cost of Ozempic per month without Insurance
cost of Ozempic per month without Insurance

Cost of Ozempic per Month: With or Without Insurance Coverage

The cost of Ozempic per month is usually the deal-breaker for people to decide on using Ozempic or not for their weight loss goals. The cost of Ozempic can vary; factors that affect the total price you pay are

  • Your treatment plan ( your dose )
  • Your insurance coverage
  • The pharmacy you use
  • Whether Ozempic has a savings program for you

Cost of Ozempic Without Insurance

The average cost of Ozempic without insurance is approximately $800-$950 per month.

Here is the cost of a 1.5-mL pen from several leading pharmacies with some Optum coupons.

Costco$991
Walmart$922
Rite Aid$890
Walgreens$893
CVS Pharmacy$872

Cost-saving options include patient assistance programs like the Novo Nordisk Patient Assistance Program and prescription discount cards.

Other GLP-1 Semaglutide Drugs Cost Without Insurance

There are other Semaglutide brands available on the market in tablet and injection form, like Rybelsus and Wegovy. Here is a cost table for each without insurance coverage.

RybelsusOral tablet once a day treating type 2 diabetes
$1000/month
OzempicInjection once a week treating type 2 diabetes$892/month
WevogyInjection once a week treating chronic obesity$1300+/month

Ozempic Cost With Insurance and Challenges

Having insurance coverage can significantly impact the cost of Ozempic for many individuals. However, navigating insurance plans and understanding coverage details is essential to ensure optimal cost savings

Many health insurance providers in the United States have recently restricted or ceased coverage for medications like Ozempic, especially when prescribed specifically for weight loss purposes.

The ones who approve go through patient history to have any chance of getting coverage for Ozempic.

It has to be private or commercial insurance, not state or federal to be eligible for Ozempic coverage.

Cigna Group: Cigna has tightened its coverage for Ozempic.

CVS Health Corp: CVS Health Corp has also tightened its coverage for Ozempic.

Eli Lilly and Co: Eli Lilly and Co has tightened its coverage for Ozempic.

Elevance Health: Elevance Health, which operates Anthem plans, has stated that in most cases it won't cover Ozempic unless a patient is diagnosed with diabetes.

Ascension: The private healthcare system Ascension stopped coverage on July 1, 2023, stating that weight loss and anti-obesity drugs will no longer be covered in its pharmacy benefits.

See also  Diabetes Drug Ozempic For Weight Loss

Most GLP-1 agonists, including Ozempic, are usually covered by state Medicaid programs for the treatment of type 2 diabetes. Most Medicare prescription drug plans (Medicare Part D) cover Ozempic for the treatment of type 2 diabetes, but not for weight loss.

However, when Ozempic is prescribed off-label for weight loss, it is often not covered by insurance. This is because the Affordable Care Act doesn’t mandate that health insurers cover obesity or overweight treatments. Furthermore, there isn’t enough evidence to show anti-obesity drugs are effective over the long-term.

If you have private or commercial insurance, such as insurance you receive through an employer, you may be eligible to pay as little as $25 for a 1-, 2-, or 3-month prescription (maximum savings of $150 per 1-month prescription, $300 per 2-month prescription, or $450 per 3-month prescription). 

Here is what one user said about her experience.

I have Aetna blue cross blue shield, I get it through access health in CT USA. I pay $25 per pen. I got lucky, they denied it at first, but me and my Dr. and both sent in appeals, and it got it approved for pre-diabetes and obesity. SW 206lbs CW 158lbs GW 145lbs. 5'2″F. Currently on 2mgs. I've been on it since December 17th, so about 40 weeks. 48lbs = 1 plus lbs a week. I've become a new woman at 52! Last year at this time, I was so depressed I didn't want to go anywhere or see anyone, I just thought I was going to die. I started advocating for myself because I just couldn't take it anymore!

Ozempic User on Reddit

Here is another user from Canada.

My insurance covered 50% so I pay $147 out of pocket every 4 weeks.

Candian User

But stay updated with your insurance providers, since they may change policies at anytime of the year giving you a huge surprise. This is precisely what happened to this user.

I have been taking Ozempic for one year. My A1C last July was 11.5. My Dr appt on July 8, 2023 it was down to 5.8. The insurance I had with my company changed as of July 1. Previously I wasn't paying anything for my Ozempic. With the new insurance I went to pick up my prescription and it was over $2000 for 90 days!! Told the pharmacist I couldn't pay that. She asked what I was going to do, I replied I guess I will die cause I can't pay that. How can these companies charge this when people need it to live. I'm devastated.

Ozempic User Deep_Writer_1522

Unlocking Savings Opportunities:

Now, for the good news! Here are some ways to potentially reduce your Ozempic expenses:

See also  Ozempic Butt: A Ozempic Weight Loss Drug Side Effect

Leverage Insurance:

Many insurance plans cover Ozempic, but coverage details vary. Contact your insurance provider to understand your specific plan's coverage and potential co-pays. Resources like GoodRx or NeedyMeds can help estimate costs based on your insurance plan.

