What are the specific costs for wegovy with my insurance?

Why Wegovy Costs Vary by Insurance

Wegovy (semaglutide) out-of-pocket costs depend on your specific insurance plan, coverage tier, prior authorization requirements, pharmacy choice, and location. No universal price exists—patients report $0–$1,350 monthly after copays or coinsurance.[1] Check your plan's formulary via your insurer's portal or app.

Typical Copays and Coverage Breakdown

• Commercial insurance (e.g., Blue Cross, UnitedHealthcare): Often Tier 3 or 4, with copays of $25–$475 per month. About 70% of plans cover it with prior authorization for obesity (BMI ≥30 or ≥27 with conditions).[2]
  
• Medicare Part D: Rarely covered for weight loss; average copay exceeds $900/month if approved for related conditions like diabetes. Inflation Reduction Act caps some costs at $35/month starting 2025 for select drugs, but Wegovy isn't confirmed.[3]
  
• Medicaid: Varies by state; some cover with strict criteria, others exclude it. Copays typically $0–$4.
  
• No coverage: List price is $1,349.02 for a 28-day supply (four 2.4mg pens).[4]
  
  Use tools like GoodRx for estimates: cash prices start at $1,200–$1,300/month with coupons.
  
  

How to Find Your Exact Cost

1. Log into your insurer's website or call the number on your card.
   
2. Search "Wegovy" in the drug lookup tool—enter dosage (starts at 0.25mg, titrates to 2.4mg).
   
3. Request prior authorization if needed (requires doctor documentation).
   
4. Compare pharmacies via apps like SingleCare or your insurer's network.
   
   Novo Nordisk's Savings Card caps costs at $25/month for eligible commercially insured patients (max $225/quarter savings).[5]
   
   

What If Insurance Denies Coverage?

Appeals succeed ~50% of the time with doctor letters emphasizing medical necessity.[6] Alternatives include manufacturer patient assistance (income-based, up to 3 months free) or switching to compounded semaglutide (~$200–$500/month, but FDA warns of risks).[7]

Patient forums note delays from shortages or step therapy (try diet/exercise first).[8]

[1]: Drugs.com - Wegovy Prices
[2]: Novo Nordisk Coverage Report
[3]: CMS Medicare Part D
[4]: GoodRx - Wegovy
[5]: Wegovy Savings Card
[6]: CoverMyMeds Appeal Data
[7]: NovoCare Assistance
[8]: Reddit r/Wegovyinsurance