Nov 16, 2023 • 11 min read

Cost of Ozempic: With Insurance & Without Insurance

  • Facebook
  • Linkedin
  • Twitter
  • Message

The popular Novo Nordisk drug, Ozempic, has gained quite the spotlight over the past year. While it was created to help manage type 2 diabetes, Ozempic also comes with some pretty impressive weight loss benefits. 

Ozempic is a glucagon-like peptide-1 receptor agonist (GLP-1) medication that works by mimicking your body’s naturally occurring GLP-1 hormone which is responsible for letting your brain know you are full. As a result, digestion is slowed and you eat less, causing weight loss.

While it may sound like a miracle drug for the treatment of obesity, it comes with a hefty price tag. 

So how much does Ozempic cost? What are the costs with and without insurance?

For those who are lucky enough to have insurance coverage for Ozempic, which typically requires a type 2 diabetes diagnosis, the cost could be as little as $25 a month. However, those who aren’t covered may be looking at a monthly cost of upwards of $900 or more.

This guide covers what you can expect to pay for Ozempic whether you have insurance or are paying out-of-pocket, how to save on Ozempic, how to get it, and potential alternatives.

Cost of Ozempic overview

Ozempic can cost as little as $25 a month for those with insurance coverage but can increase to over $1,000 or more for those paying out-of-pocket. The cost for Ozempic will vary depending on your insurance plan and the state you live in.

Ozempic is covered by most private insurance plans when it is prescribed for type 2 diabetes. If prescribed off-label for weight loss, however, most insurance companies will deny coverage as this is not an FDA-approved use. 

Below is a list of the prices for Ozempic at major pharmacies in New York City from GoodRx. These amounts are the out-of-pocket costs so your cost may be less if your insurance covers some or all of the prescription.

  • CVS Pharmacy: $967.35
  • Walgreens Pharmacy: $973.46
  • Duane Read: $973.46
  • Walmart: $978.04
  • Rite Aid: $916.02
  • ShopRite: $906.54
  • Wegmans: $906.54
dietitian patient attending appointment

Find the right dietitian for you

Cost of Ozempic with insurance

Ozempic, generic name Semaglutide, is an FDA-approved once-weekly injection for the treatment of type 2 diabetes. Because of this, Ozempic is usually approved by most private insurance companies as well as Medicare and Medicare Part D when it is prescribed for diabetes. Medicaid may also cover this medication in some states for those who qualify. 

If you aren’t sure if your plan will cover Ozempic, call the number on the back of your insurance card. While some doctors may prescribe Ozempic off-label for weight loss, these off-label prescriptions typically aren’t covered by insurance.

Even if you are granted insurance coverage for Ozempic, you may still be required to pay certain out-of-pocket expenses such as a copay, deductible, or coinsurance payment which will vary by insurance plan. 

Novo Nordisk also offers a savings card for Ozempic for those with private insurance which can save you $150 each month for up to three months. This can decrease your monthly payment down to as little as $25, however, not everyone qualifies.

Cost of Ozempic without insurance

If you’ve been prescribed Ozempic, either for type 2 diabetes or off-label for weight loss, and your insurance is denying coverage, you are looking at some pretty hefty out-of-pocket fees. The manufacturer of Ozempic lists the price of their injection pens at $935.77 for 0.25-2mg doses which is usually a month’s supply.

According to their website, the price for pens also depends on the product formulation your healthcare provider prescribes. This is if you choose to order Ozempic through your regular pharmacy. 

You may be able to save on Ozempic pens by ordering them through a different company. As long as you have a prescription for Ozempic, you can get it from different sources that may offer savings, such as NiceRx, which offers access to discount prescription drugs. 

If you are eligible, you may be able to receive Ozempic for free by paying a small service fee of $49 for one prescription per month. You can find out if you qualify by completing their online enrollment application. 

Cost of Ozempic for weight loss

Because Ozempic is not approved by the FDA for weight loss, physicians who prescribe this medication for weight loss are doing so “off-label,” and insurance will not cover the cost unless you’ve received prior authorization.

Prior authorization is when your insurance company reviews and approves a specific medication ahead of time. This is the only way you may receive partial or full coverage of an off-label medication. Even then, your doctor may need to confirm that you have type 2 diabetes.

If you are looking for a prescription weight loss medication but don’t qualify for Ozempic coverage, you may be able to get Wegovy. Wegovy is another brand name for Semaglutide that is FDA-approved for weight loss and weight management. Over half of patients in clinical trials lost 15% of their body weight after a year on Wegovy.

While both Ozempic and Wegovy are Semaglutide, they differ in their dosages as well as in the way they are provided. For example, both come in prefilled injection pens; however, you can use Ozempic pens multiple times while Wegovy pens are single-use.

Additionally, Wegovy is typically prescribed at a higher dose than Ozempic. 

Those who are looking for weight loss medication can qualify for Wegovy if they have a body mass index (BMI) of 30 or higher or a BMI of 27 and higher with at least one weight-related condition such as hypertension, type 2 diabetes, or high cholesterol.

