GLP-1 Cost Calculator
What you pay for a GLP-1 depends on how you buy it: a manufacturer self-pay price if you have no coverage, or your plan's deductible, copay and coinsurance if you do. Enter your numbers below and this calculator estimates a full year's out-of-pocket cost for each route, so you can compare them side by side.
Updated
What drives what you pay
The same medication can cost wildly different amounts depending on one thing: whether your insurance covers it. There are really three prices to keep straight.
- List price - the manufacturer's published price before any discount. Almost nobody pays this directly.
- Self-pay / cash price - what the manufacturer or a pharmacy charges if you have no coverage, often through a direct program that's lower than list.
- Your insured cost - what you actually pay after your plan's deductible, copay or coinsurance and any savings card.
This tool lets you enter each of those so you can see which route is cheaper for your situation. Because prices change, always confirm the current figure on the manufacturer's own page - linked in Sources - before you rely on it.
Self-pay programs
If your plan doesn't cover a GLP-1, both major manufacturers run direct self-pay programs that sell the drug for less than its list price - usually as vials rather than pens, and often only for people who pay cash. The exact monthly figure changes over time and depends on the specific product and dose.
Rather than quote a number that may be out of date, check the source directly: NovoCare for Wegovy and Ozempic, and Lilly's Zepbound site for Zepbound and Mounjaro. Note the price and the date you saw it, then enter that monthly amount as your self-pay figure in the calculator. It multiplies by twelve to estimate a year, so you can compare cash-pay against going through insurance.
Insurance: deductible, copay, coinsurance
If your plan does cover the drug, three terms decide your bill:
- Deductible - the amount you pay yourself before the plan starts paying. Early in the year you may pay closer to the full negotiated price until you meet it.
- Copay - a flat dollar amount per fill once coverage kicks in (for example, a set tier price for a preferred brand).
- Coinsurance - a percentage of the drug's cost that you keep paying, up to your plan's out-of-pocket maximum.
The calculator models a common pattern: you pay toward the deductible first, then a copay or coinsurance for the rest of the year, capped at your out-of-pocket max. Your plan documents (the Summary of Benefits) list these numbers, and your formulary shows which tier the drug sits on.
Worked example
These are illustrative figures to show how the math works - not a quote. Suppose your plan covers the drug, you have a $1,500 deductible you haven't met, the plan's negotiated price is $1,100 a month, and your copay after the deductible is $60.
- Month 1: you pay the $1,100 negotiated price, which clears the $1,500 deductible partway.
- Once the deductible is met, later months drop to the $60 copay.
- Add it up and a first year lands near $2,160 in this example.
Now compare that with a self-pay route: if a cash program price were, say, $499 a month, a year would be about $5,988. Which wins depends entirely on your own deductible and copay - so put your real numbers in and let the tool total both.
Questions to ask your insurer
Before you commit to a route, a short call to the number on your insurance card can save a lot. Ask:
- Is this specific GLP-1 on my formulary, and for which diagnosis - diabetes, weight management, or both?
- What tier is it, and does it need prior authorization or step therapy first?
- What's my remaining deductible, my copay or coinsurance for this tier, and my out-of-pocket maximum?
- Is there a preferred alternative that's covered at a lower tier?
Write down who you spoke to and when. Coverage rules for GLP-1s change frequently, and a documented answer helps if a claim is later denied. Then bring those numbers back here to compare against the manufacturer's self-pay price.
Frequently asked questions
Which GLP-1 is most affordable?
It depends on your coverage, not just the drug. If a medication sits on a low tier of your formulary, your copay may make it the cheapest even if its list price is high. Without insurance, the manufacturers' self-pay programs set the price. Enter each option's figures in the calculator to compare your actual out-of-pocket cost.
Can I lose 20 pounds in 3 months on Ozempic?
Results vary widely from person to person and this site can't predict or promise weight loss - that's a medical question for your doctor. Our focus is cost: estimating what a GLP-1 would cost you per month and per year through insurance or self-pay so you can plan the financial side.
Will insurance pay for a GLP-1?
Sometimes. Many plans cover GLP-1s for type 2 diabetes, while coverage for weight management is less consistent and often needs prior authorization. The only reliable answer comes from your own plan's formulary and benefits. Call the number on your card and ask whether your specific drug is covered and on what terms.
What is the cheapest way to get one?
Usually the lowest of two routes: a well-covered plan with a modest copay, or a manufacturer self-pay program if you have no coverage. Savings cards can lower the insured cost further for eligible commercially insured patients. Compare both totals in the calculator using current prices from the manufacturer's page.
How are people getting these medications for $25?
A very low copay like that usually comes from a manufacturer savings card applied on top of commercial insurance that already covers the drug. These cards have eligibility rules and typically exclude people on Medicare or Medicaid. Check the manufacturer's savings-card terms to see whether you qualify before assuming that price.
How can I afford it if my insurance doesn't cover it?
If your plan excludes the drug, look at the manufacturer's direct self-pay program, which prices it below list for cash payers, and ask your prescriber whether a covered alternative would work. A patient-assistance program may help if you meet income limits. Enter the self-pay price here to see the yearly total.
Are any GLP-1s covered by insurance?
Yes - coverage exists, especially for type 2 diabetes indications, and varies by plan and by whether the prescription is for diabetes or weight management. Your formulary lists which products are covered and at what tier. Because plans update these lists often, confirm your specific drug directly with your insurer.
Is it cheaper to go through insurance?
Not always. If you're early in the year with a high deductible, the insured price for the first fills can exceed a manufacturer's self-pay program; once the deductible is met, insurance usually wins. The calculator models both so you can see the crossover point for your own numbers.
Sources
- NovoCare (Novo Nordisk) - Wegovy & Ozempic pricing and savings
- Lilly - Zepbound (and Mounjaro) pricing and savings
- Medicare.gov - drug coverage
Related
Cost estimates only - not medical, insurance or financial advice. Talk to your doctor, pharmacist and insurer. Brand names belong to their owners; not affiliated with Novo Nordisk or Eli Lilly.