Contents
List Prices — All Major GLP-1 Drugs (2026)
No Insurance
~$935
/month
Ozempic (semaglutide)
No Insurance
~$1,349
/month
Wegovy (semaglutide 2.4mg)
No Insurance
~$1,023
/month
Mounjaro (tirzepatide)
No Insurance
~$1,060
/month
Zepbound pen
Self-Pay Vials ★
~$399
/month (2.5–7.5mg)
Zepbound vials — LillyDirect
No Insurance
~$650
/month
Saxenda (liraglutide daily)
💡 These are US list prices. Zepbound vials via LillyDirect are currently the most affordable FDA-approved GLP-1 option for self-pay patients — and tirzepatide also produces the most weight loss.
Insurance Coverage
What Determines Coverage
- Diagnosis matters most: Ozempic and Mounjaro are covered for type 2 diabetes. Wegovy and Zepbound are covered for obesity/overweight diagnoses. Mismatch is a top denial reason.
- Formulary tier: GLP-1s typically land on Tier 3–4 (specialty drugs), meaning 25–40% coinsurance — usually $50–$200/month after your deductible is met
- Prior authorization: Almost always required — your doctor documents your diagnosis, BMI, comorbidities, and clinical necessity
- Step therapy: Some plans require trying a cheaper drug first before approving a GLP-1
- Deductible timing: Before your deductible is met, you may owe full list price
How to Check Your Coverage
- Call member services on your insurance card and ask: "Does my plan cover [drug name] for [diabetes/obesity]? What tier? What is my cost share after deductible?"
- Ask your doctor's office to run a benefits verification before prescribing — most offices do this routinely
- Check your insurer's online formulary tool using your specific plan ID
If Insurance Denies Coverage
- Appeal the denial — first-level appeals succeed ~30–40% of the time with strong physician documentation
- Request a peer-to-peer review — your doctor speaks directly with the insurance medical director, resolving many denials
- File a medical necessity exception if you have documented obesity-related comorbidities
- Involve your HR department if you're on an employer plan — employers can sometimes negotiate exceptions for chronic disease management
Manufacturer Savings Cards
Both Novo Nordisk and Eli Lilly offer savings programs that can dramatically reduce out-of-pocket costs. These are only for commercially insured patients — not Medicare, Medicaid, or uninsured.
Novo Nordisk NovoCare Ozempic & Wegovy
For eligible commercially insured patients:
- Ozempic: as low as $25/month (up to $150 savings per fill)
- Wegovy: as low as $0/month (up to $225 savings per fill)
- Apply at novonordisk-us.com or activate through your pharmacy
- Must have commercial insurance that covers the drug, even partially
Eli Lilly Savings Card Mounjaro & Zepbound
- Mounjaro: as low as $25/month
- Zepbound autoinjector: as low as $25/month
- Apply at lillysavings.com or through your pharmacy
- Must have commercial (non-government) insurance
⚠️ Manufacturer savings cards cannot legally be used with Medicare, Medicaid, TRICARE, or any federal healthcare program. Using them with government insurance is illegal and can be considered fraud.
Medicare & Medicaid
Medicare Part D
- For diabetes (Ozempic/Mounjaro): Generally covered under Part D for type 2 diabetes, though formulary placement and cost-sharing vary by plan
- For obesity (Wegovy/Zepbound): The Inflation Reduction Act expanded Part D coverage for anti-obesity medications — check your specific plan's formulary
- Extra Help / Low Income Subsidy: If you qualify, your cost-sharing can be reduced to minimal or zero copays
- The $2,000 annual out-of-pocket cap (effective 2025) helps Medicare patients with high-cost specialty drugs
Medicaid
Medicaid coverage varies significantly by state. Most states cover Ozempic/Mounjaro for type 2 diabetes. Coverage for Wegovy/Zepbound for obesity is more variable. Contact your state Medicaid office directly to verify current formulary status.
