How much does oral semaglutide cost with and without insurance?

The cost of oral semaglutide varies depending on the medication prescribed, your insurance coverage, preferred pharmacy, 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 for Rybelsus. Or you could get it 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 cost of oral semaglutide depends on the specific drug: 

• Wegovy pill has a cash price of $149–$299 depending on dose through Ro and a list price of $1,349.02. 

• Rybelsus has a list price of nearly $1,000.

Let’s take a closer look, shall we?

See if you qualify

Cost of Wegovy pill without insurance 

Oral semaglutide for weight loss (Wegovy pill) costs $149–$299, depending on dose through Ro. Here are the specific cash prices:

• $149 per month for 1.5 mg dose

• $149 per month for 4 mg dose (through 4/15/26) then $199 per month 

• $299 per month for 9 mg and 25 mg doses 

It also currently has a list price of $1,349.02.

Cost of Rybelsus without insurance 

Oral semaglutide for diabetes (Rybelsus) has a list price of $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.

For individuals without insurance (or Medicare enrollees) who need help affording Rybelsus or other diabetes medications, Novo Nordisk offers a Patient Assistance Program for certain doses. If you’re eligible, a healthcare provider can help you apply to receive Rybelsus for no charge. 

Yes, insurance typically covers oral semaglutide when it’s prescribed for people with type 2 diabetes — i.e. Rybelsus. Insurance plans are less likely to cover oral semaglutide when it’s prescribed for weight loss, even when it’s on-label — i.e. Wegovy pill. 

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). 

The Wegovy pill is approved for weight loss and to reduce the risk of cardiovascular problems in certain adults with obesity or overweight. Even though these are now FDA-approved indications, insurance coverage for the Wegovy pill may 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.

Medicaid does not cover oral semaglutide for weight loss (Wegovy pill) right now. But the Centers for Medicare and Medicaid Services (CMS) is launching new programs to make GLP-1 weight loss medications more affordable for people with Medicaid. 

Does Medicare cover oral semaglutide?

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

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

Medicare currently does not cover weight loss medications. But you may qualify for Medicare coverage of Wegovy if you have cardiovascular problems in addition to obesity or overweight. The CMS is also in the process of developing new programs to make GLP-1 medications like Wegovy more accessible for people with Medicare Part D.

With insurance, oral semaglutide (Rybelsus, Wegovy pill) 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, oral semaglutide (Wegovy) may not be covered by insurance. It depends on your specific plan. 

But even if your plan doesn’t cover Wegovy, it doesn’t necessarily mean you’ll have to  pay the full list price.

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 $25, 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)

If you have commercial insurance coverage for the Wegovy pill, you may qualify for the manufacturer savings offer specific to Wegovy. This offer: 

• Lowers the cost of a monthly Rx to as low as  $25, with a maximum savings of $100 for a one-month prescription

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

The monthly costs of oral and injectable semaglutide drugs are as follows:

• Wegovy pill: $1,349.02 (list price) or $149–$299 per month depending on dose (cash price)

• Rybelsus: $997.58 (list price)

• Wegovy pen: $1,349.02 (list price) or $199–$349 per month depending on dose (cash price)

• Ozempic: $997.58 (list price)

Oral vs. injectable semaglutide costs can vary depending on:

• The brand-name medication

• Your prescription drug coverage

• The pharmacy you use

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

• Whether you qualify for the manufacturer’s savings offer

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

The price of Wegovy pill depends on whether you have insurance coverage for it or if you’re paying out of pocket. 

• Without insurance, you can opt for self-pay through Ro, starting at $149 per month. 

• If you have commercial insurance with coverage of the Wegovy pill, you may qualify to pay as low as $25 per month (up to a maximum savings of $100 per month). 

Several options are available to reduce the cost of oral semaglutide for diabetes or Rybelsus, 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 (Rybelsus) 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 $25 each month with the Novo Nordisk Savings Offer. Savings can vary by dose.

If you have commercial insurance coverage for the Wegovy pill, you can get a one-month Rx for as low as $25 per month with the Wegovy-specific manufacturer savings offer. 

However, if you pay cash for your prescriptions or have insurance coverage through state or federal programs, you are not eligible for either 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 (Rybelsus). 

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, some coupons can save you $230–$320 per refill of Rybelsus. 

There are more affordable oral medications than Rybelsus and the Wegovy pill — 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

Check for free

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

• Oral semaglutide can cost anywhere from $0 to over $1,000, depending on the brand-name medication, insurance coverage (if any), and other factors.

• The Wegovy pill has a cash price of $149–$299 depending on dose (which you can get through Ro!), and a list price of $1,349.02.

• Rybelsus has a list price of $997.58 and is more likely to be covered by insurance. 

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