Does Humana cover Zepbound, Wegovy, Ozempic or Mounjaro?

Why a Humana question is now a Medicare question

On Feb 23, 2023, Humana filed an SEC Form 8-K. It said Humana "will be exiting the Employer Group Commercial Medical Products business" ^[3]. The filing gives no completion date, and we could not confirm one. So Humana's GLP-1 coverage now runs through its Medicare Advantage and Part D drug plans. If you have employer coverage through another insurer, see the GLP-1 insurance coverage tracker. For Medicaid, see Medicaid GLP-1 coverage by state.

Coverage by drug and use

Humana Medicare coverage by drug and use, checked Oct 18, 2026

Drug	Weight loss	Heart risk	Sleep apnea	Type 2 diabetes	Plan types
Wegovy (injection or tablet)	Not under Part D; Bridge: $50 a month [1][2]	Part D may cover, per Humana; tier and criteria not confirmed [1]	Not confirmed	Not confirmed	Humana MA-PD and standalone Part D; Bridge for eligible enrollees [2]
Zepbound	Not under Part D; Bridge covers the KwikPen only, $50 a month; vials and single-dose pens not covered [2]	Not confirmed	Not confirmed on Humana drug lists; sleep apnea patients are not Bridge-eligible, and their Part D plan might cover it [5]	Not confirmed	Humana MA-PD and standalone Part D [2]
Foundayo	Not under Part D; Bridge: $50 a month [2]	Not confirmed	Not confirmed	Not confirmed	Bridge for eligible Part D enrollees [2]
Ozempic	Not a Bridge drug [2]	Not confirmed	Not confirmed	Part D may cover for diabetes, per Humana; tier not confirmed [1]	Humana MA-PD and standalone Part D
Mounjaro	Not a Bridge drug [2]	Not confirmed	Not confirmed	Not confirmed	Humana MA-PD and standalone Part D

What Part D allows for each use

• Weight loss only: excluded. Humana's own page says: "Standard Medicare Part D prescription drug plans don't cover GLP-1 medications only for weight loss" ^[1]. Wisconsin's state retiree plan administrator told its board the same thing about federal law ^[6].
• Diabetes or heart disease: Humana says Part D may cover drugs like Ozempic and Wegovy when they are prescribed for diabetes management or cardiovascular disease. Those prescriptions go through the regular Part D plan, not the Bridge ^[1].
• Sleep apnea and fatty liver disease: People with moderate to severe sleep apnea or MASH cannot use the Bridge. Medicare says their Part D plan might cover a GLP-1 ^[5]. Humana's page does not mention Zepbound for sleep apnea ^[1].

The Medicare GLP-1 Bridge for Humana members

The Bridge is a CMS demonstration. It runs outside the regular Part D benefit from Jul 1, 2026 through Dec 31, 2027 ^[4]. In 2026, members of Medicare Advantage plans with drug coverage can use it, including HMO and PPO plans. Private fee-for-service and cost plan members cannot, unless they also have a standalone drug plan. PACE plans are not eligible ^[2]. The covered drugs are Foundayo, Wegovy injection or tablet, and the Zepbound KwikPen, each at a $50 copay per 30-day supply ^[1]. Eligibility depends on BMI and related conditions. People with type 2 diabetes are not eligible ^[5]. Our Medicare GLP-1 guide covers the criteria and how to apply.

Humana's role in running the Bridge

CMS picked Humana as the central processor for Bridge prior authorization, claims and pharmacy payment. Humana already runs the Limited Income Newly Eligible Transition (LI NET) program ^[2]. CMS says the prescriber and patient get the prior authorization decision within 72 hours of submission. Approvals last through Dec 31, 2027. Refills need no new prior authorization unless the patient switches to a different Bridge drug ^[2]. This job is separate from Humana's own plans. Wisconsin's employee benefits agency told its board that CMS chose Humana to process all Bridge claims. The board's own pharmacy benefit manager, Navitus, processes no Bridge prior authorizations or claims ^[6].

What we could not confirm

• Whether this year's Humana Part D drug guides list Wegovy for heart risk or Zepbound for sleep apnea, and at what tier. The guides we opened stopped before the GLP-1 pages.
• Humana's Medicare prior authorization criteria for Wegovy, Zepbound, Ozempic and Mounjaro.
• The date Humana completed its exit from employer commercial medical plans.
• Coverage under Humana Medicaid plans.

How to check your Humana plan

1. Find your plan's drug guide or use Humana's drug list search, and search each drug by name.
2. If the drug is for diabetes or heart disease, ask Humana for the tier and prior authorization rules under your Part D plan ^[1].
3. If the drug is for weight loss, ask your prescriber whether you meet the Bridge criteria for Part D enrollees; the $50 copay applies per 30-day supply ^[1].
4. Call the member services number on your Humana card if the online list is unclear.

If Humana says no

• Ask why in writing, and ask how to appeal or request an exception. Have your prescriber add the diagnosis and records the plan asks for.
• Use the Bridge for weight loss if you qualify; see Medicare and GLP-1s.
• Pay yourself. Without coverage, Zepbound costs $299 to $449 a month on LillyDirect. The $449 price for 7.5 to 15 mg requires a refill within 45 days ^[7]. The Wegovy pen is $349 on NovoCare ^[8], and Foundayo is $149 to $299 ^[9]. All were checked Oct 17, 2026. Lilly and Novo savings cards exclude government beneficiaries such as Medicare ^[10][8]. Details: Zepbound cost, Wegovy cost, GLP-1 cost.

Drug-by-drug coverage: Wegovy insurance, Zepbound insurance, Ozempic insurance. Other insurers: TRICARE, UnitedHealthcare, Aetna.