Is Ozempic covered by insurance? When it is reimbursed and when it is not

Medically suitable: BMI, health and the doctor's assessment

GLP-1 medication for weight management is intended for adults with a BMI of 30 or higher, or of 27 or higher with a weight-related condition such as high blood pressure, sleep apnoea or impaired blood sugar. That is the threshold from the registration of the medications for weight management. Below that threshold, a doctor does not prescribe GLP-1 medication for weight loss.

BMI is only the first step. The doctor also looks at contraindications: pregnancy or a wish to have children, previous pancreatitis, severe kidney or liver problems, an eating disorder or medullary thyroid cancer in the family. Your use of medicines, your previous attempts to lose weight and your motivation are also taken into account.

So the doctor assesses whether medical weight loss suits you on an individual basis. A BMI above 30 is not an automatic yes, and a BMI of 28 with a condition is not an automatic no.

When does health insurance cover Ozempic?

Basic health insurance only reimburses Ozempic for type 2 diabetes, and even then under the conditions of Annex 2 (bijlage 2) of the Regeling zorgverzekering (the Dutch health insurance regulations). According to the 2018 advice of Zorginstituut Nederland (the Dutch National Health Care Institute), this concerns adults with type 2 diabetes and a BMI of 30 or higher whose blood sugar is insufficiently controlled with metformin and a sulphonylurea at the highest tolerated dose, and who do not use insulin. The second route: as an addition to metformin and basal insulin, after at least 3 months of optimally adjusted insulin without sufficient results.

Your doctor fills in a doctor's statement (artsenverklaring). The pharmacy checks it and then supplies Ozempic at the insurer's expense. The amount counts towards your compulsory deductible (eigen risico), which is €385 per year in 2026.

If you do not meet all the conditions, the insurer reimburses nothing, not even partly. Supplementary insurance does not cover Ozempic either.

Reimbursement per insurer: VGZ, Zilveren Kruis, Menzis and CZ

The reimbursement conditions for Ozempic are set nationally in Annex 2 and are therefore the same at every insurer. VGZ, Zilveren Kruis, Menzis and CZ apply the same rule: type 2 diabetes, aged 18 or over, BMI 30 or higher, insufficiently controlled blood sugar and a doctor's statement. None of them reimburses Ozempic or Wegovy for weight loss.

Differences between insurers are not in the conditions but in the practical handling: which form the doctor fills in and whether a preferred brand applies. Ask your pharmacy about this. So if you search for "Ozempic reimbursement VGZ" or "Ozempic reimbursement Menzis", the answer is the same as above.

Why is Ozempic not reimbursed for weight loss?

According to the European Medicines Agency (EMA), Ozempic is registered exclusively for the treatment of type 2 diabetes. Weight loss is a side effect, not an indication. For weight management there is a separate brand with the same active substance, semaglutide: Wegovy. An insurer only reimburses a medication for the indication for which it is registered and which is included in the reimbursement system.

Wegovy itself is not in the basic package. The Zorginstituut's advice on Wegovy of 16 July 2024 was: do not include it. The Zorginstituut acknowledges that the medication lowers weight, but finds research lacking on the long-term health effects and on safe tapering off, and points to a possible cost of up to €1.3 billion per year. The minister adopted that advice.

As long as that decision stands, there is no reimbursed semaglutide for weight loss. You can read more about the current situation in our article on Wegovy insurance coverage. Read more about Ozempic teeth problems.

Tried all sorts of things and want to know whether medication under a doctor's supervision is something for you? Read how medical weight loss with injections works with us →

Can your GP prescribe Ozempic?

A GP (huisarts) may prescribe Ozempic, but rarely does so for weight loss. Since the revised NHG guideline on obesity (NHG-Standaard Obesitas, October 2025), the Nederlands Huisartsen Genootschap (NHG) (the Dutch College of General Practitioners) classes the prescribing of weight-reducing medication as "additional care": optional, not basic care. GPs who do prescribe it follow the guideline: a BMI of 40 or higher, or 35 or higher with a weight-related condition, and only after a year of taking part in a recognised combined lifestyle intervention (gecombineerde leefstijlinterventie, GLI).

