GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound) have changed how many people manage type 2 diabetes and long-term weight. These weekly injections reduce hunger, slow digestion, and help achieve meaningful weight loss for thousands of patients. The results can be impressive, but the price tag often creates the biggest barrier.
Out-of-pocket costs vary dramatically depending on insurance type, plan tier, deductible status, manufacturer assistance, and whether the prescription is for diabetes or weight management. Without any coverage or savings programs, a single month can cost more than $1,000 for most branded options. Even with insurance, copays and coinsurance can reach hundreds of dollars per fill for some patients.
This article breaks down the real out-of-pocket costs people face in 2025. It compares branded versus compounded versions, shows how different insurance scenarios affect the final bill, and explains legitimate ways to lower expenses safely. The goal is to give clear, up-to-date numbers so you can plan realistically.
Branded GLP-1 List Prices in 2025
The wholesale acquisition cost (list price) for branded GLP-1 pens remains high. A single four-week supply of Wegovy (semaglutide 2.4 mg) or Zepbound (tirzepatide 15 mg) lists at approximately $1,300–$1,400 per month. Ozempic and Mounjaro carry similar list prices of $1,050–$1,350 depending on dose strength.
Retail pharmacy prices for cash-paying patients usually match or slightly exceed the list price after small markup. Most major chains and specialty pharmacies charge $1,050–$1,400 per pen when no insurance, discount card, or assistance program is applied. Annual cost without help exceeds $12,600–$16,800.
Biosimilar versions of semaglutide are beginning to appear at lower list prices in 2025, but branded products still dominate prescriptions in most clinics due to insurance preferences and physician familiarity.
How Commercial Insurance Affects Out-of-Pocket Costs
Commercial plans (employer-sponsored or marketplace) cover GLP-1 drugs most often when prior authorization criteria are met. Preferred tier placement reduces the copay to $25–$100 per month when the manufacturer savings card is applied. Higher tiers may require 25–50% coinsurance, pushing monthly costs to $200–$600.
The Wegovy Savings Card and Zepbound Savings Card lower out-of-pocket to as little as $25 per month for commercially insured patients (subject to annual caps, usually $225–$500 in savings per fill). These cards require activation and exclude Medicare, Medicaid, or government-funded plans.
High-deductible plans force patients to pay full cash price until the deductible is met. After the deductible, coinsurance applies. Many patients in high-deductible plans pay $1,000+ per month during the first few fills.
- Commercial Plan Cost Examples:
- Preferred tier + savings card: $25–$100
- Higher tier coinsurance: $200–$600
- High-deductible before deductible met: Full cash price ($1,050–$1,400)
- After catastrophic phase: 5–10% coinsurance
Medicare Part D Out-of-Pocket Costs
Medicare Part D covers Ozempic and Mounjaro when prescribed for type 2 diabetes. Copays vary by plan tier and coverage phase: deductible phase ($0–$590 in 2025), initial coverage (25% coinsurance), coverage gap (25% coinsurance), and catastrophic phase (5% coinsurance or flat copays).
Wegovy and Zepbound are excluded from Part D when used only for weight loss due to federal law. Patients pay the full cash price ($1,300–$1,400/month) unless they qualify for a limited pilot program in select regions (copays ~$50/month in participating plans).
Extra Help (Low-Income Subsidy) dramatically lowers costs for qualifying beneficiaries. Generic or preferred-tier GLP-1 drugs cost $4–$11 per prescription. Extra Help eligibility is based on income and assets.
Medicaid Out-of-Pocket Costs by State
Medicaid copays are very low or zero for most beneficiaries. When covered, GLP-1 drugs cost $0–$5 per month. Coverage for Wegovy/Zepbound is limited to about 20–25 states in 2025 and usually requires prior authorization with BMI documentation and failed prior treatments.
Most states cover Ozempic/Mounjaro for type 2 diabetes with prior authorization. Step therapy (trying metformin first) is common. States without obesity coverage deny Wegovy/Zepbound when weight loss is the primary indication.
Medicaid patients denied coverage can apply for manufacturer patient assistance programs, which provide free branded medication to qualifying individuals.
Compounded GLP-1 Costs for Uninsured Patients
Compounded semaglutide and tirzepatide from licensed telehealth providers are the most affordable option for uninsured patients in 2025. Reputable platforms charge $199–$499 per month (all-inclusive) for doses up to the maximum approved strength. The fee covers virtual consultation, prescription, medication, syringes, shipping, and messaging support.
Compounded versions are not FDA-approved, so quality depends on the pharmacy. Reputable programs use 503B outsourcing facilities and provide third-party sterility and potency testing results. Avoid companies that sell “research peptides” or ship without physician review.
Compounded costs remain stable regardless of dose in many plans, making them attractive for patients on higher maintenance strengths.