If you are considering Wegovy over Ozempic due to insurance coverage, be sure to check cost and coverage with your health insurance plan beforehand as plans differ on coverage for weight loss medications.

If covered by insurance, Wegovy can cost as little as $25 per month. However, if you must pay out of pocket for Wegovy, it can cost up to $1,627 per month. 

Like Ozempic, there is a savings card for those who qualify. The Wegovy savings card can save you up to $225 per month for up to 12 months.

How to save on Ozempic

Because Ozempic has had such huge success as an off-label weight loss medication, it has become very desirable to those in need. But it can be frustrating when the cost is so high, and the coverage is unlikely.

There are some ways you can save on Ozempic, but these savings aren’t available to everyone. Below are some options that may help you save on the cost of Ozempic and information on who may be eligible.

1) Check if your insurance covers it

The best way to save on Ozempic is to see if your insurance will cover it. While it’s unlikely to be covered if prescribed for off-label use, some insurance companies will grant coverage with prior authorization in certain circumstances. Either way, it’s worth investigating.

2) Novo Nordisk’s Patient Assistance Program

Novo Nordisk, the makers of Ozempic, have a Patient Assistance Program (PAP) that grants those who are approved free medicine from Novo Nordisk without any registration charge or monthly fee. 

To qualify for PAP, you must be a U.S. citizen, have a household income at or lower than 400% of the federal poverty level, have Medicare or no insurance, and not be currently enrolled in or qualify for any other federal, state, or government program. 

3) Ozempic savings card

As mentioned previously, Novo Nordisk also offers an Ozempic savings card which provides a temporary discount on your first one to three months for those with commercial or private insurance. 

You must have a valid prescription, and the brand on the prescription must be covered by the patient’s insurance plan. Patients are not eligible if enrolled in any federal or state health care program with prescription drug coverage.

4) Coupons and prescription cards

Some companies offer coupons for Ozempic as well as savings cards. For example, SingleCare offers Ozempic coupons with no eligibility requirements which can reduce the out-of-pocket cost to as low as $772.05 on 0.25-0.5mg doses depending on your pharmacy.

Prescription discount cards, such as this one through GoodRx, can help you lower the out-of-pocket cost of Ozempic by up to 27% depending on your pharmacy. You can use this prescription card with or without insurance or Medicare.

5) Consider a Medicare help program

If you have Medicare with limited income, you may qualify for Ozempic through the Medicare Part D Extra Help program. Under this program, you can receive assistance with the cost of prescriptions, however, they require a type 2 diabetes diagnosis.

6) Use HSA or FSA funds

If you have a Flexible Spending Account (FSA) or Health Savings Account (HSA), you can use the funds available in these to help cover the cost of your Ozempic. If you aren’t sure if your Ozempic prescription qualifies, you can call your HSA or FSA administrator to confirm.

7) Ask for a 90-day supply

Some pharmacies will give you savings for purchasing prescriptions in bulk and that includes Ozempic. While it’s no guarantee, it doesn’t hurt to see if your pharmacy offers this perk.

dietitian patient attending appointment

Find the right dietitian for you

Is it possible to get Ozempic for free?

It is difficult to get Ozempic for free but not impossible. Some qualify for their Ozempic prescription for free under the Novo Nordisk PAP.

How to get Ozempic

If you are interested in taking Ozempic to help you control your diabetes or lose weight, you may be wondering how to get it. Below are some of the steps you should follow to get your Ozempic prescription at the lowest price.

  1. Check your plan. Before obtaining an Ozempic prescription, find out what kind of coverage you have through your health insurance plan. This can help you determine what your options are for cost. Most insurance plans will cover Ozempic if prescribed for type 2 diabetes, but they don’t often cover it when prescribed for weight loss. Additionally, you can call or check online at Novo Nordisk’s Novocare support program to obtain an estimated cost for your Ozempic prescription.
  2. Get a prescription. Next, get a prescription for your Ozempic. This can be done through your primary care physician. You can also get a prescription through programs that offer telehealth services with access to providers such as Mochi, Sequence, Calibrate, Push Health, and more.
  3. Check if you need prior authorization. You may need to obtain prior authorization for your Ozempic prescription. The easiest way to learn if you need this is to search your plan’s approved medication list. You can also search to see if your plan has a prior authorization medication list available to make your life easier. If Ozempic has a notation, such as “PA” after the name, you must obtain prior authorization.
  4. Review costs. Once you have your prescription, compare cost options to get the best price, especially if your insurance plan will not cover Ozempic. This is when it’s helpful to compare coupons versus savings cards versus special programs to see what you qualify for and what will give you the best option for your budget. Don’t skip this step as it could potentially save you a lot of money.

Alternatives if your insurance doesn’t cover Ozempic or it’s too expensive

As mentioned above, insurance companies will most likely not cover Ozempic if it is prescribed for a purpose other than diabetes. It can be difficult to get insurance to cover this drug if it is used for weight loss. If your insurance does not cover Ozempic, other similar medications may be a better option for you financially. 

