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Under the 2026 standard benefit you pay up to a $615 deductible, then 25 percent coinsurance (about $278 per fill at Lilly's $1,112.16 list price), and $0 once your out-of-pocket spending on covered drugs reaches $2,100 (Medicare.gov, 2026 plan year)

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Semaglutide can provide various benefits that aren’t limited to weight loss