Self-Pay Options
Zepbound Vials via LillyDirect Best Value — Self-Pay
Eli Lilly's direct-to-consumer vial program is the most affordable FDA-approved GLP-1 option for self-pay patients:
- 2.5mg and 5mg vials: ~$349/month
- 7.5mg and 10mg vials: ~$499/month
- 12.5mg and 15mg vials: ~$549/month
- Requires a valid prescription — obtainable via telehealth
- Available at lillydirect.com
- Same tirzepatide as the autoinjector pen — requires a separate syringe for injection
GoodRx & Discount Cards Modest Savings
- Ozempic via GoodRx: ~$800–$900/month at select pharmacies
- Cannot be combined with insurance or manufacturer savings cards
- Best used when no insurance is available and LillyDirect isn't an option
Telehealth Prescribers Access Without a GP
Services like Hims & Hers, Ro, and LifeMD can prescribe GLP-1 medications online:
- Useful if you don't have a primary care doctor or face long appointment waits
- Some bundle consultation + drug in a monthly subscription (~$150–$400/month)
- Some offer compounded semaglutide — verify legality and pharmacy registration
Patient Assistance Programs
Novo Nordisk Patient Assistance Program Uninsured / Low Income
For uninsured or underinsured patients who meet income requirements:
- Free or reduced-cost Ozempic or Wegovy for eligible patients
- Income eligibility: typically up to 400% of the federal poverty level
- Apply at novonordisk-us.com or call 1-866-310-7549
- Requires proof of income and a prescription from a licensed provider
Eli Lilly Insulin & Medicines Program Uninsured / Low Income
- Free Mounjaro or Zepbound for eligible uninsured or underinsured patients
- Apply at lilly.com/medicines-assistance or call 1-800-545-5979
- Income and residency requirements apply
NeedyMeds & RxAssist Aggregator Resources
- NeedyMeds.org and RxAssist.org list all available patient assistance programs by drug name
- Useful for finding state-level programs and additional manufacturer assistance
Navigating Prior Authorization
Prior authorization (PA) is the biggest insurance hurdle for GLP-1 medications. Here's how to maximize approval chances:
What Your Doctor Needs to Submit
- Your diagnosis code (E11.x for type 2 diabetes, E66.x for obesity)
- Your BMI and weight history
- Documentation of weight-related comorbidities (hypertension, sleep apnea, dyslipidemia, etc.)
- Prior treatment history — what dietary and lifestyle interventions have been tried
- Clinical rationale for why this specific medication is medically necessary
Timelines and Next Steps
- Standard PA: decision within 3–5 business days
- Urgent PA: decision within 24–72 hours if medically urgent
- If denied: request the denial reason in writing — this is legally required
- File first-level appeal within 30–60 days of denial
- If first appeal fails: request external independent review
💡 The most common PA denial reasons are: wrong diagnosis code, insufficient documentation of comorbidities, and step therapy not completed. Addressing all three in the initial submission dramatically increases first-attempt approval rates.
Compounded GLP-1 Medications
During the FDA-declared shortage of semaglutide (2022–early 2025), licensed compounding pharmacies were legally permitted to produce compounded semaglutide. This created a large market of telehealth companies offering significantly cheaper compounded versions.
⚠️ Important 2025 update: The FDA declared the semaglutide shortage resolved in early 2025, which significantly changed the legal landscape for compounded semaglutide. Always verify current legal status before using compounded GLP-1 products.
What to Know If You're Considering Compounded GLP-1
- Verify the pharmacy: Only use FDA-registered 503B outsourcing facilities — never unlicensed online sources
- Quality variance: Compounded drugs are not FDA-approved and may have inconsistent dosing accuracy
- Watch for additives: Some compounders add ingredients (B12, NAD+) with unproven benefits and unknown interaction profiles
- No manufacturer savings cards: Savings programs only apply to branded FDA-approved drugs
- Legal risk: The legal status of compounded semaglutide post-shortage is actively contested — regulatory updates occur frequently
Your Strategy by Situation
| Your Situation | Best Strategy | Est. Monthly Cost |
|---|---|---|
| Commercial insurance, diabetes diagnosis | Ozempic/Mounjaro + savings card | $25–$150 |
| Commercial insurance, obesity diagnosis | Wegovy/Zepbound + savings card | $0–$200 |
| Medicare, diabetes | Ozempic/Mounjaro Part D coverage | Varies by plan |
| Medicare, obesity | Wegovy/Zepbound Part D (if covered) | Varies by plan |
| No insurance, can self-pay | Zepbound vials via LillyDirect | $349–$549 |
| No insurance, low income | Patient assistance program | Free or minimal |
| Insurance denied, appealing | Appeal + peer-to-peer + use savings card while waiting | $25–$200 |
Frequently Asked Questions
Ozempic lists at approximately $935/month without insurance. With commercial insurance for diabetes, costs typically fall to $25–$150/month. Novo Nordisk's NovoCare savings card reduces costs to as low as $25/month for eligible commercially insured patients.
Coverage varies significantly by insurer and plan. Many commercial plans cover Wegovy for obesity (BMI ≥30) or overweight with a weight-related comorbidity. Prior authorization is almost always required. Novo Nordisk's savings program can bring monthly costs to $0 for eligible commercially insured patients.
Zepbound's autoinjector pen lists at approximately $1,060/month. However, Eli Lilly's single-dose vial program via LillyDirect offers Zepbound for $349–$549/month depending on dose — making it the most affordable branded GLP-1 option for self-pay patients.
Yes — if you meet income and eligibility requirements. Novo Nordisk's patient assistance program provides free Ozempic or Wegovy to uninsured patients below ~400% of the federal poverty level. Eli Lilly's program offers similar assistance for Mounjaro and Zepbound.
The legal status changed significantly when the FDA declared the semaglutide shortage resolved in early 2025. Always verify current regulations before using compounded products. If you do use compounded GLP-1, only source from FDA-registered 503B outsourcing facilities and be aware that quality control standards differ from FDA-approved branded products.