Ozempic, Wegovy, Mounjaro, Zepbound and the new pill Foundayo are GLP-1 medicines. Their list prices are over $1,000 a month, but few people pay that. What you pay depends on why the drug is prescribed (diabetes or weight), what coverage you have, and which form of the drug you use. This guide walks through each way to pay, as of October 2026.
Does commercial insurance cover GLP-1s?
Commercial insurance means a plan from your job or one you buy yourself. Most of these plans cover GLP-1s for type 2 diabetes (Ozempic, Mounjaro). Coverage for weight loss (Wegovy, Zepbound, Foundayo) is much less common, because your employer chooses whether to include it.
In KFF's 2025 survey of employers, only 19% of firms with 200 or more workers covered GLP-1s for weight loss in their largest plan. Among the biggest firms (5,000 or more workers), it was 43% (KFF). Some employers that cover them add limits, such as a BMI cutoff or a required lifestyle program.
Even when a drug is covered, you may hit one of these hurdles:
- Formulary: the list of drugs your plan covers. If a drug is not on it, the plan usually won't pay.
- Prior authorization: your doctor has to send the plan paperwork showing you meet its rules (for example, a diagnosis or a BMI) before the plan will pay.
- Step therapy: the plan wants you to try a cheaper option first, and only covers the drug if that didn't work.
- Exclusion: the plan simply doesn't cover weight-loss drugs at all. A prior authorization can't fix this; only a different plan can.
If you have commercial coverage for the drug, the maker's savings card can lower your copay (see below).
Does Medicare cover Ozempic, Wegovy or Zepbound?
By law, regular Medicare drug plans (Part D) can't cover drugs used only for weight loss. But Part D can cover GLP-1s for other approved uses:
- Type 2 diabetes: Ozempic and Mounjaro, through your Part D plan.
- Heart risk: Wegovy, when prescribed to lower the risk of heart attack and stroke in people with heart disease.
- Sleep apnea: Zepbound, for moderate to severe obstructive sleep apnea in adults with obesity.
For these uses, your plan's normal rules apply: its formulary, prior authorization and copays. Check your own plan's drug list.
For weight loss alone, there is a separate program: the Medicare GLP-1 Bridge. It started July 1, 2026 and runs through December 31, 2027. If you have Part D and meet its BMI rules, you pay $50 a month for any form of Wegovy, the Zepbound KwikPen, or Foundayo (CMS). People with type 2 diabetes, moderate to severe sleep apnea or fatty liver disease aren't eligible for the Bridge; their Part D plan handles it instead (Medicare.gov). Read our full guide: The Medicare GLP-1 Bridge, explained.
Medicare Open Enrollment runs October 15 to December 7, and changes start January 1 (Medicare.gov). If you don't have Part D, this is usually when you can add it.
Does Medicaid cover GLP-1s for weight loss?
It depends on your state. Medicaid must cover GLP-1s for approved uses like type 2 diabetes, but covering them for obesity is each state's choice. Only 13 states covered them for obesity as of January 2026, down from 16 in 2025 (KFF).
A new federal program, the BALANCE model, lets state Medicaid programs cover GLP-1s for weight loss at a price CMS worked out with the makers. States could start between May 2026 and January 1, 2027 (CMS). CMS has not posted a list of states that joined, so ask your state Medicaid office or your Medicaid health plan whether yours is in.
Do savings cards work for Wegovy, Zepbound and Ozempic?
Novo Nordisk (Ozempic, Wegovy) and Eli Lilly (Mounjaro, Zepbound, Foundayo) offer savings cards. They are for people with commercial insurance. Examples as of October 2026:
- Wegovy: with insurance that covers it, you may pay as little as $25 a month, with a monthly savings limit (NovoCare).
- Zepbound single-dose pen and Foundayo: with insurance that covers them, you may pay as low as $25 a month (Zepbound, Foundayo).
These cards can't be used with Medicare, Medicaid or other government coverage. The makers' terms say "governmental beneficiaries excluded." They also have yearly limits and can end at any time.
How much do GLP-1s cost without insurance?