For Ozempic specifically, its use for weight loss is also off-label. The NHG states that semaglutide is not reimbursed for obesity and advises GPs to point this out to patients who want to pay for it themselves.

With type 2 diabetes, things are different. There, the GP or practice nurse (praktijkondersteuner) can prescribe Ozempic as part of diabetes treatment, and the reimbursement conditions above then apply. What your GP can and cannot do for weight loss is in our article on weight loss medication from your GP.

Not reimbursed: what are your options?

If Ozempic is not reimbursed for you, you have three options: a reimbursed route without semaglutide, paying yourself within a medical programme, or working on your lifestyle first.

• Reimbursed alternatives. The combined lifestyle intervention (GLI) is in the basic package. Liraglutide (Saxenda) and naltrexone/bupropion (Mysimba) are reimbursed under strict conditions, including with a high BMI after a year of GLI. The conditions are in our article on weight loss medication covered by insurance and, per insurer, in Saxenda insurance coverage.
• Paying yourself in a supervised programme. A doctor assesses whether medical weight loss suits you and writes the prescription, and a recognised Dutch pharmacy supplies the medication. This is how medical weight loss with injections works with us, with your own BIG-registered doctor (the BIG register is the Dutch register of healthcare professionals) whom you speak to every 4 weeks.
• Buying without a prescription is not an option. Web shops and private individuals who sell Ozempic without a prescription are acting illegally and regularly supply counterfeits. How the legal route works is in our article on how to buy Ozempic.

What does Ozempic cost if you pay yourself?

At the pharmacy, Ozempic costs €105.59 to €184.34 per pen, depending on the dosage (medicijnkosten.nl and Farmacotherapeutisch Kompas, July 2026). One pen contains four weekly doses. On top of that come the pharmacy's dispensing fees (terhandstellingskosten) and the cost of the doctor.

With us, a programme with semaglutide (Ozempic) costs €250 per month, plus a one-off support fee of €400. This includes the medication, home delivery and support from your own doctor. The full calculation per dosage and per year is in our article on the Ozempic price.

Would you like to know whether medical weight loss is right for you? Take the eligibility check and the doctor will assess your situation →

Frequently asked questions about Ozempic insurance coverage

How high does your BMI need to be for Ozempic?

For reimbursement with type 2 diabetes, a BMI of 30 or higher applies. For weight management with GLP-1 medication, the medical threshold is a BMI of 30 or higher, or 27 or higher with a weight-related condition. The doctor assesses whether the medication suits you.

Why is Ozempic not reimbursed?

Ozempic is only registered for type 2 diabetes, not for weight loss. The brand for weight management, Wegovy, has not been in the basic package since the Zorginstituut's advice of July 2024. As a result, there is no reimbursed semaglutide for weight loss.

How do I get Ozempic reimbursed?

Only with type 2 diabetes with a BMI of 30 or higher and insufficiently controlled blood sugar despite metformin and a sulphonylurea, or alongside basal insulin. Your doctor fills in a doctor's statement, which the pharmacy checks. Your deductible (eigen risico) applies.

How much does Ozempic cost if you have to pay for it yourself?

At the pharmacy, €105.59 to €184.34 per pen, depending on the dosage (July 2026), plus pharmacy and doctor's fees. With us, a programme with semaglutide (Ozempic) costs €250 per month, plus a one-off support fee of €400.

Can my GP prescribe Ozempic?

Yes, but for weight loss, according to the NHG, this falls under optional additional care and not under basic care. GPs who do it follow the NHG guideline on obesity: a high BMI and first a year of GLI. With type 2 diabetes, the GP can prescribe Ozempic as part of diabetes treatment.

Do VGZ, Zilveren Kruis or Menzis reimburse Ozempic for weight loss?

No. No Dutch insurer reimburses Ozempic or Wegovy for weight loss. Reimbursement for type 2 diabetes is arranged nationally and is the same at VGZ, Zilveren Kruis, Menzis and CZ.

Can I buy Ozempic without reimbursement?

Yes, with a prescription from a doctor, at a recognised Dutch pharmacy. You then pay for the medication yourself. Without a prescription, Ozempic cannot be obtained legally.

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