How insurance works with the Ro Body membership

If you want to use insurance to pay for GLP-1 medication, Ro will be there to help you navigate your coverage! As part of the Ro Body membership, you’ll get access to our insurance concierge who will:

• work directly with your insurance provider to check if your medication is covered

• handle any paperwork and coordination for you

When it comes to navigating insurance coverage, you don’t have to lift a finger. And if you're covered, you may just have a monthly copay for the medication depending on your plan. You’ll pay the pharmacy directly for your medication.

Please keep in mind: Insurance does not cover the cost of the Ro Body membership. Additionally, GLP-1 medication is not included in the cost of membership and is billed separately. Some medications offered through Ro are cash-pay only, meaning we cannot offer insurance concierge services for those options.

If for some reason your insurance will not cover the cost of your medication, you’ll have the option to either select from cash pay medication options or you can cancel your Ro Body membership at any time.

It depends on which medication is prescribed, as some medications are only available when paying cash:

• Zepbound single-dose vials are FDA-approved and contain the exact same active ingredient (tirzepatide) as Zepbound pens, and are fulfilled through our integration with LillyDirect. The costs vary by dose:

  • $349/mo for 2.5 mg dose

  • $499/mo for 5 mg dose

  • $499/mo for 7.5 mg and 10 mg doses (with manufacturer offer)

• You can pay cash for Wegovy pens through our integration with NovoCare® Pharmacy– they’re half the retail price and ship directly to you.

  • $199 for your first month (limited-time offer)

  • $499/mo thereafter

• Compounded semaglutide, offered through Ro, costs $254 per month of treatment.

• Higher-cost branded GLP-1s (Ozempic and Zepbound pens):

• The price ranges from $900–$1,100/mo

Important: These prices do not include the $145/month Ro Body membership fee.

Manufacturer savings cards may help lower costs for branded GLP-1 pens, but discounts vary by pharmacy. If you're paying cash, check with your pharmacy about available savings programs.

The first step is to study the fine print of your current plan. Our insurance concierge reviews it to see if your GLP-1 costs can be covered without prior authorization (specific approval from your insurance company to cover your medication). This is the benefits verification stage, and at this point, nothing has been submitted to your insurance.

If the fine print doesn’t show automatic coverage for your GLP-1 medication, the next step is to submit a prior authorization request to your insurance company. Prior authorization is a decision by your health insurer that your medication is medically necessary. This allows your insurer to evaluate if the treatment is covered as a plan benefit (and if they can assist with payment).

It can be a complicated process that varies by insurer. That’s why we work with our insurance concierge to do the hard work of gathering your information, submitting your prior authorization request, and going back and forth with your insurance company.

It can take about 2–9 days, but once your insurer reviews the request, there are a few possible outcomes: 

• Approved with co-pay

• Approved with no co-pay

• Denied

Prior authorization is a decision by your health insurer or plan that a health care service, treatment plan, or prescription drug is medically necessary. In our case, prior authorizations allow your insurance company to evaluate if a GLP-1 medication is covered.

The process for obtaining prior authorization varies by insurer, but involves submission of administrative and clinical information by the treating practitioner. Behind the scenes, our insurance concierge partner does the hard work of gathering your information, submitting your prior authorization request, and going back and forth with your insurance company.

Our top priority is getting patients insurance coverage, so our partners and affiliated providers do their best to maximize the likelihood of approval.

The prior authorization process usually takes 2-3 weeks but it can be longer if the initial coverage request is denied.

Our partner submits to your insurance company right away. But the process can take longer if more information about your insurance or pharmacy benefits is needed or if there's a secondary plan you want to try.

If your insurance company approves your GLP-1 treatment after that first step, great! If they don't, our partner will continue to work on your behalf. Our partner will see if your insurer requires additional information or will cover a different GLP-1 medication if prescribed.

Due to several factors, it’s difficult to say precisely when you’ll get medications after prior authorization is approved. One we learn that you’re approved, we’ll send your prescription to your preferred pharmacy and they’ll confirm that there’s medication in stock. If your pharmacy doesn’t have supply, they’ll add you to a waitlist for when medication becomes available.

Due to several factors, it's difficult to say precisely when you'll get medications after prior authorization is approved. Our partner works with a nationwide network of pharmacies to find the fastest way of getting you started with your medication.

Our partner will continue to explore all possible options. At this point, your provider will determine whether another GLP-1 medication is clinically appropriate for you. If so, your provider will write a new prescription and the prior authorization process begins again. If all attempts for coverage have been denied and there are no other options, we’ll help you understand cash pay options to see if continued treatment is right for you.

Great! Let us know by messaging the pharmacy information to your healthcare team via your Ro account chat, and we’ll look into whether that pharmacy can fill your prescription.

If you’re prescribed a branded GLP-1 (like Ozempic, Zepbound, or Wegovy) and your coverage is approved, we’ll send your prescription to your preferred pharmacy and they’ll confirm that there’s medication in stock. If your pharmacy doesn’t have supply, they’ll add you to a waitlist for when medication becomes available.

Unfortunately, no. You can access and download a copy of your prescription in your Ro account, but it’s for reference only and cannot be used to fill or transfer your prescription.

Yes, but they may not be able to fill it. You can opt to send your prescription straight to a pharmacy of your choice during your online visit. You can also check with any pharmacy of your choice and let us know if they have your GLP-1 medication in stock. We'll work with our partners to see if it can be filled at that location.

Ro can only offer compounded GLP-1s that are filled at one of our partner compounding pharmacies, as they have been vetted for quality. If you're interested in switching to the compounded medication offered by Ro, you can reach out to your provider in your account chat.

If you’re prescribed a branded GLP-1 pen (like Ozempic, Zepbound, Wegovy, or Saxenda), we’ll send your prescription to your preferred pharmacy. Once sent, we’ll reach out with the pharmacy’s details (name and phone number) in your Ro account chat.

