How much does oral semaglutide cost with and without insurance?

The cost of oral semaglutide (Rybelsus) varies depending on your insurance coverage, the pharmacy you use, and whether you qualify for any discounts or savings programs. 

So, how much does oral semaglutide cost, on average? Out-of-pocket, you could pay as much as $1,400 without insurance. Or you could get oral semaglutide completely free if it’s fully covered by your insurance plan. 

Ahead, we take a closer look at how much oral semaglutide costs and the factors that can affect how much you’ll pay. 

The list price of oral semaglutide (Rybelsus) is $997.58 for 30 tablets. But the average retail price can be much higher — up to $1,101.90–$1,402.09 for a one-month supply, according to SingleCare. 

That’s because the list price is similar to a wholesale acquisition cost. Meaning, it’s the price set by the drug’s manufacturer (in this case, Novo Nordisk) for a wholesaler to purchase the drug, before any rebates or discounts. Wholesalers, in turn, sell and distribute the drug to pharmacies — and various fees and markups may get tacked on along the supply chain.

At the moment, Rybelsus is the only form of oral semaglutide available in the United States. Novo Nordisk is currently seeking approval from the US Food and Drug Administration (FDA) for an oral form of semaglutide for weight loss. Exactly how much this “Wegovy pill” may cost is still TBD. More details should be available in early 2026, pending FDA approval.

If the FDA does approve oral Wegovy, it will be available in lower doses starting at $150 per month through select channels like Trump Rx. The discounted pricing will not be available for Rybelsus, according to The Hill. 

For individuals without insurance (or Medicare enrollees) who need help affording Rybelsus or other diabetes medications, Novo Nordisk offers a Patient Assistance Program. If you’re eligible, a healthcare provider can help you apply to receive Rybelsus for no charge. However, certain Rybelsus doses (7 mg and 14 mg) will no longer be covered by this program in 2026.

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Yes, insurance typically covers oral semaglutide (Rybelsus). 

This includes most commercial insurance plans, VA benefits, Medicaid, and Medicare Part D plans. However, there is one caveat to this: Insurers generally only cover a medication when it is prescribed for an FDA-approved indication. 

With Rybelsus, that means insurance will likely cover your Rx if it’s prescribed for people with type 2 diabetes, but not for non-diabetic people for weight loss (an off-label use). 

If the Wegovy pill is approved, insurance coverage will vary by plan. 

To find out if your insurance covers oral semaglutide, contact your plan administrator or review your plan’s drug formulary. A formulary is a list of all drugs covered by your plan with their associated cost tier. 

Does Medicaid cover oral semaglutide?

Yes, Medicaid covers oral semaglutide (Rybelsus) when prescribed for people with type 2 diabetes. 

Typically, the out-of-pocket cost for oral semaglutide on Medicaid ranges from $0–$10 per month.

Does Medicare cover oral semaglutide?

Yes, Medicare Part D covers oral semaglutide (Rybelsus) when prescribed to manage type 2 diabetes or lower cardiovascular risk in people with type 2 diabetes. 

The out-of-pocket cost for oral semaglutide on Medicare may range from $5–$47 per month, depending on the plan.

With insurance, oral semaglutide can range from $0 to several hundred dollars per month, depending on your plan. 

Almost all (98%) of commercial insurance plans cover oral semaglutide (Rybelsus). Average copays for oral semaglutide may range from $4–$20 when prescribed for type 2 diabetes. Your out-of-pocket cost may be higher if your plan has a deductible. 

When prescribed for weight loss, however, you may have to pay the full retail price for oral semaglutide — that is, however, until the Wegovy pill gets approved (if it gets approved).

Typically, insurance plans require prior authorization before they’ll cover oral semaglutide (Rybelsus). This means your healthcare provider will need to submit documentation to your insurance plan saying that oral semaglutide is a medically necessary treatment for you. 

Some plans may also require step therapy. This means you’ll first have to try a less expensive alternative for managing your condition. And your healthcare provider will need to submit documentation to show that it wasn’t effective or well-tolerated before they’ll cover oral semaglutide. 

