Does Medicare Cover Ozempic or Mounjaro in Australia?
One of the most common questions Dr Chong hears: 'Will Medicare pay for my weight loss medication?' The answer depends on your diagnosis, not just your weight. Here's what you need to know.
Dr Chun Guan Chong
MBBS · FRACGP · Grad Dip Surg Sci
The Short Answer
Medicare does not subsidise Ozempic, Wegovy, or Mounjaro for weight loss in Australia. These medications are not listed on the Pharmaceutical Benefits Scheme (PBS) for the indication of obesity or weight management.
However, if you have type 2 diabetes, Ozempic (semaglutide) *is* PBS-subsidised — which dramatically reduces its cost. And regardless of which clinic you attend, your consultation with Dr Chong attracts a Medicare rebate, so you will receive a partial refund on the appointment itself.
Here's a full breakdown.
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What Is the PBS?
The Pharmaceutical Benefits Scheme (PBS) is the Australian Government's program that subsidises the cost of medicines listed on the PBS formulary. When a medication is PBS-listed, eligible patients pay a standard co-payment (around $7.70 for concession holders, ~$31.60 for general patients in 2026), regardless of the medicine's actual cost.
When a medication is not on the PBS, you pay the full private dispensing price — which for modern GLP-1 weight loss medications can be several hundred dollars per month.
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Ozempic (Semaglutide 0.5mg / 1mg)
PBS status: Listed for type 2 diabetes management.
If your doctor prescribes Ozempic primarily to treat your type 2 diabetes, you pay the standard PBS co-payment:
- General patients: ~$31.60 per pen
- Concession card holders: ~$7.70 per pen
If you do not have type 2 diabetes and are seeking Ozempic purely for weight management, it cannot be prescribed under the PBS. You would pay full private price (~$130–$160 per pen, approximately 4 weeks' supply at the lower doses used for weight management).
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Wegovy (Semaglutide 2.4mg)
PBS status: Not listed. Private prescription only.
Wegovy is the higher-dose formulation of semaglutide specifically approved for chronic weight management. It is not PBS-subsidised for any indication in Australia as of 2026.
Approximate cost: $260–$380 per month (4 pens).
Wegovy achieved an average of 15–17% weight loss in clinical trials — one of the most effective medications available for weight management.
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Mounjaro (Tirzepatide)
PBS status: Not listed for weight management. As of mid-2026, tirzepatide is being reviewed by the TGA for weight management indication.
Mounjaro works on both GLP-1 and GIP receptors (dual agonist), making it more potent than semaglutide alone. Clinical trials show an average of 20–22% weight loss at the highest doses — the best results seen from any approved weight loss medication to date.
Approximate cost: $300–$700 per month depending on dose.
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What *Is* Covered by Medicare?
Even though the medications themselves are not subsidised, several related costs attract a Medicare rebate:
| Item | Medicare rebate? |
|---|---|
| GP consultation | Yes — partial rebate applies |
| Blood tests ordered by GP | Yes — most standard tests |
| Mental Health Treatment Plan | Yes |
| Chronic Disease Management Plan | Yes (if eligible) |
| Medications (Ozempic for T2DM) | Yes — PBS co-payment only |
| Wegovy / Mounjaro | No |
Chronic Disease Management Plans (CDM)
If you have obesity alongside a chronic condition such as type 2 diabetes, hypertension, or sleep apnoea, you may be eligible for a Chronic Disease Management (CDM) plan (previously called a GP Management Plan). This allows Medicare to subsidise up to 5 allied health visits per year — including dietitian and exercise physiology appointments — which are a key part of a comprehensive weight management program.
Ask Dr Chong whether you qualify for a CDM plan at your first consultation.
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How Much Will My Consultation Cost?
At Knox General Practice and Family Medicine, Bayswater, bulk billing is available for eligible patients (children under 16, concession card holders). For other patients, a standard consultation attracts a Medicare rebate of approximately $42–$122 depending on the length of your appointment.
At Medi Weight Loss, Bayswater, all consultations are private (no bulk billing), but your Medicare card still provides a partial rebate on the day.
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Will Ozempic or Mounjaro Ever Be PBS-Listed for Weight Loss?
This is possible in the future. The TGA has approved semaglutide (Wegovy) for weight management, and the Pharmaceutical Benefits Advisory Committee (PBAC) periodically reviews new applications. Several comparable medications have been listed for other indications overseas.
However, PBS listing for weight management in Australia has been historically slow and politically complex, given the potential cost to the healthcare budget. There is no confirmed timeline.
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What Should I Do?
If cost is a concern — and it often is — the most important thing is to have an honest conversation with Dr Chong at your first consultation. He will:
- Assess whether you have a diagnosis that makes you eligible for PBS-subsidised medications
- Recommend the most cost-effective treatment option for your situation
- Discuss the real monthly costs before prescribing anything
- Explore all available Medicare rebates and CDM plan eligibility
Weight management care does not have to mean spending hundreds of dollars every month. Many patients achieve excellent results with a combination of dietary guidance, lifestyle changes, and — where appropriate — carefully chosen pharmacotherapy.
Book a consultation at Medi Weight Loss, Bayswater or Knox General Practice by calling (03) 9967 1996 or booking online via HotDoc.
Ready to take the next step?
Book a consultation with Dr Chun Guan Chong at Knox General Practice or Medi Weight Loss, Bayswater.