How to get Wegovy covered by insurance

If you’re looking for a prescription weight loss solution that helps you reach your healthy weight goals, you’ve probably heard about Wegovy, also known by its generic name, semaglutide. Wegovy has the same active ingredient as Ozempic, another drug you might have heard of.

These medications are part of a class of drugs called GLP-1 receptor agonists (aka GLP-1s), which are quite effective for chronic weight management in most people. Wegovy’s biggest downside? It can come with a hefty price tag. 

Wondering if it’s possible to get Wegovy covered by insurance? Keep reading to understand what to expect, and what your options are if insurance coverage isn’t in the cards for you.

Every insurance provider has different coverage for medications, including Wegovy—which can, in some cases, cost over $1,300 out of pocket. Novo Nordisk, Wegovy’s manufacturer, has a handy tool on their website to check if your insurance covers Wegovy, and Ro offers a free insurance checker as well. You can also call your insurance company to find out directly. 

If your insurance does generally cover Wegovy, you’re much more likely to get approved for coverage if your prescription is considered medically necessary, defined as:

• Adults with obesity (BMI > 30)

• Adults with an overweight BMI (>27) who also experience at least one medical problem (like high blood pressure or high cholesterol) related to their weight

Wegovy insurance coverage varies depending on your specific health plan. Many commercial and private insurers cover weight loss medications, such as Wegovy, at least partially. 

If you're trying to get Wegovy or another GLP-1 medication covered by your health insurance, there are three important steps you can take: 

1. Talk to your healthcare provider: Before checking insurance coverage for Wegovy, you need to make sure the medication is suitable for you. Talk to your doctor about whether Wegovy is the right choice, based on your medical history and weight management needs. Once you get a prescription for Wegovy or another weight loss medication, such as Saxenda, you can look into insurance coverage.

2. Check in with your insurance provider: Contact your health insurance provider to determine whether your plan covers the medication. Make sure you also ask about your insurance plan’s out-of-pocket costs, and if prior authorization is needed. Before contacting your insurance provider, you can review your health insurance plan’s drug list (also known as a drug formulary), which you can find in your plan information. You can also check Novo Nordisk’s online tool to see if they list your insurance provider.

3. Don’t give up right away: If your insurance plan does not provide coverage for Wegovy, you may be able to request it with the help of your healthcare provider. Novo Nordisk, the manufacturer of Wegovy, offers a sample letter template your provider can use to request coverage for you. 

Alternatively, an online weight loss program such as Ro Body Program has a dedicated insurance concierge partner who will work to find you coverage for Wegovy, if the medication is right for you. They will take care of communicating with your insurance company and even handle the paperwork.

According to Novo Nordisk’s website, the Veterans Administration (VA) does cover weight loss treatments like Wegovy. Contact your VA provider to find out more about your options.

Since every insurance carrier has their own requirements and coverage criteria, there sadly isn’t a master list of insurance companies that cover Wegovy. 

A March 2024 story published in Entrepreneur reports that Kaiser Permanente, Elevance Health, and CVS Health’s Aetna insurance units all confirmed they would cover Wegovy. But, as we all know too well, insurance providers change their coverage often, and there’s a good chance your insurance provider might have coverage options. 

Most insurance providers will require prior authorization before they will cover your prescription.

Each state determines which prescription drugs they will include as part of their Medicaid program. As a result, drug coverage for Medicaid beneficiaries varies depending on the state in which you live. Contact your state Medicaid agency to determine whether your state’s Medicaid program covers Wegovy. 

Currently, these states Medicaid programs cover Wegovy in most circumstances according to Wegovy’s website: 

• California 

• Delaware 

• Georgia 

• Hawaii (not all plans)

• Indiana (for people 12 to 21 years old)

• Kansas

• Massachusetts 

• Michigan

• Minnesota

• Mississippi

• New Hampshire

• North Carolina (for people 12 to 21 years old)

• Oregon (for people 12 to 21 years old)

• Pennsylvania

• Rhode Island (not all plans)

• Tennessee (for people 12 to 21 years old)

• Virginia 

• Wisconsin

As for Medicare, weight loss medications like Wegovy are usually not covered, except with specific types of plans. Check your specific plan’s prescription medication coverage to find out for sure.

A package of Wegovy contains four pens, each pre-filled with a single dose of Wegovy, or about a month’s worth of the medication. Without insurance, the list price of Wegovy is $1,349.02 per package, which breaks down to $269.80 per week or $16,188.24 per year.

Many patients are able to get the medication for a lower price, as we’ll discuss in the next section.

If you have insurance coverage, your out-of-pocket cost for Wegovy depends on your specific plan. It’s important to look at your prescription copay and deductible when determining how much your supply of Wegovy will cost after insurance covers their portion.

Regardless of your insurance plan, your provider may require prior authorization to receive coverage benefits. You may also need to try a less expensive weight loss medication before receiving approval for Wegovy. 

Even without health insurance, there are ways to save on Wegovy and bring down your medication costs. 

Wegovy savings card 

With a Wegovy savings card from Novo Nordisk, the manufacturer of Wegovy, you can receive a 28-day supply of your prescription medication for as little as $0 if you have private or commercial insurance with prescription drug coverage. However, certain eligibility requirements and restrictions apply. If your insurance doesn’t cover it or you pay cash for your prescription medications, you can save up to $500 per 28-day supply. If your commercial or private health insurance covers Wegovy, you can save up to $200 per 28-day supply. 

Prescription discount cards

Companies like GoodRx or SingleCare provide prescription discount cards or Wegovy coupons for Wegovy. For example, sites like GoodRx aggregate free Wegovy coupons that can be used at a variety of pharmacies—including Walgreens, CVS, and Walmart—enabling people to save between 7% to 34% on the retailer’s price. You can also talk to your pharmacist about prescription discount cards they may offer at the pharmacy. 

Compare pharmacy prices

Prescription drug prices can vary from pharmacy to pharmacy. To find the lowest price, call several local pharmacies and ask what their retail price is for Wegovy. If you plan to use your insurance, you may need to show the pharmacy your prescription and insurance card before they can provide a price. 

If you have insurance, but they don’t offer coverage for Wegovy, you can still compare pharmacy prices to find the best deal near you. Ask your pharmacist to run the cash price of Wegovy through the various pharmacy discount programs to find the lowest price.

Ozempic manufacturer assistance program

If you also have diabetes, you might qualify for the Novo Nordisk Patient Assistance Program (PAP). This program provides eligible patients with access to free diabetes medicine, which may include Ozempic (semaglutide). Ozempic injections deliver the same medication as Wegovy but in smaller doses (0.25, 0.5 mg, and 1.0 mg). 

Talk to your healthcare provider about whether Ozempic is an option for you. Your care team will help determine the best treatment options and help you apply to the Novo Nordisk PAP if you qualify.

Ultimately, finding out whether your insurance plan covers Wegovy and how much it’ll cost comes down to reaching out to your insurance provider directly. But, even if they don’t cover it, the tips above may help you save money on this medication.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

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Current version

September 30, 2024

Written by

Lindsay Modglin

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.