The US Centers for Medicare & Medicaid Services is making it clear to Medicare Part D plans that GLP-1 drugs approved for cardiovascular indications can be covered under the prescription drug benefit – but it may not be clear until 2025 whether the agency actually expects them to do so.
US Medicare Plans 'Can' Cover Wegovy, CMS Says, But Will They?
Medicare is making clear that Part D ‘can’ cover GLP-1 inhibitors that are approved for cardiovascular indications – but in language that seems to leave plans considerable discretion for now. The formulary review process for 2025 may be a more important milestone for changes.
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