Medicare GLP-1 Costs 2025: Out-of-Pocket Guide

2025 Medicare Part D Cost Structure

For diabetes-indicated GLP-1 medications covered by Part D:

Deductible Phase

Pay 100% until deductible met ($590 in 2025)

Initial Coverage Phase

Pay 25% of drug cost (after deductible)

Catastrophic Coverage

Pay $0 after reaching $2,000 out-of-pocket cap (new in 2025 via IRA)

Note: The $2,000 out-of-pocket cap is new for 2025 thanks to the Inflation Reduction Act.

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