GLP-1 Insurance & Cost Guide: How to Actually Afford These Medications

The Reality: List Prices

Wegovy / Ozempic

$1,000-1,400

per month

Mounjaro / Zepbound

$1,000-1,100

per month

Nobody pays list price if they can help it. Here are the strategies that actually work to make these medications affordable.

Getting Insurance Coverage

1 Check Your Formulary First

Call your insurance or check their online formulary. Look for:

Is any GLP-1 covered at all?
Which tier is it on? (Lower tier = lower copay)
Is prior authorization required?
Are there step therapy requirements?

Pro Tip

Diabetes medications (Ozempic, Mounjaro) often have better coverage than weight loss versions (Wegovy, Zepbound). If you have type 2 diabetes or prediabetes, the diabetes indication may be covered.

2 Prior Authorization Success

Most insurers require prior authorization. To improve approval odds:

Document BMI ≥30, or BMI ≥27 with comorbidity (diabetes, hypertension, sleep apnea)
Show failed attempts at diet and exercise
List obesity-related conditions that could improve
Have your doctor write a detailed letter of medical necessity

If Denied

Appeal. First-level denials are often overturned. Ask your doctor's office to help with the appeal—they do this regularly.

3 Manufacturer Savings Programs

Both Novo Nordisk and Eli Lilly offer savings cards:

Program	For	Savings	Eligibility
Novo Nordisk Savings	Wegovy, Ozempic	Pay as little as $0-25	Commercial insurance
Lilly Savings Card	Mounjaro, Zepbound	Pay as little as $25	Commercial insurance

Important Limitation

These programs do NOT work with Medicare, Medicaid, or other government insurance. They're for commercially insured patients only.

When Insurance Says No

4 Compounding Pharmacies

Compounding pharmacies produce semaglutide and tirzepatide at significantly lower prices:

Semaglutide: $150-300/month
Tirzepatide: $250-500/month

Considerations

Not FDA-approved products. Quality varies by pharmacy. Regulatory status is evolving. Research the pharmacy's accreditation and reputation.

5 Telehealth Providers

Many telehealth platforms partner with compounding pharmacies to offer bundled pricing that includes consultation, medication, and ongoing support. Prices typically range from $200-500/month all-in.

6 Patient Assistance Programs

For uninsured or underinsured patients, manufacturers offer assistance:

Income requirements typically apply (usually <400% federal poverty level)
Can provide medication free or at reduced cost
Apply through manufacturer websites or NeedyMeds.org

Medicare and Medicaid

Coverage for weight loss medications under government programs has been limited, but is evolving:

Medicare: As of 2024, Medicare can cover obesity drugs through Part D, but coverage decisions vary by plan. Check your specific plan.
Medicaid: Varies dramatically by state. Some states cover, most don't for weight loss indication.
Diabetes indication: Coverage is better when prescribed for type 2 diabetes.

The Bottom Line

GLP-1 medications have $1,000+/month list prices, but most people pay significantly less. Strategies: check formulary, complete prior authorization properly, use manufacturer savings cards (commercial insurance), appeal denials, consider compounding pharmacies, or explore telehealth bundles. The access landscape is constantly changing—what's unavailable today may be covered tomorrow. Don't give up after one rejection.

Sources

Manufacturer pricing and savings program information.
Insurance industry coverage policies.
Medicare and Medicaid coverage updates 2024-2025.