How Much Does Wegovy Cost?
GLP-1 agonists like Wegovy have become game-changers in chronic weight management. Wegovy can be expensive, but there are ways you can save money on the cost of a monthly prescription for Wegovy.
In 2021, after completing peer-reviewed clinical trials, Wegovy (semaglutide) was approved by the FDA for weight loss. Obesity doctors have widely praised it as an effective weight loss solution for people with obesity who have failed to achieve effective weight loss through other methods.
Wegovy has been available for doctors to prescribe to people with obesity issues since June of 2021. To qualify for a prescription for Wegovy, patients must be obese per the BMI scale or be overweight per their BMI with one other “qualifying condition” such as diabetes, high cholesterol, or high blood pressure. During the clinical trials, such qualifying participants lost, on average, between 12 and 13% of their initial total body weight compared to those in the placebo group. For example, someone whose starting weight was 220 pounds would have lost nearly 30 pounds while taking Wegovy, which is significant weight loss.
However, while proven effective for chronic weight management, the cost of a Wegovy treatment plan can be an expensive solution. Since coming into the market, the average list price for Wegovy without insurance has been about $1600 for a 28-day supply.
Are There Ways to Save Money on Wegovy?
The list price of Wegovy could be reduced if you have insurance and your health insurance plan is willing to provide coverage for weight loss medications. However, in the past, health insurance companies were not inclined to cover obesity drugs. Traditionally, healthcare plans have only covered certain types or even certain brands of obesity medications and not others.
Before covering an obesity drug, some health insurers ask that you provide evidence that other weight loss strategies, such as exercise or dietary changes, have been tried and not worked before you were prescribed a weight loss drug. Some have also required that the drug be given as part of a coinciding and overall medical weight-loss program that includes counseling and behavioral modification before insurance coverage is provided.
Even if you can secure medical coverage for Wegovy, you could still face some fairly high out-of-pocket copay costs. Regardless of your insurance status, adults with obesity could save money through the drug manufacturers’ assistance program if you qualify.
Let’s take a closer look at insurance coverage for Wegovy, what you might expect to pay for Wegovy with or without prescription drug coverage, and some ways you may be able to reduce the cost of your monthly prescription for Wegovy.
Does Insurance Cover Wegovy?
GLP-1 treatment and related drugs for weight loss may or may not be covered by medical insurance. The version of semaglutide that is prescribed for diabetes, Ozempic, is almost always covered by insurance. Wegovy, the GLP-1 drug approved for weight loss – the same drug at a different dose – may or may not be covered by your insurance company.
To qualify for Wegovy for weight loss, you must have a BMI of 30 or higher. Alternatively, if your BMI is 27 or higher, you may qualify if you have weight-related health conditions like type 2 diabetes, high blood pressure, or high cholesterol.
Whether GLP-1 drugs like Wegovy are covered by insurance depends on several factors, including the specific insurance plan and its coverage policies. Insurance coverage can vary widely from one plan to another, even within the same insurance provider. Some insurance plans may cover Wegovy partially, while other commercial insurance plans may cover it fully, and some may not cover it at all.
To find out if your government or commercial insurance covers Wegovy, it’s best to check with the insurance provider directly or review the policy documents provided by the insurance company. You can also consult with your healthcare provider or pharmacist, who may have experience dealing with various insurance plans and can provide information about potential coverage options.
If you are unsure if your insurance will cover the cost of a prescription for Wegovy, it is best to check with them. Even if it seems in your plan’s literature that your particular insurer does not cover obesity drugs like Wegovy, you might still be able to obtain coverage.
How to Get Wegovy Covered by Insurance
Depending on who is providing your insurance coverage, here are the ways in which you may be able to get your health insurance to pay for Wegovy.
If you get your health benefits from your employer
Your employer gets to decide what prescription benefits it wishes to provide its employees. If your company’s plan doesn’t include obesity drugs like Wegovy, you can submit a request for coverage with the help of your healthcare provider to your employer.
If you have Medicare coverage
Traditional Medicare may or may not cover obesity medication. However, most select Medigap and Medicare Advantage plans for retirees do. If you have one of these plans, please check with its administrator.
If you have VA coverage
Your VA benefits include obesity management. Check with your local VA provider for additional information on getting coverage for Wegovy.
If you have Tricare Coverage
Tricare covers medications like Wegovy under certain circumstances. Please contact your Military Treatment Facility or Tricare Network provider to review the particulars of your plan and policy.
If you have Medicaid Coverage
Medicaid coverage for obesity care varies from state to state. Contact your state’s Medicaid office to learn if it covers medicines for weight management and obesity.
If you are self-employed or have individual private health insurance through Healhcare.gov
Check with your insurance company to learn if you are eligible for an upgrade or an add-on to your plan to cover Wegovy’s class of drugs for weight loss.
