Novo Nordisk narrows its Patient Assistance Program for Ozempic

Novo Nordisk has narrowed eligibility for its Patient Assistance Program (PAP), the company's free-medicine program for Ozempic and other drugs, effective in 2026. Medicare Part D beneficiaries have lost access to free Ozempic through the PAP, and uninsured applicants must now have household income at or below 200% of the federal poverty level to qualify ^[1][2].

According to NovoCare, the company's patient-support website, "Most Medicare prescription plans cover Ozempic" and Medicare beneficiaries with prescription drug coverage "will no longer be eligible to receive Ozempic through the Patient Assistance Program" ^[1]. A separate summary of the changes states Novo Nordisk explained the cutoff by saying 98% of Medicare beneficiaries already have access to Ozempic through their plans ^[2]. Patients who had been receiving Ozempic through the PAP continued to get it through the end of 2025 ^[2].

Uninsured applicants can still get Ozempic through the PAP, but only if their total household income is at or below 200% of the federal poverty level, and they must submit a copy of a Medicaid denial letter if their state's poverty threshold requires it ^[1][2]. For 2026, Novo Nordisk is also removing Rybelsus tablets (7 mg and 14 mg) and all unbranded biologic insulins from the PAP entirely, for all patients regardless of insurance status ^[2]. Tresiba and Novolog insulins remain covered ^[2].

For Medicare patients still using Novo Nordisk insulins through the PAP, income limits are being applied more strictly too: those with household income below 150% of the federal poverty level must now provide proof that they were denied Part D Extra Help (the Low-Income Subsidy program) before they can qualify ^[1][2]. NovoCare also confirmed that Medicare Part D patients no longer need to show $1,000 in prior out-of-pocket prescription spending to apply, a requirement that has been dropped ^[1].

Applications are now handled entirely online rather than by fax, according to NovoCare, which says this speeds up review and cuts delays from incomplete paper submissions ^[1]. Approved uninsured patients are enrolled for 12 months, while Medicare patients are enrolled only through the end of the current calendar year and must reapply after October 15 for the following year ^[1].

Why it matters for patients

For Medicare beneficiaries who relied on the PAP to get Ozempic at no cost, the main alternative going forward is coverage through their Part D plan, since Novo Nordisk says most plans already cover the drug ^[1]. Those facing high out-of-pocket costs even with coverage can look into the Medicare Prescription Payment Plan, which spreads prescription costs across the plan year rather than eliminating them ^[1]. This does not lower the total amount owed; it changes the timing of payments.

For uninsured patients, the tightened 200% federal poverty level threshold means some people who previously qualified for free Ozempic may no longer meet the income cutoff, depending on household size and state guidelines listed by NeedyMeds ^[1][2]. A 340B pricing guide notes that outside the PAP, uninsured patients paying out of pocket have seen estimated 340B pharmacy prices of about $315 for a one-month Ozempic pen and $332 for a 30-count box of Rybelsus, compared with GoodRx prices of roughly $500 and $984, respectively, though these figures are specific to 340B-participating pharmacies and dated October 2025 ^[2].

Patients currently on Rybelsus or unbranded insulins through the PAP will need to find other coverage or affordability options once those products are dropped from the program in 2026, since NovoCare confirms these medicines are being removed for all patients ^[2].

What happens next

Medicare Part D beneficiaries could apply for 2026 PAP enrollment for eligible Novo Nordisk products after October 15, 2025, ahead of the annual Medicare Open Enrollment period that ran from October 15 through December 7, 2025 ^[1][2]. It is not yet known from the sources how many current PAP enrollees will lose access under the new rules, or whether Novo Nordisk plans further changes to the program later in 2026.