GLP-1 drugs on every 2026 Wisconsin Part D plan
Pick a drug class, or type the drugs you want to check, and see which of the 10 stand-alone Part D plans in Wisconsin cover each one, on what tier, and with what restrictions.
- Covered
- Covered, needs prior authorization (PA) or step therapy (ST)
- Not on the formulary
- QL 60/30d = quantity limit, 60 units per 30 days
| Drug | Wellcare Classic$0.00/moS4802-097 | Wellcare Value Script$0.00/moS4802-132 | HealthSpring Assurance Rx$0.00/moS5617-223 | Humana Basic Rx Plan$0.00/moS5884-139 | Humana Value Rx Plan$0.00/moS5884-195 | AARP Medicare Rx Saver from UHC$0.00/moS5921-361 | SilverScript Choice$26.70/moS5601-032 | HealthSpring Extra Rx$56.30/moS5617-366 | Humana Premier Rx Plan$110.60/moS5884-162 | AARP Medicare Rx Preferred from UHC$113.90/moS5921-397 |
|---|---|---|---|---|---|---|---|---|---|---|
| Ozempicsemaglutide injection | Tier 3PA25%QL 3/28d | Tier 6PA$11.00QL 3/28d | Tier 3PA25%QL 3/28d | Tier 3PA25%QL 3/28d | Tier 3PA20%QL 3/28d | Tier 3PA17%QL 3/28d | Tier 3PA19%QL 3/28d | Tier 3PA17%QL 3/28d | Tier 3PA$45.00QL 3/28d | Tier 3PA15%QL 3/28d |
| Mounjarotirzepatide injection | Tier 3PA25%QL 2/28d | Tier 6PA$11.00QL 2/28d | Tier 3PA25%QL 2/28d | Tier 3PA25%QL 2/28d | Tier 3PA20%QL 2/28d | Tier 3PA17%QL 2/28d | Tier 3PA19%QL 2/28d | Tier 3PA17%QL 2/28d | Tier 3PA$45.00QL 2/28d | Tier 3PA15%QL 2/28d |
| Trulicitydulaglutide injection | Tier 3PA25%QL 2/28d | Tier 6PA$11.00QL 2/28d | Tier 3PA25%QL 2/28d | Not covered | Not covered | Tier 3PA17%QL 2/28d | Tier 3PA19%QL 2/28d | Tier 3PA17%QL 2/28d | Not covered | Tier 3PA15%QL 2/28d |
| Ozempic tabletsoral semaglutide, formerly Rybelsus | Tier 3PA25%QL 30/30d | Tier 6PA$11.00QL 30/30d | Tier 3PA25%QL 30/30d | Not covered | Not covered | Tier 3PA17%QL 30/30d | Tier 3PA19%QL 30/30d | Tier 3PA17%QL 30/30d | Not covered | Tier 3PA15%QL 30/30d |
| Wegovysemaglutide, weight | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered |
| Zepboundtirzepatide, weight | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered |
| Victozaliraglutide | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered |
| liraglutidegeneric Victoza | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered | Not covered |
| Saxendaliraglutide, weight | No 2026 Part D formulary lists this drug in the CMS files: it is too new, no longer sold, or excluded from Part D (as weight-loss-only drugs are). | |||||||||
| Byettaexenatide | No 2026 Part D formulary lists this drug in the CMS files: it is too new, no longer sold, or excluded from Part D (as weight-loss-only drugs are). | |||||||||
| Bydureon BCiseexenatide extended-release | No 2026 Part D formulary lists this drug in the CMS files: it is too new, no longer sold, or excluded from Part D (as weight-loss-only drugs are). | |||||||||
| orforglipronoral GLP-1, approved 2026 | No 2026 Part D formulary lists this drug in the CMS files: it is too new, no longer sold, or excluded from Part D (as weight-loss-only drugs are). | |||||||||
Where a plan covers several strengths or forms of a drug, the cell shows the least restricted one. Costs are the 30-day preferred-pharmacy cost-sharing in the initial coverage phase, from the CMS 2026 formulary files. Click a plan for its full drug list.