How to Save Money on Your Ozempic Prescription, According to Experts
"Hearst Magazines and Yahoo may earn commission or revenue on some items through these links."
Ozempic (with a main active ingredient of semaglutide), has gained popularity for its ability to help manage blood sugars in those with type 2 diabetes and promote weight loss. With its increased popularity, more and more people are wondering: How much does Ozempic cost? And what are the costs with or without insurance?
Before we dig into pricing, it’s important to explain that the drug, which is FDA-approved for those with type 2 diabetes “is in a class of drugs known as GLP-1 agonists, which work on GLP-1 receptors throughout the body,” explains Deena Adimoolam, M.D., a specialist in diabetes and endocrinology. “When Ozempic stimulates GLP-1 receptors in the pancreas it triggers a release of insulin which helps to lower blood sugar levels in those with type 2 diabetes, and when it works on GLP-1 receptors in the gut it promotes satiety and weight loss.”
Meet the experts: Deena Adimoolam, M.D., a specialist in diabetes and endocrinology; and Christina Madison, Pharm.D., F.C.C.P, Founder and CEO of The Public Health Pharmacist
Because of the potential for weight loss while taking Ozempic, some providers prescribe it to patients who struggle with being overweight or obesity. Although, it’s important to note that while Ozempic (semaglutide) is not approved for weight loss, Wegovy (also with a main active ingredient of semaglutide), is. Though, oftentimes Wegovy is not covered by insurance.
Individuals are acquiring Ozempic at doctor’s offices, at med spas, and even online via telehealth companies. With so many places offering the type 2 diabetes drug, prices can vary. So how much does it cost? And how can you save on your Ozempic prescription? Experts break down what you need to know.
How much does Ozempic cost without insurance?
The cost of Ozempic varies based on a number of factors, like dosage and insurance coverage. However, Dr. Adimoolam explains that out of pocket, Ozempic can cost up to $1500 per month.
According to Novo Nordisk, the manufacturer of Ozempic, most people don’t pay the list price for their prescriptions because of insurance coverage and other savings options. The manufacturer states that the list price for a single 1.5 mL pen is $935.77.
How much does Ozempic cost with insurance?
Ultimately, the answer depends on your insurance plan. But with insurance, Ozempic is generally cheaper than the out-of-pocket price. However, the medication is usually not covered by insurance without a diagnosis of type 2 diabetes, explains Dr. Adimoolam.
Does Medicaid and/or Medicare cover Ozempic?
“Medicaid will pay under certain circumstances,” explains Christina Madison, Pharm.D., F.C.C.P, founder and CEO of The Public Health Pharmacist. These circumstances include as a treatment for type 2 diabetes—not in those who are looking to lose weight. Coverage varies based on your plan, so be sure to check the details of your plan for more information.
Medicare currently covers Ozempic for those with type 2 diabetes with a Medicare Part D plan. However, Medicare advises patients to check their specific coverage, including the list of covered drugs, to be certain.
Does private insurance cover Ozempic?
Private insurance coverage differs from plan to plan, but Madison explains that with a diagnosis of type 2 diabetes, most plans are likely to cover the prescription.
However, without the proper diagnosis, you’ll likely have to pay out of pocket. “This is definitely a health equity problem as those who generally need this medication most are historically marginalized and can’t afford it,” Madison comments.
For those without a type 2 diabetes diagnosis and who are overweight or have obesity, who want to lose weight, Dr. Adimoolam suggests asking your physician about Wegovy, which “contains the same active ingredient as Ozempic, semaglutide, and is FDA approved for weight loss.” The only caveat, as explained above, is this may not be covered by insurance.
How to save money on Ozempic
There are a few ways you might be able to save some money on an Ozempic prescription. “The first thing I would do is to check your insurance coverage and find out what is needed in order for the drug to be covered,” Madison explains, for those who have health insurance. Next, consider the following options:
Novo Nordisk’s Patient Assistance Program (PAP)
Madison recommends looking into Novo-Nordisk’s Patient Assistance Program (PAP). To qualify, you must have Medicare or no insurance, and meet the household income requirement, among other factors.
Novo Nordisk’s Diabetes Savings Offer Program
Among other medications, the Diabetes Savings Offer Program can help qualifying patients with type 2 diabetes and a private insurance plan (not including Medicaid or Medicare) save on Ozempic. Patients can save up to $450 per month, depending on the dosage and quantity of the prescription.
Coupons and other programs
Madison notes that there are a number of other patient assistance programs that can help patients save money. She recommends: Cover My Meds, GoodRX, and SingleCare.
You Might Also Like
