GLP‑1 Weight‑Loss Costs: Insurance, Coupons, and Out‑of‑Pocket Pricing

Key takeaways

• Sticker prices hover around four figures per month, but manufacturer self-pay programs can be materially lower for some products. Coverage varies widely across employer and marketplace plans.
   

• Medicare Part D may cover Wegovy for cardiovascular risk reduction in patients with established CVD and obesity/overweight; Part D generally does not cover drugs solely for weight loss.
   

1) What you might pay without insurance
 

Uninsured or excluded plans often see cash prices near or above ~$1,000/month for branded autoinjectors, though discounted vial programs and cash‑pay options can reduce this. For example, Lilly’s Zepbound Self Pay program offers single‑dose vials for $499/month or less, depending on dose and channel. Novo Nordisk has publicized $499 cash‑pay options via select channels for Wegovy and later Ozempic; details and availability can change. Always confirm current terms.
 

2) If you have commercial insurance
 

• Prior authorization is common. Plans may require a BMI threshold and documentation of a weight‑related condition for obesity indications.
   

• Co‑pays vary; some plans exclude anti‑obesity meds entirely, while others cover Wegovy/Zepbound with step edits.
   

• Savings cards: If your plan covers the drug, manufacturer savings cards can lower monthly out‑of‑pocket amounts (restrictions apply). Example: Mounjaro’s savings card for eligible commercially insured patients.
  
   

3) Medicare and Medicaid
 

In March 2024, the FDA added a new cardiovascular risk‑reduction indication to Wegovy. CMS guidance opened a pathway for Medicare Part D plans to cover Wegovy for that specific indication (not for weight loss alone). Coverage decisions still vary by plan and are evolving. State Medicaid programs may make their own determinations. Check your plan’s formulary and criteria.
 

4) Telehealth packages and total cost of care
 

Telehealth visits, lab work, and follow‑ups may be billed separately or bundled. When comparing offers, total everything: consults, the drug, needles or pens, shipping, and required follow‑ups.
 

5) Ways to lower costs
 

• Verify indications that your plan covers (e.g., Wegovy for CVD risk reduction if you qualify).
   

• Use manufacturer programs when eligible.
   

• Avoid unapproved compounded products sold online; FDA has warned about safety and dosing errors. Counterfeits have also been found in the supply chain. Buy only from licensed pharmacies.
  
   

Where to go next
 

• Compare drugs head‑to‑head
   

• See telehealth and pharmacy safety steps
   

Not medical or insurance advice. Confirm coverage and pricing with your plan and pharmacy.