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Humana

Does Humana cover Ozempic?

Yes. Humana covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy documents

  • Medicare Part D: Covered with requirements. See the qualification pathways below.
  • Medicare Advantage: Covered with requirements. See the qualification pathways below.

Earliest policy review June 2, 2026. How we verify · Check your exact plan

Full requirements: Ozempic for Type 2 Diabetes (2 plan types)

Applies to Medicare Part D plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Type 2 Diabetes Mellitus

All of:

  • Diagnosis of type 2 diabetes mellitus

Documentation to bring

  • Documentation of type 2 diabetes mellitus diagnosis

Approval and renewal

  • Initial approval: 12 months

Not covered when

  • Use for weight loss is excluded

Policy note: Document header states 'OZEMPIC - TABLET' which may be an error as Ozempic is an injectable; Rybelsus is the oral semaglutide tablet. The policy covers only type 2 diabetes mellitus. Approval duration is plan year duration. Prescriber restriction is licensed practitioner. Part B prerequisite is 0. The document is a single-page excerpt (page 269 of 446) likely from a Medicare Advantage formulary or PA criteria compendium, inferred from the Y0040 plan identifier prefix.

Policy effective June 1, 2026 · verified June 2, 2026 · source: 2026%20 Super%20 National%205%20 Mapd Prior%20 Authorizationpdf · View policy document (PDF)

Applies to Medicare Advantage plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Type 2 Diabetes Mellitus

All of:

  • Diagnosis of type 2 diabetes mellitus

Documentation to bring

  • Documentation of type 2 diabetes mellitus diagnosis

Not covered when

  • Use for weight loss is explicitly excluded

Policy note: Policy states only 'The member has a diagnosis of type 2 diabetes mellitus.' No additional criteria specified. Explicit exclusion: 'The member is using for weight loss.' Coverage duration is Plan Year Duration. Prescriber restriction: Licensed Practitioner.

Policy effective July 1, 2026 · verified July 13, 2026 · source: 2026%20 Super%20 National%205%20 Mapd Prior%20 Authorizationpdf · View policy document (PDF)

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Full requirements: Ozempic for Weight Loss (1 plan type)

Applies to Medicare Advantage plans.

Not covered

Exclusion Criteria states: 'The member is using for weight loss.'

Policy note: Ozempic is explicitly excluded when used for weight loss per the Exclusion Criteria of the OZEMPIC PA policy.

Policy effective July 1, 2026 · verified July 13, 2026 · source: 2026%20 Super%20 National%205%20 Mapd Prior%20 Authorizationpdf · View policy document (PDF)

Open on its own page →

Questions people ask
Does Humana cover Ozempic?
Yes. Humana covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Ozempic approval last with Humana?
Type 2 Diabetes — Applies to Medicare Part D plans. Initial approval: 12 months.
How current is this information?
The oldest review date among the policies on this page is June 2, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Humana: Mounjaro

Ozempic under other plans: Aetna, Centene, Cigna, UnitedHealthcare, Alabama Medicaid, Arkansas Medicaid, BCBS Alabama, BCBS Arizona

All insurance plans · All medications

Summary of Humana's written policy, not a guarantee of coverage. Plans vary by employer and benefit design.