How much do weight loss drugs cost with & without insurance?
The Cost of Weight Loss Drugs With and Without Insurance
Just like when you find a glitzy resort in your dream destination, your first question about weight loss drugs might be, How much is this going to set me back? Lucky for you, we’ve done our homework.
The cost of GLP-1 weight loss drugs varies depending on which type of weight loss drug you get and where you get it from. You may be eligible for insurance coverage or manufacturer savings programs to reduce your out-of-pocket costs.
Below, we’ll dive into how much different drugs cost and the more affordable weight loss medications to consider.
This article was reviewed by Craig Primack, MD, FACP, FAAP, FOMA.
Image Credit: Carolina Rudah/istockphoto.
Are Weight Loss Drugs Covered by Insurance?
Weight loss drugs aren’t usually covered by insurance, but it’s always worth checking your plan.
Still, coverage is evolving: some large employers and private insurers are beginning to cover GLP-1s for weight management, but access is limited and inconsistent.
If your plan does cover weight loss medications, you may have to meet some criteria.
This could include having a body mass index (BMI) above a certain amount or having a weight-related health condition — like high cholesterol, high blood pressure, or type 2 diabetes.
You may be able to get diabetes drugs — like Ozempic® and Mounjaro® — covered if you have type 2 diabetes. But it’s unlikely you’ll get these drugs covered if they’re prescribed off-label for weight loss.
We can’t speak for insurance providers, but some of them see weight loss as a cosmetic issue and therefore don’t offer coverage for weight loss medications.
Additionally, appeals or prior authorizations are often required.
We dive into other reasons weight loss drugs aren’t covered by insurance here.
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Do Medicaid and Medicare Cover Weight Loss Drugs?
Medicare doesn’t usually cover weight loss drugs. But Medicare coverage may change in the future as legislation and obesity treatment guidelines evolve.
Medicaid covers some weight loss drugs in some states, though.
For example, Medicaid doesn’t currently cover Zepbound®, but it does cover Wegovy® in some states. If eligible, you could get Wegovy® for $3 or less.
Check Wegovy ® ’s website or your state’s Medicaid website to find out if you can get insurance coverage.
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The Cost of Weight Loss Medications without Insurance
The cost of GLP-1 weight loss drugs ranges from about $165 to $2,000 per month, depending on which type of weight loss drug you get and where you get it from. You may be eligible for insurance coverage or manufacturer savings programs to reduce your out-of-pocket costs.
We’ve broken down the list price given by each drug’s manufacturer and the price you can expect to find from pharmacies and telehealth companies to help give you a more specific idea.
Note that many pharmacies and telehealth providers offer subscription models that may slightly reduce costs. And additional costs may include provider visits, lab tests, or follow-ups.
Image Credit: Carolina Rudah/istockphoto.
Drug List Prices
Ozempic®
The list price is $968.52 per month. In pharmacies and online, costs range from about $900 to $1,800 a month.
Wegovy®
The list price is $1,349.02 a month. In pharmacies and online, costs range from about $1,300 to $2,000 a month.
Rybelsus®
The list price is $968.52 a month. Costs range from about $950 to $1,080 a month in pharmacies and online.
Mounjaro®
The list price is $1,069.08 per month. Costs range from about $1,000 to $1,100 a month in pharmacies and online.
Zepbound®
The list price is $1,059.87. Costs range from about $1,000 to $1,100 a month in pharmacies and online.
There are, of course, more weight loss drugs than this. Prices vary here too.
Keep in mind that weight loss drugs are prescription drugs, so you’ll need to connect with a healthcare provider to get them. If you don’t have health insurance, you may have to pay for this consultation too.
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The Cost of Compounded vs. Brand Name Weight Loss Drugs
You might have noticed that compounded GLP-1s are the cheapest weight loss injection option— and there’s quite a dramatic drop in price. Here’s the deal.
Compounded versions are not FDA-approved and may have safety or efficacy risks, even though they’re more affordable.
They may have been changed in some way from the version approved by the U.S. Food and Drug Administration (FDA).
This could include:
- Adding a new ingredient
- Removing an ingredient
- Combining different drugs
It’s legal to make compounded versions of a drug when a person’s medical needs can’t be met by an FDA-approved drug or when a drug is on the FDA’s drug shortage list.
A compounded GLP-1 uses the same active ingredient as its non-compounded cousin, but it’s not the exact same medication. The FDA hasn’t approved it as safe or effective.
However, if you get compounded GLP-1s from a trustworthy source, they can be a more available and more affordable weight loss treatment. Only use compounding pharmacies that are state-licensed and transparent about sourcing.
One more thing: For now, there are no generic versions of GLP-1s like Ozempic® and Wegovy®.
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The Cost of Weight Loss Drugs With Insurance
With insurance coverage, your weight loss drug costs could be zero…or you could have some out-of-pocket costs. It depends on your insurance plan and whether you have any copays or deductibles.
You may also be eligible for manufacturer savings programs or rebates that can help cut down your costs. Eligibility often depends on diagnosis, insurance type, and prior authorization.
For example, Novo Nordisk — the drugmaker behind Ozempic®, Wegovy®, and Rybelsus® — offers savings cards for each of its medications. Offers vary depending on the drug you’re prescribed.
If eligible, you could:
- Save up to $150 per one-month supply of Ozempic® and pay as little as $25 per prescription.
- Save up to $225 per month on Wegovy® and pay as little as $0 per prescription.
- Save up to $300 per one-month supply of Rybelsus® and pay as little as $10 a month.
Keep in mind that these savings programs can change at any moment, and they have an expiration date.
The Ozempic® savings card, for one, is currently only available for 24 months, so your costs may increase drastically in two years’ time.
As you may end up taking a weight loss drug for an extended time, it’s important to check expiry dates and factor this into your decision when looking into weight loss treatments.
Image Credit: Carolina Rudah/istockphoto.
How Much Is Weight Loss Medication? The Grand Total
If you have overweight, obesity, or a weight-related condition, weight loss drugs can help you take charge of your health and improve your quality of life.
But there’s a catch (isn’t there always?). The cost of weight loss drugs can be off-putting or a complete barrier stopping you from getting treatment.
Here are the key takeaways:
- Weight loss drugs are expensive. Weight loss drugs can set you back between $1,000 and $2,000 per month. That’s right. Per. Month. And you may need to take the drugs for a long period of time.
- They’re not usually covered by insurance. Double- or triple-check your plan just in case, but you’ll probably have to pay out of pocket for weight loss drugs. That said, you can look into savings programs, rebates, and coupons to cut down your costs.
- Compounded weight loss drugs are more affordable. Compounded semaglutide contains the same active ingredient as Ozempic® and Wegovy®, but it’s not FDA-approved.
Whether you’re considering a compounded GLP-1 medication, a brand-name weight loss drug, or another weight loss treatment entirely — or you just want expert advice on your options — touch base with a trusted healthcare provider.
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This article originally appeared on Hims.com and was syndicated by MediaFeed.org.