NEWS & EVENTS 
SPECIALTY CARE
Navigating Medicare Coverage for Ozempic: A 2026 MCT2D Guide
Updated: 11/03/25
This two-page resource, developed by MCT2D Co-Program Director Heidi Diez, PharmD, was designed to help clinicians guide patients who are losing access to the NovoCare Patient Assistance Program for Ozempic beginning in 2026. It translates a complex coverage change into concrete, patient-friendly steps and supports informed decision-making during Medicare open enrollment.
What the tool includes:
- Step-by-step instructions for patients to check if their current Medicare Advantage or Part D plan covers Ozempic, including how to identify copay or coinsurance amounts.
- A walkthrough of how to search coverage information on Medicare.gov and Q1Medicare.com, with example search terms and screenshots for reference.
- Guidance on how to compare plans and use the open enrollment window (before December 7, 2025) to switch to a plan that better meets a patient’s medication needs.
- Contact details for the Michigan State Health Insurance Assistance Program (SHIP) so patients can access free, unbiased help in reviewing plan options.
How this tool helps clinicians:
- Simplifies a high-volume counseling topic—Medicare coverage transitions—into a concise, ready-to-use handout for patient conversations.
- Provides a reliable, evidence-based script to guide patient inquiries about medication affordability and benefit design.
- Reduces the need for ad-hoc research or lengthy phone calls by compiling all the relevant federal and state navigation resources in one place.
- Reinforces patient self-efficacy by offering clear, actionable instructions that patients can follow independently or with caregiver support.
- Complements other MCT2D tools on medication access, including the Guide to Patient Assistance Programs (2026) and GLP-1 Receptor Agonist Shortages: How to Support Patients resources.
Tags: Coverage Guides, Created By MCT2D, For Providers, For Patients, Handout, Point-of-care
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Support for The Michigan Collaborative for Type 2 Diabetes (MCT2D) is provided by Blue Cross Blue Shield of Michigan as part of the BCBSM Value Partnerships program.
Although Blue Cross Blue Shield of Michigan and MCT2D work collaboratively, the opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of BCBSM or any of its employees.