If you’re prescribed Zepbound single-dose vials, we work with a LillyDirect partner pharmacy to fulfill your prescription. The medication will typically be shipped to you within 1-4 days.

If you’re prescribed Wegovy and choose to pay cash, we work with a NovoCare® Pharmacy to fulfill your prescription. The medication will typically be shipped to you within 1-4 days.

If you’re prescribed a compounded GLP-1, we’ll send your prescription to our partner compounding pharmacy to be filled. You’ll get it shipped to you within 1-4 days.

It depends on if you're paying cash or using insurance – let's walk through it!

If you’re paying cash:

• The fastest way to start treatment is to pay cash for Zepbound vials, Wegovy, or compounded semaglutide. These options ship to you in 1-4 days.

• You can also pay cash for higher-cost GLP-1 options, including Ozempic or Zepbound pen. We’ll send your prescription to your pharmacy. The time it takes to fill it depends on if they have it in stock. If you’re using insurance:

• We can help you try and get Wegovy, Ozempic, or Zepbound pen covered. It takes 1-2 weeks to receive a decision from your insurance company.

• Once approved, we’ll send your prescription to your pharmacy. The time it takes to fill it depends on if they have it in stock.

Keep in mind: If you want medication faster, you can always request to switch to a cash-pay medication. Just message your provider, and they’ll help you find the right option.

Please note: We can only write you one prescription at a time, we cannot prescribe you a cash-pay option while you await prior authorization results.

If you’re using insurance to help cover medication costs, know that copays can range substantially and depend on your insurance coverage and fulfilling pharmacy. If your insurance company shares estimated copay information with our team, we'll pass it along to you.

If you decide to pay cash for your medication, costs are:

• Zepbound vials:

  • Starting at $349/mo

  • It’s the same medication as the Zepbound Pen, but in single-dose vials that are sent straight to you through our integration with LillyDirect™.

• Wegovy:

  • $199 for your first month (limited-time offer)

  • $499/mo thereafter

  • Access Wegovy through our integration with NovoCare® Pharmacy sent straight to you

• Higher-cost GLP-1 options (like Ozempic and Zepbound pen):

  • ~$900–$1,100/mo of treatment

This does not include the monthly cost of the Ro Body membership fee.

Manufacturer savings cards can help reduce the cost of certain branded medications, but eligibility varies.

Savings card details:

Ozempic (Novo Nordisk):

• You can’t use the savings card if paying cash. It’s only for insurance-approved prescriptions.

• Eligible patients can save up to $150/mo off the full price.

• See eligibility and how to enroll here.

Wegovy (Novo Nordisk):

• If your commercial insurance covers Wegovy without a prior authorization, you may save up to $225/mo on your copay.

• See eligibility and how to enroll here.

• If your commercial insurance doesn’t cover Wegovy, you can access it for $499/month by paying cash – either seamlessly through Ro or picked up at your preferred pharmacy. See eligibility and how to enroll here.

Zepbound (Eli Lilly):

• Available through the end of 2025.

• If your commercial insurance covers Zepbound, you may save up to $150/mo on your copay.

• If your commercial insurance doesn’t cover Zepbound, you may save up to $469/mo off the full price.

• See eligibility and how to enroll here.

Note: this savings card program only applies to Zepbound pens, not Zepbound single-dose vials.

Important notes:

• Savings cards aren’t guaranteed and may vary by pharmacy.

• Tell your pharmacist if you’re using a savings card—they may need specific details from it.

• Savings cards only apply to branded medications.

• They can’t be used for compounded GLP-1s through Ro, which are cash-pay only.

Yes, we do this for you! Ro-affiliated providers survey the clinically appropriate medication options between Wegovy, Ozempic, and Saxenda. If your insurer denies your request for coverage for one of those medications, your provider will see if you’re eligible for the other (if clinically appropriate). Our insurance concierge will resubmit your prior authorization request if you’re eligible.

Paying cash is always an option if:

• GLP-1 medication is not a covered benefit under your plan.

• Prior authorization is denied, and there are no other options for coverage.

• You're uninsured, or do not want to go through insurance.

• You want to access in-stock FDA-approved medication, like Zepbound single-dose vials through Ro’s integration with LillyDirect (starting at $349/mo) or Wegovy through Ro’s integration with NovoCare Pharmacy ($199 for your first month for a limited time and $499/mo thereafter)

• You’re willing to pay about $900–$1,100 for higher-cost GLP-1 options like Ozempic and Zepbound pen

• If you have Medicare, a Medicare supplement plan, or TRICARE, you may be able to pay cash for certain medication options.

Paying cash for the medication does not change your Ro Body membership experience, including pharmacy support, ongoing care, and coaching through Ro. The separate membership cost is $145/mo.

If your provider orders a metabolic health test, testing at any Quest location is included in the cost of the Ro Body membership. Or you can purchase an at-home blood collection kit through Ro for $75.

If you live in a state where Quest is not available, we’ll automatically send you an at-home collection kit for no charge.

Ro can’t help coordinate coverage for GLP-1 medications for government insurance plans — but depending on your plan, you may still have options to get started.

If you have Medicare, a Medicare supplement plan, or TRICARE: You can join the Ro Body membership and pay out of pocket for certain cash pay medication options. Once you submit a treatment request, a provider will review your info to find the best fit if you’re eligible.

If you have Medicaid or any other government-funded plan: Unfortunately, you can’t join the Ro Body membership or pay out of pocket for treatment through Ro.

If you have a plan through the Federal Employee Health Benefits Program (FEHB): You can join the Ro Body membership and access our insurance concierge. They’ll coordinate your coverage and handle any approval paperwork!