Out-of-pocket expenses refer to the money patients pay directly for healthcare services, medications, or supplies when insurance does not cover the full cost or when no insurance is in place. For GLP-1 medications such as semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), these expenses can range from almost nothing to over $1,300 per month depending on coverage, discounts, and assistance eligibility. Many people starting these treatments are surprised by how much—or how little—they end up paying after all programs are applied.
The costs fluctuate based on several factors: whether the prescription is for diabetes or weight management, the insurance plan type, the dose strength, the pharmacy used, and whether branded or compounded versions are chosen. Branded GLP-1 drugs remain expensive without help, but savings programs, discount cards, and emerging compounded options have made treatment more reachable in 2025. Knowing the full picture helps patients plan budgets and avoid unexpected bills.
This article breaks down real out-of-pocket costs for GLP-1 medications in 2025. It compares scenarios with different insurance types, explains major savings programs, shows typical monthly amounts, and offers practical steps to minimize expenses. All figures reflect average national pricing and policy information available in mid-2025.
Branded GLP-1 List Prices Without Any Assistance
The wholesale acquisition cost (list price) for a single four-week supply of branded Wegovy (semaglutide 2.4 mg) or Zepbound (tirzepatide 15 mg) sits at $1,300–$1,400 in 2025. Ozempic and Mounjaro carry similar list prices of $1,050–$1,350 per pen, depending on the exact dose strength. Retail pharmacies add only small markups for cash-paying customers, so most uninsured patients face close to these full amounts.
Annual out-of-pocket cost without any discounts or assistance exceeds $15,600–$16,800 for a full year of treatment. This figure does not include doctor visits, lab work, needles, sharps containers, or any supportive medications needed to manage side effects.
Biosimilar versions of semaglutide have started appearing at lower list prices in 2025, but branded GLP-1 products still dominate most prescriptions because of insurance preferences and physician familiarity.
Commercial Insurance Out-of-Pocket Costs
Commercial plans (employer-sponsored or marketplace) cover GLP-1 medications 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 until the deductible is met or catastrophic coverage begins.
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 health plans force patients to pay the full negotiated cash price until the deductible is satisfied. After the deductible, coinsurance applies. Many patients in high-deductible plans pay $1,000+ per month during the first few fills of the year.
- Typical Commercial Scenarios:
- Preferred tier + savings card: $25–$100/month
- Higher tier coinsurance: $200–$600/month
- High-deductible before deductible met: Full negotiated 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.
Manufacturer Savings and Patient Assistance Programs
Novo Nordisk and Eli Lilly offer 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.
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 typically covers virtual consultation, prescription, medication, syringes, shipping, and messaging support.
Popular providers include Henry Meds, Lavender Sky Health, OrderlyMeds, Eden, Mochi Health, and Sesame Care. Many use 503B outsourcing facilities that follow stricter manufacturing standards. Monthly pricing often remains flat regardless of dose.
Compounded versions are not FDA-approved, so quality depends on the pharmacy. Reputable programs provide third-party sterility and potency testing results for each batch. Avoid companies that sell “research peptides” or ship without physician review.
Comparison of Out-of-Pocket Costs (2025)
| 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.
Practical Steps to Minimize 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 can reduce out-of-pocket costs to $0–$499 per month for most eligible patients in 2025. Compare legitimate sources, prioritize safety, and work with your doctor to find the most affordable path that keeps treatment effective and safe.
FAQ
What is the full cash price for Wegovy or Zepbound without insurance?
The cash price for a 4-week supply of branded Wegovy or Zepbound is typically $1,300–$1,400 at retail pharmacies in 2025. Discount cards can 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 even with discounts?
Contact your prescribing 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.