  • Wegovy. Like Ozempic, Wegovy is an injectable medication used specifically for weight loss. It is not typically covered by health insurance, however, there are still some ways to receive coverage. If your employer-covered insurance does not cover medication to treat obesity, you may submit a request for coverage to increase your chances of gaining coverage. You can learn about the cost of Wegovy here and foods to eat and avoid on Wegovy here.
  • Mounjaro. Mounjaro is a relatively new brand-name medication that is used to help manage type 2 diabetes. It may also trigger weight loss. Some insurance plans cover Mounjaro, however, coverage varies from plan to plan. You can learn about the best foods to eat while taking Mounjaro here.
  • Rybelsus. Rybelsus is a Semaglutide tablet prescribed to improve blood sugar. Most Medicare prescription drug plans and other insurance plans have this drug on their formulary. If you are eligible, you may receive a Rybelsus savings offer to pay as little as $10 for one month. You can learn about the ideal Rybelsus diet plan here.
  • Trulicity. Trulicity is used along with diet and exercise by adults with type 2 diabetes to improve glycemic control. It is not a weight loss drug, but it may lead to weight loss for some people. Most Medicare prescription drug plans and insurance plans cover Trulicity. While you may still have a copay or other out-of-pocket expenses, you will most likely receive some sort of coverage. Note that there are important foods to avoid while taking Trulicity.
  • Saxenda. Saxenda is an injectable prescription medication for adults who are overweight and have weight-related health issues. Insurance may or may not cover Saxenda, however, there are other ways to gain coverage. You may be able to receive coverage through your employer if you have Medicaid or if you are a government employee. You can learn more about the best diet while taking Saxenda here.

Reviewing Ozempic costs & coverage for major types of health insurance plans

Whether or not you receive coverage for Ozempic will depend on your health insurance plan and your medical condition. While most major health insurance plans cover Ozempic for diabetes, the out-of-pocket expenses may vary. 

Private or employer-sponsored health insurance plans

Private insurance plans usually have diabetes medications, such as Ozempic, on their formulary. If you have private insurance, you also may qualify for the Ozempic savings card to lower your costs even more. 

Medications for weight loss are typically not covered by employer-sponsored health insurance plans. However, employers may cover Ozempic for type 2 diabetes. As with any insurance plan, coverage and out-of-pocket expenses will vary from plan to plan. 

Medicare

Most Medicare prescription drug plans have a list of drugs they cover. Prescription medications are listed in tiers, which is a way to determine the cost of medicine. Tier 1 lists more generic, less expensive medications and Tier 5 contains high-cost prescription drugs. The higher the tier, the more you will have to pay for your copayment. 

Ozempic is on the list of most prescription drug plans, however, you should check your plan’s formulary to make sure Ozempic is listed and to check which tier it is in. The amount that you pay will depend on the details of your plan, your copay, and whether your deductible has been met. 

Medicaid

To be eligible for Medicaid, you must be considered low or very low income. Ozempic and other GLP-1 antagonists are typically covered by Medicaid programs to treat type 2 diabetes. 

However, coverage varies by state because each state Medicaid program has its own rules and requirements. Be sure to check with your state’s Medicaid agency for details about coverage for Ozempic. 

Why working with a dietitian while taking Ozempic is a good idea

There are many benefits to working with a dietitian, particularly when taking a medication like Ozempic. Ozempic was designed to work along with lifestyle modifications. If you are not eating well and getting enough exercise, you may have trouble losing weight on Ozempic, or you may struggle with plateaus.

The best way to ensure long-term success is to work with a Registered Dietitian (RD). RDs can help provide tailored recommendations and guidance to ensure you are not just losing weight but also changing your habits to keep it off. They can also educate you on the timeline you can expect for weight loss on Ozempic.

RDs are also essential for making sure you get the most out of Ozempic. For example, appetite reduction is common on this medication however, if you don’t eat enough, you may lose muscle mass which can lower your metabolism and make further losses more challenging. A dietitian can steer you to the best foods to eat on Ozempic.

Another reason to work with a dietitian is to help manage potential side effects. Possible side effects of taking Ozempic include nausea, diarrhea, and constipation. Your dietitian can help you choose the best foods to help manage your symptoms. 

So, if you are considering taking Ozempic to help you meet your weight loss goals, schedule an appointment with an RD as well. You won’t regret it.

dietitian patient attending appointment

Find the right dietitian for you

Meghan is a Registered Dietitian/Nutritionist from San Jose, California. She received her undergraduate degree from San Diego State University in 2015. Following an unexpected cross-country trip that landed her in Florida, she completed her didactic training through AdventHealth Orlando. Meghan has extensive experience in multiple aspects of dietetics including critical care, motivational interviewing, writing, and research. She is passionate about health and wellness and has dedicated her free time to breaking down complicated nutrition topics and disseminating them to the public through the arena of writing.