How Much Is Rybelsus Without Insurance?

Rybelsus (semaglutide) is a glucagon-like peptide-1 (GLP-1) agonist. It’s FDA approved to improve blood sugar (glucose) and hemoglobin A1C levels in adults with Type 2 diabetes. Your healthcare professional may also prescribe you Rybelsus off-label for chronic weight management. The once-daily pill has been proven to help people with Type 2 diabetes lose weight. 

Your out-of-pocket expenses for Rybelsus will depend on factors such as your insurance status, location, and pharmacy. A generic form doesn’t exist. But you may be able to lower the price of brand-name Rybelsus by using a savings card, enrolling in a patient assistance program, or downloading a GoodRx coupon.

How much does Rybelsus cost per month?

The retail price for Rybelsus ranges between $1,100 to $1,240 for 30 tablets, which come in 3 mg, 7 mg, and 14 mg doses. Your prescriber will likely start you at a dosage of 3 mg per day. Then, they may increase your dosage as needed.

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What factors affect the cost of Rybelsus?

Rybelsus is the first and only FDA-approved GLP-1 agonist that doesn’t need to be injected. This makes it unique in a class that includes Ozempic (semaglutide) and Trulicity (dulaglutide). Many factors may affect the price of your Rybelsus prescription, including:

• Pharmacy: The manufacturer may have different pricing strategies, discounts, and negotiated rates at different pharmacies.

• Location: Where you live will likely affect the cost of Rybelsus. For example, according to GoodRx research, the most expensive city for prescription medications in the U.S. is Little Rock, Arkansas. The most affordable city is Denver, Colorado.

• Insurance: If your health insurance plan covers Rybelsus, you will likely pay less out of pocket for the medication. Though, you may still have some out-of-pocket expenses, such as coinsurance or copayments. These cost-sharing amounts are determined by the type of plan you have, whether it’s commercial insurance, Medicare, or Medicaid.

• Savings offer: If you qualify for a savings card through the manufacturer, it can reduce the amount you pay for Rybelsus.

• Why you’re taking it: Rybelsus is sometimes prescribed off-label for weight loss in people who don’t have Type 2 diabetes. Your insurance coverage and savings program eligibility may be different if you don’t have diabetes.

Talking to your insurance provider, pharmacist, and prescriber can give you a better idea of how much you will have to pay for Rybelsus. 

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Is there a generic version of Rybelsus?

As of now, Rybelsus is only available as a brand-name medication. There is no generic version on the market. 

The FDA approved Rybelsus to improve control of blood glucose in adults with Type 2 diabetes in September 2019. The manufacturer, Novo Nordisk, has exclusive rights to sell the medication until the patent expires in the U.S. in 2032. Typically, a new patent’s term is 20 years from the application's filing date. 

Generic medications are typically cheaper than their brand-name equivalents because the companies making generic versions don't need to redo clinical trials to prove the medications are safe and effective.

Does insurance cover Rybelsus?

The FDA doesn't decide which medications insurance providers cover or the amount of coverage. However, insurers tend to follow FDA-approved guidelines on product labels when making their policies. 

This means that the amount your insurance covers will likely depend on whether you’re taking Rybelsus for Type 2 diabetes or off-label for chronic weight management. Your insurance provider may also require you to have tried other medications before covering Rybelsus. You can check commercial insurance, Medicare Part D, and Medicaid coverage according to your zip code on the Rybelsus website or fill out a form for personalized details. 

Does employer-sponsored health insurance cover Rybelsus?

According to Novo Nordisk, Rybelsus is covered for 98% of commercially insured patients. If you have commercial insurance, you may also be eligible to pay as little as $10 per month for the medication after you apply for a copay savings card. 

Coverage for Rybelsus varies depending on the insurance provider. Check your plan and formulary — a list of medications covered by your policy — for details on the requirements for coverage and out-of-pocket costs.

Does Medicare cover Rybelsus?

Rybelsus is covered for 95% of people with Medicare Part D, according to Novo Nordisk. The manufacturer’s website also states that 1 in 2 Medicare enrollees with Type 2 diabetes may qualify for Extra Help, also called the Low-Income Subsidy (LIS). This could mean paying $10.35 or less monthly for the medication. 

Review your Medicare Part D plan and formulary for coverage details and criteria. 

