Published 1 July 2026. Last updated: 1 November 2026Americans Pay $50 a Month for Wegovy Under Medicare. Australians Pay Up to $460. Here's Why.
The US just made Wegovy available for as little as $50 a month under a new Medicare program. Meanwhile, the indicative Australian private price range for Wegovy is $250–$460 AUD per month, varying by dose and pharmacy. Here's where Australia's PBS listing actually stands and what you can do while the status remains unchanged.
Is Wegovy on the PBS? Not yet. As at 1 November 2026, the PBS medicine status page shows the PBAC recommended listing for people with established cardiovascular disease and obesity in November 2025, but the medicine has not been listed (PBS, checked 1 November 2026).
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What the US just did, and why it matters
In December 2025, the US Centers for Medicare and Medicaid Services (CMS) announced the BALANCE model, Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth, a voluntary program that makes Wegovy and other GLP-1 weight loss drugs available to eligible Medicare enrollees for as little as US$50 per month (approximately A$78).
Under the program, Medicare covers approximately US$245 of the drug's cost, with patients paying just $50. Around 10% of Medicare enrollees are eligible under the initial rollout, with access expected to expand through 2026 and 2027 as more Part D plans and state Medicaid programs join.
This is a significant policy shift. Until this announcement, US federal law actually banned Medicare from covering medications prescribed purely for weight loss. The BALANCE model changes that, and it sends a clear signal to the rest of the world about where GLP-1 policy is heading.
Source: CMS press release: BALANCE model launch, December 2025
What Australians are paying right now
Wegovy is not PBS-listed, as at 1 November 2026. While Americans enrolled in the BALANCE model pay $50 a month, Australians pay an indicative private price range of $250–$460 AUD per month, varying by dose and pharmacy.
At the standard maintenance dose of 2.4mg per week, private prices range from approximately $370 to $460/month. Starter doses (0.25mg–1.0mg) range from approximately $250 to $360; costs increase as the dose escalates.
Some private health insurers may offer partial relief on certain policy tiers. Check directly with your insurer for current eligibility and any out-of-pocket amount.
| Country / Program | Monthly patient cost | Coverage |
|---|---|---|
| USA: Medicare BALANCE model | ~A$78 (US$50) | Medicare covers ~US$245 |
| Australia: not PBS-listed, as at 1 November 2026 | $250–$460 AUD | Full out-of-pocket |
| Australia: hypothetical PBS price if listed | No confirmed price | A listing and price have not been confirmed |
No PBS listing or price has been announced for Wegovy. The figures above show current private costs; any future PBS co-payment would depend on an approved listing.
Track your Wegovy or Ozempic while you wait for the PBS
MediRemind Scripts tracks your weekly injection schedule, stores your eScript, and reminds you before your repeat supply runs out. MediRemind offers a 30-day trial, then a subscription.
Free to download with a 30-day free trial. Subscription applies after the trial.
Where Australia's PBS listing actually stands
Australia is not standing still. In November 2025, the Pharmaceutical Benefits Advisory Committee (PBAC) gave a positive recommendation for Wegovy (semaglutide 2.4mg) to be listed on the PBS, but with specific eligibility criteria:
- BMI ≥35 kg/m² (or ≥32.5 kg/m² for people of Asian, Aboriginal, or Torres Strait Islander background)
- Established cardiovascular disease, such as a prior heart attack, stroke, or symptomatic peripheral arterial disease
The recommendation is consistent with Wegovy's cardiovascular risk-reduction indication, which the TGA approved based on the landmark SELECT trial showing a 20% reduction in major cardiovascular events in patients with obesity and pre-existing heart disease.
Novo Nordisk lodged its listing documentation on 27 February 2026. The PBS medicine status page, current at 1 October 2026, shows the documentation as “Not Accepted”, and the remaining listing steps have not started. No listing date has been announced.
A PBAC recommendation does not mean a medicine is listed. As of 1 October 2026, the Wegovy documentation is Not Accepted and no PBS listing date has been announced.
Sources: RACGP newsGP · Diabetes Australia
The global momentum is undeniable
The US is not alone. GLP-1 drugs are being fast-tracked for subsidised access in multiple countries simultaneously:
- United States: Medicare BALANCE model: Wegovy from US$50/month (December 2025)
- United Kingdom: NHS England approved Wegovy for obesity management in specialist weight management services (2023), with broader rollout underway
- Denmark: Partial coverage through national health insurance schemes
- Australia: PBAC recommendation November 2025; documentation Not Accepted as of 1 October 2026, no listing date announced
The pattern is clear: governments that initially resisted subsidising GLP-1s on cost grounds are now moving, driven by compelling evidence that these drugs prevent cardiovascular events, reduce hospitalisations, and ultimately save the health system money. The US Medicare decision, from an institution that was literally banned from covering weight loss drugs, is the strongest signal yet.
What you can do right now if you're on Wegovy or Ozempic in Australia
Waiting for a PBS listing is frustrating when you're paying up to $460 a month. Here's what's worth doing in the meantime.
1. Track your repeat prescription carefully
The most common reason patients stop Wegovy or Ozempic mid-treatment is a repeat expiring before it is renewed. Weekly injectable medications like Wegovy run on a strict repeat schedule, and your repeat can lapse faster than you expect. MediRemind Scripts sends you a reminder before your repeat runs out so you can avoid a paperwork-related schedule gap.
