Does Get Healthy Medicine accept insurance?

Yes. We accept most major insurance plans, Medicare, and TRICARE. For patients without in-network coverage, we offer a self-pay option of $219 for the initial visit and $99 for follow-ups, plus CareCredit financing.

Who qualifies for GLP-1 therapy like Wegovy or Zepbound?

FDA criteria allow GLP-1 therapy for patients with a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related condition such as type 2 diabetes, hypertension, high cholesterol, or obstructive sleep apnea. We see patients age 12 and older.

Do you offer telehealth?

Yes. We see patients in person at our Lake Nona clinic and via secure video or audio telehealth for anyone located anywhere in Florida.

What services do you offer?

Medical weight loss including GLP-1 therapy (Wegovy, Zepbound, compounded semaglutide and tirzepatide), metabolic health optimization, and men's health services including testosterone replacement therapy.

Does Medicare cover Zepbound or Wegovy in 2026?

May 20

Written By Manuel Carrazana

What does Medicare Part D currently cover for weight loss?

Historically, Medicare was prohibited from covering medications used solely for weight loss. However, as of 2026, the landscape has shifted: Medicare Part D plans can now cover these medications if they are prescribed for an additional FDA-approved "medically accepted indication" that Medicare does recognize.

When is Wegovy covered under Medicare?

Medicare Part D plans may cover Wegovy if you have a body mass index (BMI) that classifies you as overweight or obese AND you have established cardiovascular disease (CVD). This is because Wegovy is FDA-approved to reduce the risk of major adverse cardiovascular events like heart attacks and strokes.

When is Zepbound covered?

Similar to the cardiovascular rule, Zepbound can be covered by Medicare for patients who have moderate-to-severe Obstructive Sleep Apnea (OSA). If your physician documents that the medication is being used to treat your OSA—a condition Medicare does cover—your Part D plan may approve the prescription.

What are my options if Medicare won't cover it?

If you do not meet the cardiovascular or sleep apnea criteria, options include using manufacturer savings cards (though these are often restricted for government-insured patients), looking into clinical trials, or discussing compounded semaglutide options from legitimate, high-quality compounding pharmacies.

How do I start the coverage process with my doctor?

First, obtain a recent sleep study or cardiovascular workup. We then submit a detailed Prior Authorization (PA) that highlights your comorbid conditions rather than weight loss alone.

Interested in personalized weight-loss treatment?

If you’re ready to explore advanced, evidence-based options for weight management — including GLP-1 medications, lifestyle coaching and metabolic testing — schedule a consultation today.

📍 Get Healthy Medicine
Located inside Lake Nona Performance Center in Lake Nona
Serving patients across Florida via telemedicine

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