Is Ozempic (Semaglutide) Covered by Insurance? What to Know About Costs and Coverage

Of the more than 38 million Americans living with some form of diabetes, the vast majority of them have Type 2 diabetes. Ozempic (semaglutide), a prescription-only medication administered through injections, is FDA approved to help adults with Type 2 diabetes manage their blood glucose (sugar) levels. It can also lower the risk of major cardiovascular and kidney-disease-related events in certain people with Type 2 diabetes.

Most health insurance providers cover Ozempic when it’s being used to treat Type 2 diabetes. However, there may still be out-of-pocket costs, including deductibles, copays, and coinsurance, depending on the plan.

Healthcare professionals may also prescribe Ozempic off-label to help people who don’t have diabetes lose weight, but the medication is not FDA approved for this purpose. As a result, many health insurance companies won’t cover Ozempic for chronic weight management.

What is Ozempic?

Ozempic is classified as a glucagon-like peptide-1 (GLP-1) receptor agonist, a type of medication that imitates the actions of a gut hormone known as GLP-1. Ozempic works by reducing blood sugar levels following meals and reducing sugar production in the liver. It also slows the movement of food out of the stomach.

GLP-1 is believed to directly impact the area of the brain that regulates appetite. So, by acting like GLP-1, Ozempic can also affect appetite and make you feel full. This can reduce your calorie intake, resulting in weight loss.

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How much does Ozempic cost without insurance?

The list price for Ozempic is approximately $998 per injection pen. But most people who don’t have coverage for Ozempic pay the retail price and not the list price. On average, the retail price for 1 Ozempic injection pen ranges from $1,000 to $1,200. But you could pay more, depending on the pharmacy you visit. 

The cost of Ozempic can be affected by many factors, including:

• Your location

• The pharmacy you choose

• The dosage you’re prescribed

• Your insurance coverage

• Your eligibility for patient assistance programs 

Since Ozempic is intended for long-term use, the costs can add up over time. And a generic version doesn’t exist, so Ozempic prices have remained high. But you could save money by using a GoodRx discount or manufacturer savings card, if you’re eligible.

Do health insurance plans cover Ozempic?

Whether insurance will cover Ozempic depends on the plan and what the medication is being used to treat. Many plans cover Ozempic for people with Type 2 diabetes, though there may still be copays or other out-of-pocket costs. 

Coverage for Ozempic as a weight-loss treatment depends on several factors and can vary by plan. Ozempic is not FDA approved for chronic weight management, so many insurers don’t cover it solely for this purpose. It’s also not FDA approved for polycystic ovary syndrome (PCOS), though some healthcare professionals prescribe it off-label for that condition. 

EXPERT PICKS: WHAT TO READ NEXT

• Paying for Ozempic: Ozempic can cost over $1,000 per month, but there are ways to save with or without insurance. 

• Wondering if your glucagon-like peptide-1 (GLP-1) medication is covered by insurance? Here are some steps to take to find out if your medication is covered. 

• Off-label coverage: Some GLP-1 receptor agonists are prescribed off-label for weight loss and other uses. Find out if your insurance covers off-label prescriptions.

Most plans only pay for costs associated with weight-related health problems once the problems develop — not for weight-loss treatments to prevent health issues from occurring. But if you’re seeking weight-loss treatment and don’t have diabetes, you may be eligible for a similar medication called Wegovy (semaglutide). Your insurance plan may be more likely to cover Wegovy if you also have heart disease or a type of fatty liver disease called metabolic dysfunction-associated steatohepatitis (MASH).

Even if your plan does cover Ozempic, there’s a good chance you’ll need to take extra steps to qualify. Most insurers require prior authorization to confirm Ozempic is medically necessary, and some may also require that you try other medications first (a process known as step therapy).

Below, read about how various insurance providers approach coverage for Ozempic. You can also track insurance coverage for Ozempic and other GLP-1s through GoodRx.

How different insurance plans cover Ozempic

The table below breaks down the percentage of enrollees who have coverage for Ozempic by insurance type. It also shows the likelihood of having prior authorization and step therapy requirements.

Source: Managed Markets Insight & Technology, LLC™, as of August 8, 2025. (See methodology below.)