Track your GLP-1 treatment in MediRemind
Weekly injection reminders · Repeat script alerts · eScript QR code storage
Download MediRemind: 30-day trial, then a subscription2. Check your private health cover
Bupa, Medibank, and nib offer partial reimbursement on select policy tiers. It's worth calling your insurer to ask whether your current cover includes weight management medications. Even $80–$130/month back makes a meaningful difference over a 12-month course.
3. Join the PBS waitlist
We'll email you the moment Wegovy gets a confirmed PBS listing date in Australia. Join the waitlist here, no spam, one email when the listing is confirmed.
4. Ask your GP about cardiovascular eligibility
The PBAC's recommendation specifically covers patients with established cardiovascular disease. If you've had a heart attack, stroke, or have peripheral arterial disease, you may qualify for PBS access when it's listed. Your GP can confirm whether you meet the criteria now so you're ready to apply the moment the listing goes live.
Wegovy isn't on the PBS yet: what's your situation?
PBS Waitlist
Not on Wegovy yet? Join the waitlist.
We'll email you the moment a PBS listing date is confirmed, no spam, one email only.
No spam. One email when Wegovy gets PBS-listed. Unsubscribe any time.
Already on GLP-1
Already using Wegovy, Ozempic or Mounjaro?
Download MediRemind to track your weekly doses, repeat scripts and eScript QR codes while you wait for the PBS listing.
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Frequently asked questions
Is Wegovy covered by Medicare in Australia?
No. Medicare in Australia does not currently cover Wegovy for weight loss. The PBAC recommended a restricted listing in November 2025. Novo Nordisk lodged its listing documentation on 27 February 2026; the PBS status page, current at 1 October 2026, shows it as Not Accepted, and the remaining listing steps have not started. No listing date has been announced.
How much does Wegovy cost in Australia in 2026?
The indicative private price range is $250–$460 AUD per month, varying by dose and pharmacy. Starter doses are approximately $250–$360 per month; the 2.4mg maintenance dose is approximately $370–$460 per month. Some private health insurers may offer partial relief on certain policy tiers; check directly with your insurer for current eligibility and any out-of-pocket amount.
When will Wegovy be listed on the PBS in Australia?
The PBAC recommended a restricted listing in November 2025. Novo Nordisk lodged its listing documentation on 27 February 2026; the PBS status page, current at 1 October 2026, shows it as Not Accepted, and the remaining listing steps have not started. No listing date has been announced.
Who qualifies for Wegovy on the PBS in Australia?
The PBAC's November 2025 recommendation covers adults with a BMI ≥35 kg/m² (or ≥32.5 for people of Asian, Aboriginal, or Torres Strait Islander background) who also have established cardiovascular disease, such as a previous heart attack, stroke, or symptomatic peripheral arterial disease.
How does the US Medicare Wegovy BALANCE model work?
Announced in December 2025 by CMS, the BALANCE model is a voluntary Medicare program in which eligible enrollees pay just US$50/month (approximately A$78) for Wegovy and other GLP-1 weight loss drugs. Medicare covers approximately US$245 of the drug cost. Around 10% of Medicare enrollees are eligible in the initial phase.
Is Wegovy on the PBS in 2026?
Is Wegovy on the PBS? Not yet. As at 1 November 2026, the PBS medicine status page shows the PBAC recommended listing for people with established cardiovascular disease and obesity in November 2025, but the medicine has not been listed (PBS, checked 1 November 2026).
Can I track my Wegovy injections with MediRemind?
Yes. MediRemind tracks weekly GLP-1 injection schedules (Wegovy, Ozempic, Mounjaro), stores your eScript QR codes, and sends repeat prescription reminders before your supply runs out. Available on App Store and Google Play. MediRemind offers a 30-day trial, then a subscription.
Track your Wegovy or Ozempic while you wait for the PBS
MediRemind Scripts tracks your weekly injection schedule, stores your eScript, and reminds you before your repeat supply runs out. MediRemind offers a 30-day trial, then a subscription.
Sources
- Centers for Medicare and Medicaid Services. CMS Launches Voluntary Model to Expand Access to Life-Changing Medicines. December 2025. cms.gov
- CNN Politics. Medicare opens door to covering blockbuster drugs for weight loss. December 2025. cnn.com
- RACGP newsGP. Wegovy recommended for PBS listing. November 2025. racgp.org.au
- Diabetes Australia. Wegovy to be listed on PBS. 2026. diabetesaustralia.com.au
- Pharmaceutical Benefits Scheme. Medicine Status: semaglutide 2.4mg (Wegovy). pbs.gov.au
- Lincoff AM et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT trial). NEJM, 2023. nejm.org
- Pharmacy Daily. PBAC recommends Wegovy PBS listing for weight loss. pharmacydaily.com.au
This article is for general information only and does not constitute medical or pharmaceutical advice. Information about PBS listings, TGA approvals and medication pricing is accurate at the time of writing and subject to change, verify current status at PBS.gov.au or TGA.gov.au before relying on it. Speak to your doctor or pharmacist before making any decisions about your medication or treatment. MediRemind is not affiliated with Novo Nordisk or any other pharmaceutical manufacturer.
References to weight management medications on this page are for general information only. MediRemind does not prescribe, supply or endorse any specific medication. Individual circumstances vary, speak to your doctor about which treatment is appropriate for you.