If you have a commercial insurance plan with coverage for Rybelsus, you may qualify for additional savings through the Novo Nordisk Savings Offer. This offer:

• Lowers the cost of a monthly Rx to as low as $10, with a maximum savings of $300 for a one-month prescription

• Has specific eligibility requirements, such as having a commercial insurance plan with coverage and being prescribed Rybelsus for type 2 diabetes

• Excludes those who pay cash for their prescriptions or have coverage through state or federal programs (e.g. Medicare, VA)

The list prices of the oral and injectable semaglutide drugs currently available are as follows:

• Rybelsus: $997.58

• Ozempic: $997.58 

• Wegovy: $1,349.02 

The price of the Wegovy pill (oral semaglutide for weight loss) is unknown until the FDA approves it and Novo Nordisk announces the cost. However, it’s possible it could cost less than injections — if it’s less expensive to make. 

Oral vs. injectable semaglutide costs can vary depending on:

• Your prescription drug coverage

• The pharmacy you use

• If you’re taking either form for its FDA-approved condition

• Whether you qualify for the manufacturer’s savings offer

• Whether you use any pharmacy discounts or semaglutide coupons (for cash payers)

There are several ways to reduce the cost of oral semaglutide, including:

• Price-shopping at different pharmacies

• Enrolling in the Novo Nordisk Savings Offer

• Using semaglutide coupons and pharmacy discounts

Currently, there isn’t a generic available for oral semaglutide. The earliest we could expect one would be in 2032, as that’s when Novo Nordisk’s patent expires. 

Until then, you can try these strategies to save on oral semaglutide.

Price-shop at different pharmacies

Pharmacies set their own retail prices for prescription drugs. 

For example, the average one-month cost of oral semaglutide is $1,176.90  at CVS and  $1,198.20 at Walgreens, according to SingleCare. So, by filling your Rx at CVS, you could save over $21 per month — or over $250 per year. But keep in mind that pharmacy prices can vary by location.

Enroll in the Novo Nordisk Savings Offer Savings Offer

If you have commercial insurance with coverage for Rybelsus, you can get a one-, two-, or three-month Rx for as low as $10 with the Novo Nordisk Savings Offer. 

However, if you pay cash for your prescriptions or have insurance coverage through state or federal programs, you are not eligible for the savings offer.

Use semaglutide coupons and pharmacy discounts

Websites like GoodRx, SingleCare, Optum Rx, and BuzzRx offer pharmacy-specific coupons for drugs, including oral semaglutide. 

To use them, simply visit the website, enter your dosage of oral semaglutide, and then download or save the coupon and present it to your preferred pharmacy. 

These coupons can lead to serious savings. As an example, SingleCare’s coupons can save you $230–$320 per refill. 

There are more affordable oral medications than Rybelsus — some of which are approved for type 2 diabetes and others that are approved for weight loss. These alternatives include:

• Metformin, a daily diabetes medication that’s available as a generic and can be prescribed off-label for weight loss  

• Qsymia (phentermine/topiramate), a daily weight loss pill

• Contrave (bupropion/naltrexone), a twice-daily weight loss pill

• Xenical (orlistat), a thrice-daily weight loss pill

• Alli (orlistat), an over-the-counter version of Xenical

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See if you qualify

Oral semaglutide costs can vary widely depending on your insurance coverage, preferred pharmacy, and what you’re taking it for. Here’s what to keep in mind before you fill your prescription.

• Without insurance, semaglutide tablets cost between $1,101 and $1,402 for a 30-day supply. 

• Insurance usually covers semaglutide pills for type 2 diabetes. If it’s prescribed for weight loss, however, most plans won’t cover it until an FDA-approved weight loss version (such as the Wegovy pill) hits the market. 

• With commercial insurance, semaglutide pills cost significantly less. Eligible patients can use Novo Nordisk’s savings offers to pay as little as $10 per monthly Rx.

• Price shopping at different pharmacies and using pharmacy-specific coupons can also help you cut the cost of oral semaglutide.