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As of January 2026: OSA pathway: Medicare Part D can cover Zepbound for moderate-to-severe obstructive sleep apnea in adults with obesity 2025 out-of-pocket cap: $2,000 annual maximum for covered Part D drugs (rising to $2,100 in late 2026) [8] Coming mid-2026: The BALANCE bridge demonstration may offer $50/month access for qualifying beneficiaries Medicaid Coverage: State-by-State 13 states explicitly cover at least one GLP-1 for weight management under fee-for-service Medicaid, while 36 states cover GLP-1s for other indications like type 2 diabetes

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Primary care providers can offer specific advice for these groups

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With Retatrutide producing average weight losses of 24.2% at the 12mg dose, many users with moderate sleep apnea experience dramatic symptom reduction or complete resolution