Novo Nordisk narrows Ozempic patient assistance program for 2026

Novo Nordisk has narrowed its Patient Assistance Program (PAP) for Ozempic (semaglutide) for 2026, closing the program to Medicare beneficiaries with prescription drug coverage and setting a lower income limit for uninsured applicants ^[1][2].

Under the 2026 rules, Medicare beneficiaries with Part D coverage are no longer eligible to receive Ozempic through the PAP ^[1]. Novo Nordisk says most Medicare prescription plans cover Ozempic and that beneficiaries can access it through those plans ^[1]. The 340B Price Guide quotes the company as saying 98% of Medicare beneficiaries have access to Ozempic ^[2]. Patients already on the program will continue to receive Ozempic through the end of 2025, according to a summary by Sara Jones, a consulting pharmacist at Northwest Human Services in Salem, Oregon, published by the 340B Price Guide ^[2].

For uninsured patients, the PAP still covers Ozempic, but total household income must be at or below 200% of the federal poverty level ^[1]. The 340B Price Guide describes the cutoff as below 200% of the federal poverty level ^[2], so the two accounts differ on whether income exactly at 200% qualifies. The dollar amounts that correspond to those thresholds are not listed in either source; Novo Nordisk directs applicants to the NeedyMeds website, which lists the current Federal Poverty Level guidelines ^[1].

The income limit is stricter for Ozempic than for Novo Nordisk's other PAP products. Uninsured patients applying for all other covered medications must have household income at or below 400% of the federal poverty level ^[1]. Medicare patients on Novo Nordisk insulins also face a 400% limit, and those with income below 150% of the federal poverty level must provide proof they were denied Part D Extra Help, also called the Low-Income Subsidy ^[1].

Two products are leaving the PAP entirely in 2026: Rybelsus (semaglutide) tablets 7 mg and 14 mg, and all unbranded biologic insulins ^[2]. Novo Nordisk says some medicines will no longer be part of the program for 2026 and points applicants to a covered-product list ^[1]. Uninsured applicants must include a copy of a Medicaid denial letter ^[1][2]. People who qualify for Medicaid or Medicare's Low-Income Subsidy must submit a copy of their denial letter with the application ^[1]. There is no registration charge or monthly fee to participate ^[1].

Applications submitted with all supporting documents and required fields are processed within two business days, and approved patients receive medicine at home within five business days, shipped by Neovance Specialty Pharmacy ^[1]. Shipping costs remain covered by the program ^[1]. Uninsured patients are enrolled for 12 months; Medicare patients are enrolled through the end of the current calendar year ^[1]. Novo Nordisk also says it no longer requires Medicare Part D patients to spend $1,000 out of pocket before they can apply ^[1].

The 340B Price Guide listed estimated prices as of October 10, 2025 for patients paying without insurance: Ozempic 2 mg/dose (8 mg/3 mL), one pen, at $315 under 340B pricing versus about $500 through GoodRx, and Rybelsus 3 mg tablets, 30 count, at $332 versus $984 ^[2]. 340B pricing is available through participating covered entities, not all pharmacies.

Why it matters for patients

Medicare Part D enrollees who relied on the PAP for Ozempic lose that route in 2026 and will need to check what their Part D plan covers. Medicare's open enrollment for 2026 ran from October 15 to December 7, 2025 ^[2]. Novo Nordisk points to the Medicare Prescription Payment Plan, which spreads prescription costs across the plan year, as one option ^[1].

Uninsured patients with income above 200% of the federal poverty level can no longer get Ozempic through the PAP, although the same patients may still qualify for other Novo Nordisk medicines under the 400% limit ^[1]. People taking Rybelsus lose PAP access regardless of income ^[2].

Timing matters for people who reapply. Novo Nordisk says patients may submit a new application 30 days before their enrollment ends, and Medicare Part D patients may apply after October 15 to enroll for the following year ^[1]. Patients who switch pharmacies may need a new prescription sent, the 340B Price Guide notes ^[2].

It has not been reported how many patients will lose assistance or what the changes are expected to save the company. Novo Nordisk says it reserves the right to modify or cancel the program at any time without notice ^[1].

What happens next

• 2026 program year: the new eligibility rules apply, including the end of Ozempic PAP access for Medicare beneficiaries with Part D coverage ^[1][2].
• Current enrollees: Novo Nordisk says no immediate action is required unless they are notified, but future renewals and new applications must be completed online ^[1].
• Medicare Part D patients: applications for the following year's enrollment open after October 15 ^[1].