Medicare Part D prescription drug plans and Medicare Advantage plans that include prescription drug coverage may cover the costs of Rybelsus for type 2 diabetes management only.
You would first need to meet the plan’s annual deductible (if it has one), which in 2025 can be no more than $590.
Once this is met, you’ll typically pay 25% of the medication costs for generic and brand-name drug versions. However, Rybelsus does not currently have a generic version.
If you have type 2 diabetes, you’ll have more sugar (glucose) in your blood than usual. This happens when your body becomes resistant to insulin.
If lifestyle modifications alone do not help to lower blood sugar levels, a doctor or healthcare professional may suggest adding in prescription medications like Rybelsus.
In 2019, the
Read more about Rybelsus.
Managing costs
Medicare drug plans have lists of covered medications called formularies. You can check your formulary for more information on Rybelsus coverage, although it may not be a preferred drug option.
Deductible aside, prescription drug plans may have some out-of-pocket expenses, but from 2025, a person will pay no more than $2,000 per calendar year. After this amount is paid, the plan will cover all eligible costs.
You’ll also have the choice of spreading your drug costs with a payment plan.
To avoid unexpected out-of-pocket expenses, consider contacting your insurer for prior approval or authorization for Rybelsus.
Help with Rybelsus costs with Medicare
If you need help paying for prescription medications, you can use Medicare’s Extra Help program. If you’re eligible, it can help cover the costs of plan premiums, deductibles, and coinsurance.
The manufacturer’s website offers a tool that may help you estimate your Rybelsus costs.
While Medicare doesn’t currently cover Rybelsus for weight loss purposes, it may cover costs in the future.
Medicare is reviewing its current antiobesity medication exclusions, which could mean that weight loss medications will become available through Medicare in 2026.