Ozempic, Wegovy and other GLP-1 drugs have become widely used medications, but those hoping to use them may encounter significant costs. Insurance coverage varies for these drugs, and even with coverage, patients may still face copays or coinsurance. Here’s what to know about pricing and insurance.
What These Drugs Cost
Ozempic carries a list price exceeding $1,000. However, patients with Type 2 diabetes may obtain insurance coverage. With insurance, costs vary by plan, with copays typically ranging from $25 to $50.
Wegovy and Zepbound are FDA-approved for weight management. Wegovy’s list price exceeds $1,300 for a 28-day supply, though insurance can reduce monthly costs to as little as $25. Zepbound lists for up to $1,086 for a 28-day supply, with similar insurance reductions possible.
Monthly medication costs represent only part of the total expense. Doctor visits, lab work, and other associated costs add to the overall bill. Additionally, prices are subject to change. List prices for Ozempic and Wegovy are expected to decrease by up to 50% next year, potentially making them more accessible for insured patients.
Insurance Considerations
Insurance coverage for GLP-1 drugs varies significantly. Some medications are covered only for diabetes, while others qualify for weight management coverage. Coverage depends on the drug’s tier and whether prior authorization is required.
Plan details also determine patient costs, including deductible requirements and copay structures. This variability affects public programs as well. The Centers for Medicare & Medicaid Services recently indicated broader GLP-1 access for weight loss could begin in Medicaid as early as May and in Medicare Part D in January 2027, under its BALANCE Model.
Patients should review annual costs to determine if their budget can accommodate these medications. Tax-advantaged accounts like flexible savings accounts and health savings accounts can help offset expenses. When starting these drugs, plan for ongoing monthly payments rather than basing financial decisions on first prescription costs alone.