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What to Know About MA Plans Formularies vary: Not all MA plans have added Zepbound for OSA to their formulary Prior authorization required: Nearly all plans require PA with sleep study documentation Cost sharing varies: Plans have different tiers, copays, and coinsurance 2026 out-of-pocket limits: In-network maximum is $9,250 (down from $9,350 in 2025) [5] Open Enrollment Consideration If your current Medicare plan doesn't cover Zepbound for OSA, you may be able to switch to a plan that does during the Annual Enrollment Period (October 15 - December 7) or Medicare Advantage Open Enrollment (January 1 - March 31)

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The Bottom Line on Microdosing GLP-1 While the desire to minimize side effects and costs is understandable, microdosing GLP-1 medications carries significant risks without proven benefits