pill, however, is not included on the VA formulary. That means your provider must request an exception (known as a non-formulary request) and get it approved before the VA will dispense them.

Typically, the VAreserves oral semaglutide for people who have trouble using injectable medications (for example, if you have vision loss or dexterity issues). 

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Does the VA cover Ozempic for weight loss?

Generally, no. Both injectable and oral Ozempic are approved by the US Food and Drug Administration (FDA) for type 2 diabetes, not weight loss, so the VA’s coverage criteria typically require you to have type 2 diabetes to qualify. While healthcare providers can prescribe Ozempic off-label for weight loss, the VA generally won’t cover it when weight loss is the only reason it’s prescribed.

That said, if you’re interested in semaglutide for weight management, Wegovy may be an option. It contains the same active ingredient as Ozempic (semaglutide) but it’s FDA-approved for chronic weight management in certain adults and adolescents. The VA may cover Wegovy for this purpose if you meet its eligibility requirements. 

Wegovy is also available in an injectable form and as a Wegovy pill.

VA coverage requirements for Ozempic

The VA has specific requirements for Ozempic coverage. While the details can depend on your health and treatment history, the main requirements include:

• Your diagnosis. You must have a confirmed diagnosis of type 2 diabetes. The VA does not generally cover Ozempic when it’s prescribed solely for weight loss.

• Trying other common treatments first. Depending on your situation, you may need to try other recommended medications before going on Ozempic. For example, the VA generally recommends first trying metformin for diabetes unless you can’t take it or have another reason that makes Ozempic appropriate sooner. You may also qualify if you have a heart or kidney condition but can’t use a common treatment like empagliflozin.

• Getting prior authorization. The Ozempic pen requires prior authorization, meaning your provider must confirm that you meet the VA’s criteria before it’s covered. The Ozempic pill is not on the VA’s formulary, so it requires a non-formulary request and prior approval.

Wondering whether the VA will cover Ozempic for you specifically? Here are a few ways to check:

• Check the VA Formulary Advisor. Search for Ozempic in the VA Formulary Advisor to see its current coverage status and criteria for use.

• Ask your VA healthcare provider. Your provider can review your medical history, current medications, and blood sugar levels to determine whether you meet the VA’s criteria. If you do, they can submit the appropriate authorization or non-formulary request for the type of semaglutide you’re prescribed.

• Contact your VA pharmacy. Your local VA pharmacy can answer questions about whether injectable or oral Ozempic is available through the VA and what you can expect to pay out-of-pocket for your prescription.

• Explore your options through Ro. Ro’s GLP-1 Insurance Coverage Checker can help you see whether your insurance covers the Ozempic pen (and certain other GLP-1 medications) and what you might pay.

How much Ozempic costs through the VA depends largely on your VA priority group. Your group is based on factors such as your military service history, disability rating, income, Medicaid eligibility, and whether you qualify for certain VA benefits. 

Veterans in priority group 1 generally don’t pay medication copays. If you’re in priority groups 2–8, you may have a copay for medications used to treat conditions that aren’t service-connected. The amount depends on the medication’s copay tier and how much medication you receive at once.

The form of Ozempic you take matters here. Injectable Ozempic is currently Tier 2 under the VA formulary, while the Ozempic pill is non-formulary and listed as Tier 3. For 2026, the corresponding copays are:

• Tier 2 (injectable semaglutide). $8 for a 1–30 day supply, $16 for a 31–60 day supply, or $24 for a 61–90 day supply

• Tier 3 (oral semaglutide): $11 for a 1–30 day supply, $22 for a 31–60 day supply, or $33 for a 61–90 day supply

Some veterans in priority groups 2–8 may still qualify for free medications based on factors such as their income or whether the medication treats a service-connected condition. 

The VA also caps copays for covered medications at $700 per calendar year. Once you reach that amount, you won’t pay additional medication copays for the rest of the year.

Without insurance or VA coverage, Ozempic’s list price is $1,027.51 per month, but there may be ways to pay less.

Novo Nordisk offers the Ozempic pen for $349 per month for the 0.25 mg, 0.5 mg, and 1 mg doses, or $499 per month for the 2 mg dose for eligible self-paying patients. New patients may also qualify for a limited-time offer of $199 per month for their first two fills of certain starting doses.

For the Ozempic pill, Novo Nordisk offers self-pay prices of $149 per month for the 1.5 mg dose, $199 per month for the 4 mg dose, and $299 per month for the 9 mg dose.

If cost is a concern, it may also be worth exploring insurance coverage or other GLP-1 medications. Ro can check your insurance coverage for injectable Ozempic and certain other GLP-1s for free, or offer several GLP-1 treatment options at cash-pay prices if prescribed.

If the VA doesn’t approve Ozempic, you still have options. Depending on why it was denied, you can:

• Appeal the decision. If you believe you meet the VA’s criteria, talk to your healthcare provider about submitting an appeal. They may be able to provide additional information to make a case for why Ozempic is appropriate for you.

• Ask about other covered medications. Your VA provider can help you find another diabetes medication that’s covered and appropriate for your health needs.

• Consider Wegovy for weight management. If you were hoping to use Ozempic for weight loss, ask whether Wegovy could be an option. 

• Check other insurance coverage. If you have insurance (like Kaiser or United Healthcare) in addition to VA benefits, find out whether that plan covers Ozempic or another GLP-1. If you have Medicare Part D, you may be able to get a GLP-1 for weight loss for $50 per month, if you meet the Bridge Program requirements.

• Explore cash-pay options. Paying out of pocket is another option if coverage isn’t available. Ask your provider about manufacturer self-pay programs or cash-pay GLP-1 options through Ro.

Start your journey

Ozempic is covered through the VA, but only for veterans who meet specific criteria. Here’s the information you should know:

• The VA may cover Ozempic if you have type 2 diabetes and meet at least one of its additional coverage requirements.

• Coverage differs by formulation. The Ozempic pen requires prior authorization, while the Ozempic pill requires a non-formulary request and prior approval.

• The VA generally won’t cover Ozempic solely for weight loss. If weight management is your goal, Wegovy may be a covered alternative if you meet the eligibility requirements.

• Veterans who owe copays may pay $8–$24 per prescription for injectable Ozempic or $11–$33 for the Ozempic pill.

• If the VA doesn’t cover Ozempic for you, talk to your provider about other covered medications, whether the decision can be reviewed, or other ways to access GLP-1 treatment.