GLP-1 Costs & How to Get Coverage

Here's what these medications cost without any discounts or insurance:

Semaglutide:

• Ozempic (0.25mg-2mg): ~$900-1,000/month
• Wegovy (0.25mg-2.4mg): ~$1,300-1,400/month
• Rybelsus (oral): ~$900-1,000/month

Tirzepatide:

• Mounjaro (2.5mg-15mg): ~$1,000-1,100/month
• Zepbound (2.5mg-15mg): ~$1,000-1,100/month

Yes, these prices are shocking. Yes, they're higher than in other countries. That's the US pharmaceutical market for you. But don't close this page yet—there are real options to bring these costs down.

If your insurance covers GLP-1s for weight loss, this is your best option. Copays typically range from $25-100/month.

The challenge: Many insurers don't cover weight loss medications, or have strict requirements. Coverage is improving but still inconsistent.

What helps your case:

• BMI over 30 (or over 27 with weight-related conditions)
• Documented history of weight-related health issues (type 2 diabetes, hypertension, sleep apnea, etc.)
• Previous attempts at diet/exercise without lasting success
• Prior authorization from your doctor (almost always required)

Insurance types that more often cover GLP-1s:

• Employer plans (especially large companies)
• Some state employee health plans
• Medicare Part D (for diabetes indication, not weight loss)
• Some Medicaid programs (varies by state)

How to check your coverage:

1. Call the number on your insurance card
2. Ask specifically about Wegovy and Zepbound (the weight loss versions)
3. Ask about prior authorization requirements
4. Get it in writing if possible

Here's a reality of the current system: Ozempic and Mounjaro (the diabetes versions) are often covered when Wegovy and Zepbound (the weight loss versions) are not.

They contain the exact same medications—just branded and priced differently.

If you have type 2 diabetes or prediabetes: Your doctor may be able to prescribe Ozempic or Mounjaro "on-label" for your diabetes, with weight loss as a beneficial side effect. Insurance is much more likely to cover this.

If you don't have diabetes: Some doctors prescribe Ozempic "off-label" for weight loss if Wegovy coverage is denied. The medication is the same (though Ozempic's max dose is 2mg vs. Wegovy's 2.4mg).

Important considerations:

• Not all insurers cover off-label use
• This approach is common and legal, but you should discuss it honestly with your doctor
• The diabetes versions sometimes have different (often better) coverage

The drug companies offer savings cards that can significantly reduce costs—but there are catches.

Novo Nordisk (Ozempic/Wegovy):

• Savings cards available that can bring copays down to $25
• Eligibility: Commercial insurance only (no Medicare/Medicaid)
• Usually caps at $150-200/month in savings
• Visit NovoCare.com for current offers

Eli Lilly (Mounjaro/Zepbound):

• Lilly offers savings cards for eligible patients
• Can bring costs to $25 for insured patients
• Cash-pay programs sometimes available
• Visit Mounjaro.com or Zepbound.com

The fine print:

• These programs change frequently—check current offers
• Government insurance programs (Medicare, Medicaid, VA) are excluded
• Some programs have income requirements
• Most savings cards expire after 12-24 months

A new industry has emerged: telehealth companies that provide GLP-1 prescriptions and medication access as a bundle. Here's how they work:

How it works:

1. You sign up and complete a health questionnaire
2. A licensed provider reviews your case and prescribes if appropriate
3. Medication is shipped to your door (usually compounded versions)
4. You pay a monthly fee that includes everything

Typical pricing:

• Compounded semaglutide: $200-500/month (all-in)
• Sometimes includes consultations, supplies, support
• Pricing varies by dose and provider

Notable telehealth options:

• Ro, Hims/Hers, Calibrate, Found, Sequence
• Each has different pricing, approaches, and medication sources
• Research current reviews before choosing

Pros:

• Much lower cost than brand-name
• Convenient—everything handled online
• No insurance hassles

Cons:

• Usually compounded medications (see next section)
• Quality varies by provider
• Less personalized care than in-person doctor

Compounding pharmacies can legally produce semaglutide while brand-name versions are on the FDA shortage list. This is the most affordable option for many people.

What is compounding?

Compounding pharmacies mix medications from raw ingredients. When a brand-name drug is in shortage, they can create equivalent formulations. Compounded semaglutide contains the same active ingredient as Ozempic/Wegovy.

Typical costs:

• $150-400/month depending on dose and pharmacy
• Some telehealth programs bundle this at $200-500/month
• Significantly cheaper than brand-name

Important considerations:

• Quality varies between compounding pharmacies
• Look for 503B-registered pharmacies (held to higher standards)
• Ask for certificates of analysis (COA) showing purity
• The FDA has warned about some low-quality compounders
• Compounded tirzepatide is less common and potentially riskier

Legal status: Compounded semaglutide is legal while semaglutide is on the FDA drug shortage list. If/when shortages resolve, this could change. It's a legitimate but somewhat uncertain option.

Some people purchase GLP-1s from other countries where prices are lower. This is a gray area.

The reality:

• Technically illegal to import prescription medications for personal use
• FDA generally doesn't pursue individuals importing 90-day supplies
• Risk of counterfeit or improperly stored medications
• No recourse if something goes wrong

If you're considering this:

• Use established, verified international pharmacies only
• Avoid anything that seems too cheap
• Check that medications are properly refrigerated during shipping
• Understand you're accepting additional risk

We're not recommending this option, but we acknowledge people do it. If you go this route, be extremely careful about sourcing.

Here's how to think through your options:

Step 1: Check your insurance thoroughly

• Call and confirm coverage for both Wegovy/Zepbound and Ozempic/Mounjaro
• Understand prior authorization requirements
• Know your copay/coinsurance amounts

Step 2: Apply for manufacturer savings

• Even with insurance, savings cards can reduce costs further
• Check current programs on manufacturer websites

Step 3: Consider telehealth/compounding if needed

• If insurance doesn't cover or you don't have insurance
• Research providers carefully
• Prioritize quality over lowest price

Step 4: Budget realistically

• GLP-1s work best as long-term medications
• Consider if you can sustain the cost for years
• Factor in food cost reduction (you'll eat less)

The GLP-1 market is evolving rapidly:

Generic semaglutide:

• Patent expiration in 2031-2033 (depending on formulation)
• Generic versions could drop prices by 80%+
• But that's years away

Insurance coverage trends:

• More employers are adding GLP-1 coverage
• State legislatures are pushing for obesity treatment coverage
• Medicare coverage is being debated
• Trend is toward better coverage, but slowly

New medications coming:

• Oral GLP-1s may be cheaper to produce
• New competitors could drive prices down
• Combination drugs in development

If you're on the fence because of cost, know that access will likely improve over the next few years. But if you need the medication now, the options above are your current best bets.

GLP-1 medications are expensive at list price, but most people don't pay list price. Your realistic options:

• Best case ($25-100/month): Insurance covers it with manufacturer savings card
• Good case ($200-500/month): Compounded semaglutide through telehealth or local pharmacy
• Expensive case ($900-1,400/month): Brand-name, no insurance, no savings

Start by exhausting insurance options—even if you're initially denied, appeals often work. If insurance isn't viable, compounded semaglutide through a reputable source is a reasonable alternative for many people.

Don't let cost stop you from exploring options. But also be realistic about what you can sustain long-term—these medications work best when you can take them consistently.