Both makers now sell directly to people paying cash. Prices below are as of October 2026 and come from the official pages. They change often, so check the link before you order.
| Drug | Price | Where |
|---|---|---|
| Wegovy pen | $199 for the first two fills of the two lowest doses (new patients, through Dec 31, 2026), then $349; $399 for Wegovy HD 7.2 mg | NovoCare Pharmacy or a pharmacy coupon via TrumpRx |
| Wegovy pill | $149 to $299, depending on dose | NovoCare |
| Ozempic pen | $199 for the first two fills (new patients, lowest doses), then $349; $499 for the 2 mg dose | Pharmacy coupon via TrumpRx |
| Zepbound KwikPen or vial | $299 to $449, if you refill within 45 days; higher doses rise to $499 to $699 if you don't | LillyDirect |
| Foundayo pill | $149 to $299, depending on dose; some lower prices last through Dec 31, 2026 | LillyDirect |
TrumpRx.gov is a government site that lists these cash offers in one place. You don't buy from it. For Wegovy and Ozempic it gives you a coupon to show at a retail pharmacy; for Zepbound it sends you to LillyDirect. The offers are for self-pay only: if you have insurance or Medicare, what you pay won't count toward your deductible or out-of-pocket limit (TrumpRx, Medicare.gov). TrumpRx's own advice is worth following: check your copay first, since it may be lower.
Can I use my HSA or FSA for a GLP-1?
Often, yes. A health savings account (HSA) or flexible spending account (FSA) can pay for prescribed drugs that treat a medical condition. The IRS counts weight-loss costs when they treat a disease a doctor diagnosed, such as obesity, but not when the goal is appearance or general health (IRS Publication 502). Lilly lists Zepbound and Foundayo bought through LillyDirect as HSA/FSA eligible, but says eligibility may vary by plan (LillyDirect). Ask your plan administrator before you pay, and keep your receipts and prescription.
What about compounded semaglutide or tirzepatide?
Compounded drugs are made by a pharmacy that mixes the ingredients itself, rather than by the maker. They are often sold online at lower prices. Here is what the FDA says (FDA):
- Compounded GLP-1s are not FDA-approved. The FDA does not check them for safety, effectiveness or quality before they are sold.
- The FDA has received reports of people hurt by dosing mistakes, some needing a hospital stay. As of May 31, 2026 it had 990 reports for compounded semaglutide and more than 730 for compounded tirzepatide.
- Some products use salt forms (semaglutide sodium or acetate) that differ from the approved drugs.
- The FDA warns about fake Ozempic and illegal online sellers, and says not to buy products labeled "for research" or "not for human consumption."
If you are thinking about a compounded drug, talk it over with your doctor or pharmacist first.
Which way to pay fits you?
| Route | Who it's for | Typical cost | What to do next |
|---|---|---|---|
| Commercial insurance | People with a job-based or individual plan | Your plan's copay; often as little as $25 with a savings card | Check your plan's formulary and ask about prior authorization |
| Medicare Part D | Medicare members with type 2 diabetes, heart disease or sleep apnea | Your plan's copay; varies by plan and phase | Look up the drug on your plan's formulary at Medicare.gov |
| Medicare GLP-1 Bridge | Part D members using it for weight loss who meet BMI rules | $50 a month | Ask your doctor; see Medicare.gov/glp1bridge |
| Medicaid | Medicaid members; weight-loss coverage depends on your state | Small or no copay where covered | Ask your state Medicaid office if it covers obesity or joined BALANCE |
| Maker self-pay | People without coverage for the drug | $149 to $699 a month, by drug and dose | Compare NovoCare, LillyDirect and TrumpRx |
| HSA or FSA | People with one of these accounts | Pays with pre-tax money | Ask your plan administrator if it qualifies |
What should I ask my insurer or pharmacy?
- Is this drug on my plan's formulary, and for which uses (diabetes, weight, heart, sleep apnea)?
- Does my plan exclude weight-loss drugs entirely?
- Do I need prior authorization or step therapy? What does my doctor need to send?
- What will I pay each month, and does that change during the year?
- Can I use the maker's savings card with my plan?
- If I have Medicare, am I eligible for the GLP-1 Bridge, or should this go through my Part D plan?
- Is a cash price lower than my copay for this fill?
How Check In helps once you have your medicine
Check In is a free AI companion for GLP-1s that you text. For this part of life on a GLP-1, it does three things:
- Text “took my shot”
It's logged, so your shot history is in one place.
- It checks in two days after your shot
A quick text to see how you're feeling, timed to your shot day.
- Ask anything about your medicine
Plain answers from the FDA label, with a picture when it helps.