Comparison of Monthly Out-of-Pocket Costs
| Coverage / Access Method | Typical Monthly Out-of-Pocket (USD) | Includes Doctor Visits & Support? | FDA-Approved Product? |
|---|---|---|---|
| Commercial insurance + copay card | $25 – $50 | No | Yes |
| Medicare Part D (diabetes only) | $0–$100 (Extra Help) or $200–$600 | No | Yes |
| Uninsured + manufacturer PAP | $0 | No | Yes |
| Compounded telehealth (top providers) | $199 – $349 | Yes | No |
| Cash pay branded (discount card) | $900 – $1,100 | No | Yes |
Compounded telehealth programs offer the lowest predictable monthly cost with medical oversight for uninsured patients.
Manufacturer Savings and Assistance Programs
Novo Nordisk and Eli Lilly run patient assistance programs that provide free branded medication to qualifying uninsured or underinsured patients. Income eligibility is generally ≤400% of the federal poverty level, and applicants must show denial from other coverage sources.
Applications require recent tax returns, proof of income, denial letters (if applicable), and a valid prescription. Approval takes 2–6 weeks; medication ships directly at no cost for 12 months (renewable). These programs do not cover office visits or lab work.
Commercial copay cards reduce out-of-pocket to $25–$50 per month for insured patients (subject to annual caps). These cards are not available to Medicare or Medicaid beneficiaries.
Practical Steps to Lower Out-of-Pocket Costs
- Check eligibility for manufacturer patient assistance programs if uninsured (free medication if qualified).
- If commercially insured, activate copay cards before filling.
- Compare cash prices using GoodRx, SingleCare, RxSaver, or Blink Health.
- Research 3–5 reputable telehealth compounded providers. Ask about pharmacy source, testing, and total fees.
- Schedule a virtual consultation and share recent labs (A1C, kidney function, lipids).
- Verify the provider is licensed in your state and uses a 503B facility.
- Track progress and side effects weekly.
Safety and Monitoring Considerations
All GLP-1 medications carry similar gastrointestinal side effects (nausea, vomiting, diarrhea, constipation) that are most intense during dose escalation. These usually improve after 4–8 weeks. Rare serious risks include pancreatitis, gallbladder problems, and thyroid concerns (seen in animal studies).
Regular follow-up with your prescriber is essential. Blood work (A1C, kidney function, lipids) is recommended every 3–6 months. Monitor for severe abdominal pain, persistent vomiting, or signs of dehydration.
Weight loss injections are powerful tools but require medical supervision. Never start, stop, or adjust doses without guidance from a licensed provider.
Conclusion
GLP-1 medications remain expensive without insurance, but manufacturer assistance programs, copay cards, discount platforms, and reputable compounded telehealth options make them accessible to many more patients in 2025. Costs can drop from over $1,300 per month to $0–$499 depending on eligibility and chosen path. Work closely with your doctor and compare legitimate sources to find the safest, most affordable option for your needs.
FAQ
What is the cash price for Wegovy or Zepbound without insurance?
The cash price for a 4-week supply is typically $1,300–$1,400 at retail pharmacies in 2025. Discount cards reduce it to $900–$1,100 per month at participating locations.
Can I get GLP-1 medication free without insurance?
Yes. Manufacturer patient assistance programs from Novo Nordisk and Eli Lilly provide free branded medication to uninsured or underinsured patients who meet income guidelines (usually ≤400% of the federal poverty level). Approval requires financial documentation and takes 2–6 weeks.
Are compounded GLP-1 programs much cheaper than branded?
Yes. Reputable telehealth compounded programs cost $199–$499 per month all-inclusive. These are cash-pay only and not FDA-approved. Quality varies, so choose providers with 503B pharmacies and batch testing.
How do copay cards work for GLP-1 drugs?
Copay cards from Novo Nordisk and Eli Lilly reduce out-of-pocket to $25–$50 per month for commercially insured patients (subject to annual caps). They cannot be used with Medicare, Medicaid, or government programs.
Does Medicare cover GLP-1 drugs for weight loss?
No. Medicare Part D excludes coverage for drugs used only for weight loss or obesity. Ozempic and Mounjaro are covered when prescribed for type 2 diabetes.
What should I do if I cannot afford GLP-1 medication?
Contact your doctor immediately. They can help apply for manufacturer assistance, switch to a lower-cost compounded option, adjust to a lower dose if appropriate, or prescribe an alternative medication with better financial support. Never stop treatment abruptly without medical guidance.
Dr. Usman is a medical content reviewer with 12+ years of experience in healthcare research and patient education. He specializes in evidence-based health information, medications, and chronic health topics. His work is based on trusted medical sources and current clinical guidelines to ensure accuracy, transparency, and reliability. Content reviewed by Dr. Usman is for educational purposes and does not replace professional medical advice.