Monthly out-of-pocket for Wegovy, Ozempic, Mounjaro, Zepbound, or compounded semaglutide. Factors insurance tier (covered/not covered), deductible status, manufacturer savings card eligibility, July 2026 Medicare bridge.
Detailed instructions, formula notes, and US-context guidance shown in the calculator above.
Disclaimer: Estimate only. Consult a qualified professional for decisions with major financial, legal, or health consequences.
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📋 How to use this calculator
- Select the GLP-1 medication — Wegovy, Ozempic, Mounjaro, Zepbound, or compounded.
- Select insurance status — not covered, covered by commercial, or Medicare Part D.
- Indicate manufacturer savings card eligibility (commercial insurance + non-government).
- Mark whether your insurance deductible is met for the year.
- Review monthly OOP cost, annual cost, and any savings card credit.
- Note: As of July 2026, Medicare Part D covers Wegovy/Zepbound for CV-risk indication only.
🧮 GLP-1 Monthly OOP Cost Estimation
OOP = Retail - Coverage_offset - Savings_card_credit
- Wegovy retail: ~$1,349/mo; Zepbound: ~$1,059/mo; Mounjaro (T2D): ~$1,069; Ozempic (T2D): ~$968; compounded: $200-400
- Coverage offset: depends on plan tier (Tier 3/Specialty), deductible status, copay structure
- Savings card credit: Wegovy $650/mo cap; Zepbound $550/mo cap; Ozempic/Mounjaro $25 with commercial
- Medicare Part D: cannot use savings cards (govt insurance exclusion)
- Compounded GLP-1: pharmacy cash price, no insurance/savings card
FDA enforcement narrowed compounded GLP-1 access in April 2025; only personalized formulations (BMI, allergy, etc.) legally compounded today. Manufacturer cash programs (LillyDirect, Wegovy NovoCare): brand at reduced cash price ($349-499/mo) for self-pay patients — competitive with compounded but legal.
💡 Worked example: Commercial insurance, Wegovy not covered, savings card eligible
Given:- Drug: Wegovy
- Insurance: commercial (HSA-eligible HDHP), Wegovy NOT on formulary
- Retail list price: $1,349/month
- Savings card status: eligible (commercial insurance, not Medicare)
- Wegovy savings card cap: $650/month
Steps:- Without insurance coverage, savings card applies vs retail price
- Savings card brings monthly cost down to $650
- Annual OOP: $650 x 12 = $7,800
- Compare LillyDirect cash program if switching to Zepbound: $499/mo = $5,988/yr
- Decision: switch to Zepbound via LillyDirect saves $1,812/yr
Result: $7,800/yr on Wegovy with savings card, or $5,988/yr on Zepbound via LillyDirect cash. Switching considerations: efficacy is similar (tirzepatide modestly more effective), but consult MD before switching.
❓ Frequently asked questions
Why is my insurance not covering Wegovy?
Most commercial insurance plans exclude GLP-1s for weight loss (Wegovy, Zepbound) unless your plan specifically offers obesity drug coverage. They're more likely to cover GLP-1s for Type 2 diabetes (Ozempic, Mounjaro). Some employer plans (CVS Caremark, Express Scripts) have selectively dropped coverage in 2024-2025 to control costs. Check your formulary — if not covered, request a formulary exception with medical documentation of comorbidities.
What's the cheapest legal way to access GLP-1 in 2026?
Three tiers from cheapest: (1) Insurance coverage with $25-50 copay (lottery — depends on plan); (2) Manufacturer cash programs: Zepbound via LillyDirect ($349-499/mo), Wegovy via NovoCare ($499/mo); (3) Manufacturer savings card on top of partial insurance ($25-650 depending on drug + insurance status). Compounded GLP-1 is harder to access legally post-FDA enforcement.
Does Medicare cover GLP-1s for weight loss?
Historically NO (Medicare Part D statutorily excludes weight-loss drugs). HOWEVER: starting July 2026, Medicare Part D plans MAY cover Wegovy and Zepbound for cardiovascular risk reduction (the FDA-approved CV indication, not just obesity). Coverage varies by plan; expect $50-150/month copay if covered. Manufacturer savings cards don't apply to Medicare patients due to anti-kickback statute.
Is compounded semaglutide / tirzepatide still legal?
Mostly NO as of mid-2026. FDA declared shortage resolved in 2024-2025 (tirzepatide in October 2024, semaglutide in February 2025), triggering 60-90-day enforcement windows. Compounders cannot mass-produce 'essentially the same' formulations. They CAN still produce 'personalized' formulations (different strength, with B12, allergic-component-removed, etc.) under traditional 503A compounding. Quality varies wildly; FDA has seized impure batches.
What about Ozempic for weight loss off-label?
Ozempic is FDA-approved only for Type 2 diabetes. Doctors can prescribe it off-label for weight loss, but insurance won't cover the off-label use, and the Novo Nordisk savings card only applies for diabetes patients. Cash price is $968/month with no manufacturer discount in off-label scenario. Wegovy (same active ingredient, weight-loss approved) is the legitimate choice — same molecule, just labeled differently.
📚 Sources & references
Last updated: May 23, 2026