Key takeaways:
Azithromycin (Zithromax) is an FDA-approved antibiotic used for treating mild-to-moderate bacterial infections in adults and children ages 6 months and older.
Most insurance plans cover azithromycin, with Medicaid covering the highest percentage of enrollees. If you’re paying out of pocket, you can download a GoodRx coupon to save money.
Without insurance, the average cost for 6 tablets of 250 mg azithromycin may cost around $23.22. For Zithromax, the brand-name version of azithromycin, you can expect to pay about $72.11 for the same dose and quantity.
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Azithromycin (Zithromax) is a macrolide antibiotic. It is FDA approved to treat bacterial infections, including sinus infections, ear infections, and pneumonia.
Azithromycin works by preventing the growth of certain bacteria in adults and children ages 6 months and older. But antibiotics like azithromycin don’t work for colds, the flu, and other virus-related illnesses.
How much azithromycin costs without insurance depends on your prescribed dose and quantity. Whether you receive the brand or generic version also plays a large role in your out-of-pocket cost.
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How much does azithromycin cost?
Without insurance, the average cash price for six tablets of 250 mg azithromycin is $23.22. For the same quantity and dose of the brand-name version, the cost is about $72.11.
It's common to receive a prescription for six azithromycin 250 mg tablets. The tablets are often prescribed in a popular prepackaged form known as a Z-Pak. Your recommended dosage of azithromycin treatment will depend on the type and severity of the illness being treated. Some infections require only one dose, while others require several days of treatment. And this will ultimately affect your total cost.
The exact price you pay for azithromycin may vary based on several factors, including:
The area you live in
The prescription dose, quantity, and form
The pharmacy you select
The availability of coupons, discounts, or insurance
Whether you receive a brand-name or generic version of the medication
The table below shows the average retail price for different quantities, forms, and doses of brand-name and generic azithromycin.
Azithromycin | Quantity and form | Dose | Average retail price |
|---|---|---|---|
Azithromycin (generic) | 6 tablets | 250 mg | |
Azithromycin (generic) | 3 tablets | 500 mg | |
Azithromycin (generic) | 1 bottle of oral suspension | 15 mL of 100 mg/5 mL | |
Azithromycin (generic) | 1 bottle of oral suspension | 15 mL of 200 mg/5 mL | |
Azithromycin (generic) | 1 Z-Pak (6 tablets) | 250 mg | |
Azithromycin (generic) | 1 packet of dry powder | 1 g | |
AzaSite eyedrops (brand name) | 1 package | 2.5 mL of 1% | |
Zithromax (brand name) | 6 tablets | 250 mg | |
Zithromax (brand name) | 3 tablets | 500 mg | |
Zithromax (brand name) | 1 bottle of oral suspension | 15 mL of 100 mg/5 mL | |
Zithromax (brand name) | 1 bottle of oral suspension | 15 mL of 200 mg/5 mL | |
Zithromax (brand name) | 1 Z-Pak (6 tablets) | 250 mg | |
Zithromax (brand name) | 1 packet of dry powder | 1 g |
Does insurance cover azithromycin?
Most health insurance plans, including Medicare and Medicaid plans, cover azithromycin. State marketplace and Medicare plans typically cover the medication without restrictions.
Medicaid also covers azithromycin for most enrollees, with prior authorization rarely required. Check your plan’s formulary (list of covered medications) to confirm your out-of-pocket costs and coverage for azithromycin, brand-name Zithromax, or both.
How different insurance plans cover azithromycin
The following table shows the likelihood of coverage — as well as requirements for prior authorization or step therapy — for azithromycin based on the type of insurance plan.
Insurance type | Enrollees covered for this medication | Enrollees required to get a prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Affordable Care Act (ACA) plans | 85.9% | 0% | 0% |
Commercial (not including ACA plans) | 98.6% | 0.1% | 0% |
Medicare (original Medicare and Medicare Advantage) | 96.8% | 0% | 0% |
Medicaid, including state-run and managed care plans | 99.9% | 1.7% | 0% |
Source: Managed Markets Insight & Technology, LLC™, as of December 13, 2024. (See methodology below)
If your insurer does not cover azithromycin, you still have several options:
Check if your plan covers a different dosage form of the generic.