Does Medicaid cover Rybelsus?

Medicaid coverage of Rybelsus varies from state to state. Out-of-pocket costs for the medication may also depend on whether the medication is preferred or non-preferred on a plan’s formulary. 

For example, Rybelsus is preferred on formularies in Nevada and South Dakota. However, it’s non-preferred on formularies in Missouri and Arkansas. Non-preferred medications typically cost more than preferred. Both classifications may require prior authorization and have quantity limits. Check your state Medicaid plan for details.

How can you get your insurance to cover Rybelsus?

There are certain steps you can take to increase your chances of getting Rybelsus insurance coverage, including:

• Review your health insurance plan. Read your summary of benefits and coverage (SBC) and review your formulary to find out if Rybelsus is covered and the requirements.

• Talk to your medical team about a prescription. If you and your healthcare professional determine Rybelsus is right for you, they will prescribe you the medication. Coverage may depend on why you’re prescribed Rybelsus.

• Get a prior authorization. Your insurance provider may require a prior authorization before it will pay for Rybelsus. If so, your pharmacy will inform your prescriber, who will then supply the required information to your insurance provider. Your pharmacist will contact you regarding the decision.

• Find out about step therapy. Your insurance provider may also require you to do step therapy before covering Rybelsus. For example, your insurer may want you to try metformin before covering Rybelsus. 

• Ask for a formulary exception. What if Rybelsus is not on your formulary, and your prescriber doesn’t believe an alternative medication will work? Ask your insurance provider to make an exception and cover your Rybelsus prescriptions.

• Submit an appeal. If your request for Rybelsus coverage is denied, you can file an appeal with your insurance provider to ask for the decision to be reversed.

What are the best ways to lower the cost of Rybelsus?

With or without insurance, there are several ways you can lower the cost of Rybelsus at the pharmacy:

• Apply for a patient assistance program. A patient assistance program offers free or low-cost medication to those who qualify. Rybelsus is included in Novo Nordisk’s patient assistance program. The eligibility criteria include being a U.S. citizen or legal resident, having a total household income at or below 400% of the federal poverty level, having Medicare or being uninsured, and not being enrolled in or qualified for a federal, state, or government assistance program.

• Use a GoodRx coupon. Search for Rybelsus on the GoodRx website or app to find coupons you can use at various pharmacies. Choose the coupon for your preferred pharmacy and show it to your pharmacist. 

• Compare pharmacy prices. While you’re on the GoodRx app or website, compare the cost of Rybelsus at various pharmacies in your region to find the lowest price. You may be surprised to find the medication for a cheaper price at a pharmacy you don’t typically visit.

• Sign up for a savings program. With commercial insurance and a Rybelsus copay savings card, you may pay as little as $10 for a 1-, 2-, or 3-month prescription of Rybelsus. For the 3 mg, 7 mg, or 14 mg tablets, the maximum savings are $300 for a 1‑month prescription. For the 7 mg or 14 mg tablets, the maximum savings are $600 per 2‑month or $900 per 3‑month prescription. Activation is valid for 48 months from the enrollment date. You’re ineligible if you’re enrolled in a federal or state health insurance program with prescription medication coverage. 

• Ask your prescriber for samples. Your healthcare professional may submit one sample request per month to Novo Nordisk for free samples of Rybelsus 3 mg tablets. But they must be a licensed practitioner who can legally prescribe medication in your state.

• Use an HSA or FSA. If you have a health savings account (HSA) or flexible spending account (FSA), consider using those funds to cover the cost of Rybelsus. These accounts help you reserve pretax money for eligible medical expenses such as prescription medications. 

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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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References 

Mahapatra, M. K., et al. (2022). Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Reviews in Endocrine and Metabolic Disorders.

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NovoCare. (n.d.). Diabetes savings offer program: Novo Nordisk savings offer. Novo Nordisk.

Novo Nordisk. (2024). Annual report 2023. 

South Dakota Department of Social Services. (2023). PDL 2024. OptumRx.

U.S. Food & Drug Administration. (2019). FDA approves first oral GLP-1 treatment for type 2 diabetes.

U.S. Food & Drug Administration. (2020). Frequently asked questions on patents and exclusivity.

U.S. Food & Drug Administration. (2023). Frequently asked questions about drugs.