Insurance vs. Self-Pay for GLP-1s: Weighing Your Options

Glucagon-like peptide-1 (GLP-1) receptor agonists with the related GIP/GLP-1 receptor agonists are medications prescribed for Type 2 diabetes, weight loss, and other conditions. Examples of these drugs include Ozempic (semaglutide) and Zepbound (tirzepatide). GLP-1 medications are in high demand. But they also have prices that make them unaffordable for many.

Some health insurance plans cover these medications. But self-pay or cash-pay options for GLP-1s are available. To learn how to navigate your options for affording GLP-1 and GIP/GLP-1 receptor agonists, read on. (Going forward, these will be referred to as GLP-1 medications.)

What are the main ways to pay for GLP-1 treatment?

Let’s look at the common ways to pay for GLP-1 treatment:

• Insurance: What’s covered by your insurance depends on your diagnosis and your plan’s formulary. GLP-1s prescribed for Type 2 diabetes are more likely to be covered. Your out-of-pocket costs may still be too high with insurance. If so, check GoodRx to see if there’s a manufacturer copay card available. Using one could drop your cost to less than $50 per fill.

• Self-pay: If you’re new to using GoodRx, you can qualify for lower self-pay prices for GLP-1s that treat diabetes. These medications include Ozempic, Mounjaro (tirzepatide), and Victoza (liraglutide). With GoodRx, the introductory price is $199 per month for Ozempic pens and $149 per month for Ozempic tablets. Certain doses and ongoing fills have a higher monthly cost.

• GoodRx for Weight Loss: Subscribers to GoodRx for Weight Loss can access FDA-approved, brand-name GLP-1 medications prescribed for weight management. If you’re new to the GoodRx for Weight Loss subscription program, there’s an introductory price for the first two fills of certain doses: $199 per month for Wegovy injections, $149 for the Wegovy pill or the Foundayo pill, and Zepbound KwikPens and vials starting at $299 per month. After that, most fills have a higher monthly cost, depending on the medication and dose.

• Manufacturer direct-to-consumer programs: GLP-1 manufacturers offer direct-to-consumer self-pay programs, which can save you money without insurance. For example, NovoCare Pharmacy offers starting prices of $149 and $199 per month for Wegovy (pill and pen) and $149 and $199 per month for Ozempic (pill and pen) direct to consumers. Prices can be higher based on the dose and form. LillyDirect offers Zepbound KwikPens and vials direct to consumers starting at $299 per month. Mounjaro pens start at $499 a month, Foundayo pills start at $149 a month, and Trulicity (dulaglutide) for Type 2 diabetes starts at $389 a month.

• Medicare GLP-1 Bridge Program: Historically, Medicare hasn’t covered medications prescribed for weight loss. But that changed in July 2026 with the Medicare GLP-1 Bridge program. This new pilot initiative offers Medicare prescription plan enrollees access to weight-loss medications for a $50 monthly copay. Only certain GLP-1s are covered under the Medicare GLP-1 Bridge program. They include all formulations of the following medications: Foundayo (orforglipron), an oral tablet; Wegovy (semaglutide) pills and injections; and Zepbound (tirzepatide) KwikPens.

Does insurance usually cover GLP-1s?

It depends. Most people in the U.S. have health insurance that covers prescriptions, whether they are under age 65 or have Medicare. GLP-1s used to treat diabetes, such as Ozempic and Mounjaro, are more likely to be covered than related medications prescribed for weight loss. In all cases, GLP-1 coverage is subject to insurance plan coverage limits and reviews such as prior authorization and step therapy.

Insurance coverage for GLP-1s used for weight loss varies widely. Many insurance plans exclude them from their formularies. But your GLP-1 may be covered by your insurance when prescribed for other FDA-approved uses such as Type 2 diabetes or reducing the risk of serious cardiovascular problems.

A pharmacy benefit manager (PBM) is a company that works with insurance plans, pharmacies, and pharmaceutical companies to handle prescription drug benefits. PBMs have many roles, including designing formularies. The formulary is one way payers manage costs and control the pharmacy benefits offered to health plan enrollees.

The largest PBMs — Cigna Express Scripts, CVS Caremark, and UnitedHealth Group’s Optum Rx — control more than 80% of the U.S. market. Which drugs appear on formularies affects prescription medication access for millions of people and determines what enrollees pay out of pocket. Many people aren’t aware that a formulary may be updated frequently. This means medications can be dropped and added throughout the coverage year.

For example: In July 2025, CVS Caremark dropped Eli Lilly’s Zepbound as a preferred medication. But it continued to cover Wegovy after negotiating a better price from its manufacturer, Novo Nordisk. Patients and doctors said the treatments weren’t interchangeable. Studies show that people lose more weight using tirzepatide, Zepbound’s active ingredient. Tirzepatide is also approved to treat sleep apnea.

As a result, Zepbound will return to standard CVS Caremark formularies in October 2026. This means 25 million to 30 million people may gain coverage for the medication. (Employers typically decide which medications to cover.)

Can you get GLP-1s without insurance?

Yes, you can get GLP-1s without insurance, but costs can vary from a few hundred dollars to more than $1,000 per month. Most GLP-1s don’t have generic alternatives. This means they’re available only as brand-name products. Check out GoodRx savings and special offers or patient assistance programs for ways to save.

Many self-pay options may be affordable for you to access GLP-1s without insurance.

What is self-pay for GLP-1s?

Self-pay for GLP-1s means accessing these medications without using health insurance. Affordable access to your GLP-1 medication is important, especially if your insurance doesn’t cover the medication you need or your plan stops covering your medication.

How can you tell if insurance or cash pay is more affordable?

The best way to find out if insurance or cash pay is more affordable is to do your research and weigh your options. The first step is to:

• Find out what your prescription plan covers.

• Determine if you can meet the requirements for coverage.

• Determine your out-of-pocket costs when using your insurance.

A good place to start is by reviewing your formulary. This is usually available through your health insurance website. You can also call your health plan. The formulary includes covered GLP-1 medications, coverage limits, and the expected cost. Your prescriber, the medical office staff, and your pharmacy can also help you with insurance verification.

You may pay less by using a copay discount, such as the Zepbound savings card. This helps people whose commercial insurance covers this medication pay as little as $25 for up to a 3-month fill. Or you may qualify for the Medicare GLP-1 Bridge Program, which provides certain medications for $50 a month.

Otherwise, a self-pay option may be your best bet to access GLP-1 medications without insurance barriers.

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Written by:

Veneta Lusk

Veneta Lusk is a personal finance and healthcare writer with 15 years of experience. She holds a bachelor of arts in journalism from the University of North Carolina at Chapel Hill.

Edited by:

Cindy George, MPH

Cindy George, MPH, is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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