Ask a healthcare professional about alternative medications that your insurance may cover.
Request a formulary exception for azithromycin from your insurer.
If the exception is denied, consider filing an appeal.
During open enrollment, explore different insurance plans that better align with your medication needs.
Ways to save on azithromycin
Regardless of whether you have insurance, here are four ways you can save on brand-name and generic azithromycin:
1. Use a GoodRx coupon
With a free GoodRx coupon, you can save on your brand-name or generic azithromycin prescription.
Here’s what you could expect to pay for various doses of brand-name and generic azithromycin using a GoodRx coupon.
Azithromycin | Quantity and form | Dose | Price with a GoodRx coupon |
|---|---|---|---|
Azithromycin (generic) | 6 tablets | 250 mg | |
Azithromycin (generic) | 3 tablets | 500 mg | |
Azithromycin (generic) | 1 bottle of oral suspension | 15mL of 100 mg/5 mL | |
Azithromycin (generic) | 1 bottle of oral suspension | 15 mL of 200 mg/5 mL | |
Azithromycin (generic) | 1 Z-Pak (6 tablets) | 250 mg | |
Azithromycin (generic) | 1 packet of dry powder | 1 g | |
AzaSite eyedrops (brand name) | 1 package | 2.5 mL of 1% | |
Zithromax (brand name) | 6 tablets | 250 mg | |
Zithromax (brand name) | 3 tablets | 500 mg | |
Zithromax (brand name) | 1 bottle of oral suspension | 15 mL of 100 mg/5 mL | |
Zithromax (brand name) | 1 bottle of oral suspension | 15 mL of 200 mg/5 mL | |
Zithromax (brand name) | 1 Z-Pak (6 tablets) | 250 mg | |
Zithromax (brand name) | 1 packet of dry powder | 1 g |
To get your free coupon for azithromycin:
Visit www.goodrx.com, or download the GoodRx app on your phone or tablet.
Search for “azithromycin,” and click or tap "Start saving."
Choose your prescribed dose, dosage form, and quantity of the brand-name or generic version.
Select to receive your coupon by text or email, or print it out.
Present the coupon at your pharmacy before picking up your azithromycin prescription. Providing this information earlier in the filling process can help you avoid delays at the register.
You can access discounted prescription medications with a GoodRx Companion subscription. Over 200 medications are available for free, with hundreds more under $10. The program also includes benefits to help you cut your self-pay costs, such as lower prices for online care visits, discounts on dental care, and other health services.
2. Consider a lower-cost alternative
Other medications similar to azithromycin may treat your condition just as effectively at a lower price. Ask a healthcare professional about options, including generic alternatives.
3. Compare pharmacy prices
Use the GoodRx app or website to compare azithromycin prices at pharmacies near you. You might discover a lower price at a pharmacy you don’t usually use.
4. Tap into your HSA, FSA, or HRA
Consider using funds from a health savings account (HSA), flexible spending account (FSA), or health reimbursement arrangement (HRA) to purchase azithromycin. These accounts let you use pretax dollars to pay for copays, coinsurance, and other qualified medical expenses. This can help you reduce your costs through tax savings.
Just be sure to check if the money in your account has to be used before a certain time. FSA dollars have an expiration date. But HSA funds roll over and can be saved for later. HRA funds may or may not expire, depending on your account.
The bottom line
Without insurance, six 250 mg tablets of generic azithromycin cost around $23.22, while the brand-name version, Zithromax, costs about $72.11. Prices for azithromycin can vary depending on your location, dosage, pharmacy, and insurance coverage. But there are ways to save money, including using a GoodRx coupon.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of December 2024.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Bryant Ranch Prepack. (2026). Azithromycin- azithromycin tablet, film coated.
HealthCare.gov. (n.d.) Appealing a health plan decision.
Medicaid.gov. (n.d.). Managed care.
