Your guide to costs, insurance, and access for GLP-1s

Key takeaways

• Glucagon-like peptide-1 receptor agonists (GLP-1s) often have list prices over $1000 per month, but insurance, manufacturer savings programs, and discount cards can significantly reduce out-of-pocket costs.
• Insurance coverage for GLP-1s varies widely, with diabetes-approved medications like Ozempic more likely to be covered than weight management drugs like Wegovy, which may require prior authorization.
• Medicare Part D is expanding weight management coverage through a temporary 2026 program offering select GLP-1s for a $50 monthly copay, with plans for permanent coverage starting in 2027.

Overview

Glucagon-like peptide-1 receptor agonists (GLP-1s) are rising in popularity, but they often have high list prices of over $1000 per month. However, you usually won’t pay that much out of pocket. There are several savings options available for GLP-1s, including:

• health insurance
• manufacturer savings programs
• discount cards

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Does insurance cover GLP-1s?

There is wide variation between employer and individual plans as to whether GLP-1s for weight loss are covered. GLP-1 coverage is often limited, but it may be expanding.

Insurance coverage for GLP-1s depends on your plan, the specific GLP-1, and what it’s being used to treat, but denials are still common for these expensive medications.

Insurance will typically only cover GLP-1s when prescribed for an approved reason, such as Ozempic for diabetes or Wegovy for weight management. Using a GLP-1 for a use not approved by the FDA is known as off-label prescribing.

Diabetes-approved drugs like Ozempic are likely to be covered under standard chronic disease coverage, whereas weight management drugs like Wegovy may require a separate prior authorization process.

What is prior authorization?

Prior authorization is a process where your insurance provider needs your doctor to prove that a treatment is medically necessary for you before agreeing to cover the cost. For weight management, this may involve the doctor submitting documents that show:

• that you meet certain criteria, like BMI thresholds
• that you have tried less expensive treatments that haven’t worked
• participation in a weight-management program or using a health app to track your progress
• that you have implemented lifestyle changes, like a reduced-calorie diet and increased exercise

The insurer will then review the request and approve or deny it, or ask for more information. If they deny the request, you have the right to appeal the decision or pay out of pocket for the medication.

Medicare and Medicaid coverage

Medicare and Medicaid are more likely to cover GLP-1s for type 2 diabetes than for weight management. Medicaid coverage for weight loss drugs typically varies by state. As of January 2026, only 13 states cover GLP-1 medications for obesity.

However, Medicare Part D is now covering weight management medications for the first time, following the Treat and Reduce Obesity Act signed in late 2025. To provide immediate access while full implementation is finalized, the government launched a temporary 18-month program called the Medicare GLP-1 Bridge, running from July 1, 2026, through December 31, 2027.

Under this initiative, patients can access Wegovy tablets, the Wegovy injection, or the Zepbound KwikPen for a flat $50 monthly copay, with the Centers for Medicare & Medicaid Services (CMS) covering the rest of the $245 monthly cost.

From 2027, the government plans to introduce the BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive Health) model. If enough Part D plans opt in by January 2027, this model will permanently add weight-loss GLP-1s to the standard benefit package, likely alongside a requirement to enroll in a supportive lifestyle program.

How to save on GLP-1s

If insurance won’t cover GLP-1s, there are many other ways to save on the costs:

• Manufacturer savings programs: Many GLP-1 manufacturers offer savings programs that can be used alongside insurance to reduce the cost of your copay. They can also help you save on the list price even if insurance won’t cover the drug.
• Self-pay options: Some manufacturers offer fixed, reduced pricing for patients paying entirely out of pocket. These often offer other benefits like home delivery.
• Prescription discount cards and coupons: Some third-party companies offer a free or low cost discount card that can help you save on many medications, including GLP-1s. This is available through negotiations with drug manufacturers.
• Government programs: TrumpRx is a federal platform that allows people to find and access discounted drug prices for some prescription drugs, including GLP-1s. Medicare is also expanding coverage for GLP-1s for obesity.

Online care for GLP-1s

If a doctor has prescribed a GLP-1, it’s important to take the medication as directed for as long as your doctor recommends. However, some people might face barriers to accessing GLP-1s, including high costs and access to healthcare appointments.

With Optum Perks Online Care, you can request a new weight loss prescription, get a refill, or get help with an existing prescription. There’s no monthly membership needed — all you’ll pay is $29 for the appointment plus the cost of the medication.

With this service, you can submit an online form answering a few questions about your condition, and a licensed healthcare professional will respond soon after, without the need to make an in-person appointment.

Why are GLP-1s so expensive?

One reason why GLP-1s are expensive is that they are still fairly new. When a new drug is approved, the Food and Drug Administration (FDA) grants the manufacturer a period of exclusivity to sell the medication under a brand name.

Initial prices for brand-name drugs tend to be high because the research and development process for a drug is often costly, so the manufacturer tries to recover some of those costs and fund future research.

The majority of GLP-1s are only available in brand-name form, and some 2024 research suggests that GLP-1 medications tend to have longer exclusivity periods than other medications, with an average of 18.2 years.

Currently, only one generic GLP-1 is available, and it’s approved for weight management. This is injectable liraglutide, the generic form of Saxenda, and it was approved in 2025.

Will more generic GLP-1s become available?

Drug manufacturers have exclusivity to sell branded GLP-1s until their patent expires. It’s difficult to know exactly when a drug’s patent will expire, especially because they tend to expire at different times in different countries.

For example, Novo Nordisk, the manufacturer of Ozempic and Wegovy, holds a patent for semaglutide (the active ingredient) that lasts until 2032 in the United States, but the patent is set to expire in 2026 in several countries, including Canada, India, and China.

This means that drug companies in these countries can begin to make generic versions of these drugs, but it may still be some time before they are approved for use, and longer still until they are available in the U.S. However, this increased competition in the market may lead to lower costs overall.

A note on safety

Be wary of websites offering cheap compounded GLP-1s. The FDA cannot guarantee the safety and effectiveness of these drugs. If a deal seems too good to be true, it probably is.

Summary

GLP-1s can be very expensive, costing over $1000 per month without insurance or discounts. However, this is rarely the final price you’ll pay.

Private and federal insurance coverage is expanding for GLP-1s, beginning to include GLP-1s for weight loss in many cases. You can also look into discount cards and manufacturer savings programs to save on your prescription costs.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.