Novo Nordisk’s Saving Card

The manufacturer of Ozempic, Novo Nordisk, provides a Diabetes Savings Offer Program. However, this offer is not accessible to individuals enrolled in Medicaid, Medicare, or any other federal or state health programs.

Ozempic offers a savings card tailored for individuals with commercial insurance, alternatively referred to as a copay card or coupon card, designed to reduce your copay expenses. Enrolling in the Ozempic savings card program can be done by dialing 877-304-6855 or visiting the program's website.

Once enrolled, you can present the manufacturer's coupon card at your pharmacy. Pharmacists can then apply it alongside your commercial insurance coverage. However, it's important to note that if you currently have Medicaid or Medicare insurance, you are not eligible for the Ozempic savings card. Similarly, individuals without insurance coverage are also ineligible for the Ozempic coupon card.

Novo Nordisk’s Patient Assistance Program

Novo Nordisk also offers a Patient Assistant Program (PAP). People who qualify will receive Ozempic at no cost.

To be eligible for this offer, individuals must:

  • be a United States citizen or legal resident
  • have a total household income at or below 400% of the federal poverty level (FPL)
  • have Medicare or have no insurance
  • not enroll, or not be eligible for, any other state, federal, or government assistance such as Medicaid, Low Income Subsidy, or Veterans Affairs Benefits

Individuals can verify their eligibility against the Federal Poverty Level (FPL) requirements by visiting the Office of the Assistant Secretary for Planning and Evaluation website. For instance, a family of three would qualify under the FPL criteria if their total household income is $99,440 or less.

If an individual qualifies for any state, federal, or government assistance, Novo Nordisk will request them to sign a Patient Declaration, affirming they will not enroll in any other programs. Proof of denial may be required.

Novo Nordisk indicates that applicants will typically receive notification of their application status within approximately two business days.

It's important to note that Novo Nordisk's Patient Assistance Program (PAP) is exclusively available for individuals diagnosed with type 2 diabetes.

Compare Pharmacy Prices:

National chains and local pharmacies may offer different prices. Consider using online tools or contacting pharmacies directly to compare prices and find the best deal.

Beyond Ozempic: If You Can't Afford It

While Ozempic has proven effective, it's not the only weight-management option. There are infact better than Ozempic option that are natural and scientific.

See also  Wegovy vs Ozempic: Is Wegovy the same as Ozempic

Dr. Robert Posner. who has been featured on mainstream media outlets like NBC, CBS and FOX. has created this Ozempic alternative that reduced your carb intake by 50%.. This natural solution is scientifically backed and has been tested by more than 24000 users with average weight loss of 35 pounds in just 12 weeks.

Check out this Ozempic alternative here.

Frequently Asked Questions

How much does semaglutide cost?

Semglutide comes in 3 different brands. Rybelsus is oral tablets that cost close to $1000/month. Ozempic is an injection and costs around $892/month. Wegovy is FDA-approved drug for weight loss and costs around $1300/month. All these costs are without insurance.

What is Ozempic cost without insurance?

The cost of Ozempic without insurance is around $892/month. This varies depending on three factors – Your dose, pharmacy source, and any savings coupon availed from the manufacturer.

Does Ozempic offer copay assistance for individuals with Medicare?

Yes, Ozempic offers copay assistance for individuals with Medicare. If you have private or commercial insurance, such as insurance you receive through an employer, you may be eligible to pay as little as $25 for a 1-, 2-, or 3-month prescription (maximum savings of $150 per 1-month prescription, $300 per 2-month prescription, or $450 per 3-month prescription).

This offer is valid for up to 24 months from the date of savings offer activation. However, it's important to note that Medicare coverage for Ozempic is available for the treatment of type 2 diabetes, but not for weight loss.

Medicare prescription drug plans might cover Ozempic, but only for diabetes treatment. The coverage for Ozempic differs between plans, and the final cost will depend on the specific plan and formulary. 

What is the cost of Ozempic at Walmart with insurance coverage?

The cost of Ozempic at Walmart with insurance coverage can vary depending on the specific insurance plan and formulary. According to Drugs.com, the cost for Ozempic subcutaneous solution (2 mg/1.5 mL (0.25 mg or 0.5 mg dose)) is around $1,029 depending on the pharmacy you visit.

However, the final cost will depend on the specific insurance plan and formulary. Medicare prescription drug plans may cover Ozempic, but only for diabetes treatment. The coverage for Ozempic differs between plans, and the final cost will depend on the specific plan and formulary.

If you have private or commercial insurance, you may be eligible to pay as little as $25 for a 1-, 2-, or 3-month prescription (maximum savings of $150 per 1-month prescription, $300 per 2-month prescription, or $450 per 3-month prescription) through the Ozempic Savings Offer.

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