Novo Nordisk, the manufacturer of Ozempic, has an online tool to help determine the cost of Ozempic with your insurance plan. A representative will review your benefits and give you an estimate over the phone or online. But you must have your prescription insurance card details available to get assistance. 

If you have commercial insurance that covers Ozempic, you may be able to pay as little as $25 for a 1-, 2-, or 3-month supply of Ozempic with the help of a savings card from the manufacturer. This offer is valid for up to 48 months and could lead to savings of up to $100 on a 1-month prescription, $200 on a 2-month prescription, or $300 on a 3-month prescription of Ozempic. If you are uninsured or pay out of pocket, you could pay as little as $499 per month with a GoodRx discount.  

Does Medicare cover Ozempic? 

Medicare insures people who are 65 or older, certain younger people with disabilities, and individuals with end-stage renal disease. Medicare Part D covers a variety of diabetes medications, and nearly all Medicare plans cover Ozempic for FDA-approved uses. Most of these plans also require prior authorization. If you have Medicare, or a Medicare Advantage plan, check the details of your prescription medication coverage to see if Ozempic is covered and if there are any requirements for coverage.

Medicare does not cover medications used solely for weight loss. Congress prohibited the program from covering obesity treatments as part of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA).

Does Medicaid cover Ozempic? 

Medicaid coverage for Ozempic varies by state. Medicaid provides health coverage to more than 77 million Americans, including children, pregnant women, low-income families, and people with disabilities. All states currently offer outpatient prescription medication coverage as part of their Medicaid programs, and nearly all enrollees have coverage for Ozempic when it’s used for FDA-approved conditions. 

However, many enrollees face restrictions. Nearly 3 in 4 are required to get prior authorization, and more than half must try other treatments first through step therapy. Each state has its own rules around these requirements, as well as limits on quantities and other specifics. Contact your state's Medicaid agency for details about your plan and whether Ozempic is covered.

How to get Ozempic covered by insurance

Though most insurance carriers cover Ozempic for FDA-approved conditions, you may have to provide proof of your condition before your plan will pay for the medication. Below are four steps you can take to increase your chances of getting Ozempic covered by your insurance provider: 

1. Review your health insurance plan. Reach out to your insurance provider to get a better understanding of what’s covered by your plan. You can also review your plan’s formulary to see if Ozempic is listed as a covered medication for your condition.

2. Get a prescription. Ozempic is a prescription-only medication for adults with Type 2 diabetes. It’s also approved to lower the risk of major cardiovascular and kidney-disease-related events in certain people with Type 2 diabetes. Schedule an appointment with your prescriber to discuss your medical condition, the potential benefits of Ozempic, and the possibility of getting a prescription.  

3. Obtain prior authorization, if needed. If your insurance company requires prior authorization for Ozempic, your prescriber may need to provide details about your condition and why the medication is medically necessary for treatment. 

4. Request an appeal, if necessary. If your insurance provider denies your initial request for coverage, you may appeal to reverse the decision. Review your health insurance plan details and the reason for the denial, so that you can write a solid appeal letter.

Can you get Ozempic for free?

You can obtain some medications at no cost through the Novo Nordisk Patient Assistance Program, if you qualify. More than a dozen medications, including Ozempic, are on the list of covered products. To be eligible for the program, you must meet several requirements, including:

• Being a U.S. citizen or legal resident

• Falling below a certain income level

• Having Medicare or not having insurance

You can apply for the patient assistance program online.

Ozempic alternatives

Although there is not a generic version of Ozempic on the market, there are alternative medications for managing Type 2 diabetes. There are also FDA-approved medications for weight loss. The following table includes some of these medications and their FDA-approved uses. 

Whether these Ozempic alternatives are covered and, if so, how much of the cost is covered depends on your insurance plan and provider. For example, even if your policy covers weight-loss medications, it may only pay for specific ones. And there could be a high copay or the need for prior authorization, depending on the medication.

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Written by:

Mitzi S. Morris

Mitzi S. Morris is a freelancer who writes long-form content such as blogs, e-books, and white papers. She has a certificate in digital communication from the University of North Carolina at Chapel Hill and a Bachelor of Arts in Communication from Hanover College.

Edited by:

Charlene Rhinehart, CPA

Charlene Rhinehart, CPA, is a personal finance editor at GoodRx. She has been a certified public accountant for over a decade.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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Methodology

We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of August 2025. 

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).