Remember that insurance coverage can change over time, so staying up-to-date with the latest information from your insurance provider and relevant healthcare professionals is essential. If your insurance or its coverage does not cover Wegovy is limited, you may explore other options, such as patient assistance programs or discount cards offered by the manufacturer or other organizations, to help offset the cost.
What insurance covers Wegovy?
Several medical insurance sources may offer some degree of insurance for a Wegovy prescription.
Medicare may or may not cover obesity drugs.
Tricare insurance provides some coverage for Wegovy. For example, Tricare Prime and Tricare Select plans may offer coverage if it’s determined to be a medically necessary treatment of obesity.
Private insurance may or may not cover Wegovy. Many do, but coverage may vary depending on your plan. Some insurance providers may require preauthorization from your doctor before you can start the medication. Other insurance providers may require you to meet specific eligibility criteria before giving coverage approval. Check with your providers, such as Kaiser, Aetna, Anthem, Blue Cross Blue Shield, etc., to see if they cover Wegovy and their requirements.
How Much Does Wegovy Cost With Insurance
Determining your Wegovy cost with insurance depends on your coverage; it is possible that you could pay as little as $25 per 28-day month for Wegovy with insurance. The drug’s manufacturer, Novo Nordisk, offers additional savings with a $25 copay card to help significantly lower the cost of Wegovy. Still, it is only issued to patients who have insurance that covers Wegovy and also meet certain other requirements.
If your usual copay is more than $25, you’d be saving money by using the copay card at a participating retail pharmacy. According to Wegovy’s manufacturer, This discount card is only available to commercially insured people with coverage for Wegovy and a valid prescription. You must live in the US. People covered by public programs such as Medicaid, Medicare, TRICARE, or VA benefits aren’t eligible.
To determine the cost of Wegovy with insurance, it’s best to contact your health insurance provider directly. They can provide specific details about your coverage, copayments, deductibles, and any other costs of obtaining Wegovy. Additionally, your doctor or pharmacist might be able to offer information about potential costs and assistance programs that could help reduce the out-of-pocket expenses for the medication.
How Much Does Wegovy Cost Without Insurance?
The cost of Wegovy without insurance can vary based on factors such as the dosage, the quantity of medication prescribed, and the location of the pharmacy. Additionally, drug prices are subject to change over time, so it’s essential to check for the most up-to-date pricing.
Currently, the cash price for Wegovy for those without insurance averages about $1620 per month. This price could be higher or lower depending on the factors mentioned earlier. Additional savings may be available to obese patients without insurance. Eligibility for savings programs varies. It’s crucial to inquire about discounts, manufacturer coupons, or patient assistance programs that may help reduce your out-of-pocket cost. You may also save on Wegovy by ordering a 1- or 3- month prescription. Most pharmacies provide a discount for the 3-month prescription.
How Do I Get a Prescription for Wegovy Near Me?
You cannot legally buy Wegovy in the US at any price without a prescription from a healthcare provider. Any healthcare provider licensed and authorized to write prescriptions can provide you with a legitimate prescription for Wegovy once he or she determines that you meet the prescribing requirements. This means you could get a prescription from your primary care provider or even online by using an appropriate telehealth provider authorized to prescribe medications online.
Can You Buy Wegovy Online?
You can get a prescription for semaglutide online. Still, you must follow specific procedures and consult a legitimate telehealth professional licensed and authorized to prescribe semaglutide, such as a physician, nurse practitioner, or physician assistant.
The average price for Wegovy online could be slightly lower with or without insurance than at a local pharmacy like Walgreens or CVS.
Can I buy Wegovy in Mexico?
Many people who live on or near the border will travel to Mexico for prescription drugs. While we do not endorse such practices, many prescription medications are available in Mexican “farmacias” without a prescription. While you can save a significant amount of money buying prescription medications like Wegovy in Mexico, there is no guarantee of the safety or authenticity of such medications, and purchasing Wegovy in Mexico or anywhere without a prescription to save money should be discouraged. Using this or any prescription medication without a doctor’s supervision could be hazardous.
Are there Wegovy Alternatives for Weight Loss?
Since Wegovy is a newly approved weight-loss drug, it is patented, and a generic version will not be available for quite some time. Current law states that a pharmaceutical patent lasts for 20 years. However, while no generic version of semaglutide is currently available, it is not the only injectable medication currently available for chronic weight management.
There are two brand-name drugs approved for weight loss, Zepbound and Saxenda. They are in the same class of medications – GLP-1 agonists – as Wegovy, and they work similarly but have different active ingredients.
There are other prescription medications that contain semaglutide, the active ingredient in Wegovy; however, these drugs are not FDA-approved specifically for weight loss. Two such drugs are Ozempic and Rybelsus; both are drugs that are forms of semaglutide for blood sugar control for patients with Type 2 diabetes.
Now that you know more about the cost of Wegovy, why not Contact Us today and learn more about this life-changing weight loss medication?