Manufacturer direct-pay program
Both Lilly and Novo Nordisk run self-pay programs for people without coverage. Pricing tiers change frequently — check the official program page for current rates.
Does insurance cover GLP-1
You are trying to work out what this will cost you per month.
Reference and calculator, not medical advice. Dosing figures below are transcribed from FDA-approved prescribing information and link back to it. Last reviewed August 2026.
The answer turns on one thing far more than any other: what the prescription is written for. Coverage for a GLP-1 prescribed for type 2 diabetes is common. Coverage for the same molecule prescribed for weight management is much less so, and plenty of plans exclude weight-loss drugs as a category regardless of what they contain.
That is why two people can be told opposite things about the same drug. Wegovy and Ozempic are both semaglutide; Zepbound and Mounjaro are both tirzepatide. Within each pair, one carries a weight-management indication and the other a diabetes indication, and your plan is looking at the indication, not the molecule.
Side-by-side
Structural facts from each product’s prescribing information.
| Product | Active ingredient | Indication | Frequency | Start | Max labelled | Steps to max |
|---|---|---|---|---|---|---|
| Wegovy Novo Nordisk | Semaglutide | Weight management | Weekly | 0.25 mg | 2.4 mg | 5 |
| Ozempic Novo Nordisk | Semaglutide | Type 2 diabetes | Weekly | 0.25 mg | 2 mg | 4 |
| Zepbound Eli Lilly | Tirzepatide | Weight management | Weekly | 2.5 mg | 15 mg | 6 |
| Mounjaro Eli Lilly | Tirzepatide | Type 2 diabetes | Weekly | 2.5 mg | 15 mg | 6 |
This site does not publish which plans cover what, and will not. Formularies change at least annually, vary between employers who buy the same insurer's product, and differ by state. Any list published here would be wrong within months, and being wrong about someone's coverage is worse than being silent.
Where the price comes from
The routes people actually pay through, and what determines the number in each.
Through insurance (copay)
If your plan covers the drug for your indication, your cost is the plan copay. Coverage for weight-loss indications is far less common than for type 2 diabetes.
Telehealth platform (brand drug)
Online clinics bundle a prescriber visit with brand-name medication. Membership fee is usually separate from drug cost.
Compounded semaglutide / tirzepatide
Compounded versions are prepared by pharmacies rather than the original manufacturer. Availability and legality depend on FDA shortage status, which has changed several times — verify current status before relying on this route.
Retail pharmacy cash price
List price without insurance, sometimes reduced by discount cards.
Common questions
- How do I actually find out?
- Your plan documents, searching for the drug by brand name in the formulary, or a call to the number on your insurance card asking specifically: is this drug on formulary, for which indication, at what tier, and does it need prior authorisation. Those four answers settle it. Nothing online can.
- Why does the tier matter?
- Being on formulary is not the same as being affordable. Tier determines your share of the cost, and specialty tiers can leave a covered drug still costing hundreds a month.
- What if my plan excludes weight-loss drugs entirely?
- Then the question shifts to whether you have a different qualifying indication, which is a clinical matter for your prescriber rather than an appeal you can write yourself. If not, self-pay routes are covered elsewhere on this site.
Cost comparison calculator
Enter the quotes you have actually been given. Everything is normalised to cost per month and cost per milligram so the options are comparable.
Monthly requirement21.65 mg4.33 doses/month × 5 mg
| Option | Per month | Per year | Per mg | One unit lasts |
|---|---|---|---|---|
| Option A | — | — | — | — |
| Option B | — | — | — | 2.0 weeks |
Common questions
- Why do quoted GLP-1 prices vary so much?
- Because the quotes are not measuring the same thing. A membership fee, a per-vial price, and a per-pen price all describe different quantities, and the dose you are on determines how long that quantity lasts. Converting everything to cost per milligram is the only way to compare them directly.
- Does insurance usually cover this?
- Coverage is far more common for type 2 diabetes indications than for weight management. Whether your specific plan covers your specific indication is something only your plan documents can answer.
Sources and last review
Every dosing figure on this page is transcribed from an FDA-approved label and links back to it. Conversions are arithmetic you can repeat by hand. Nothing here is reviewed by a clinician, and this site does not employ one — which is exactly why what I do publish stays traceable to its source.
- Wegovy (Semaglutide) prescribing information — Novo Nordisk, label revised 30 June 2026, checked 7 August 2026
- Ozempic (Semaglutide) prescribing information — Novo Nordisk, label revised 10 June 2026, checked 7 August 2026
- Zepbound (Tirzepatide) prescribing information — Eli Lilly, label revised 6 May 2026, checked 7 August 2026
- Mounjaro (Tirzepatide) prescribing information — Eli Lilly, label revised 6 May 2026, checked 7 August 2026
Transcribed from the labels above and checked by me — Gavin, who builds this site, takes a GLP-1, and is not a clinician. Last reviewed August 2026. Found an error? [email protected] — I treat corrections as bugs. How this site is built and funded.
Also searched as: glp 1 insurance coverage · glp-1 insurance coverage