Feeling frustrated with your weight loss efforts? You're not alone. For many, diet and exercise just don't seem to budge the scale. Fortunately, the weight loss market has made significant strides with semaglutide.
Originally created as a treatment for type 2 diabetes, semaglutide has shown incredible effectiveness for weight loss in clinical trials. For those with obesity or who are overweight, this drug may transform how you think about losing weight and keeping it off.
But how do you actually get a prescription for semaglutide? What does it cost with or without insurance? And most importantly, how can you reduce those costs?
This article will provide an overview of what you need to know to get started with semaglutide for weight loss, including requirements to obtain it, costs with and without insurance coverage, and tips to lower the price tag.
How to Get a Semaglutide Prescription for Weight Loss
First things first - semaglutides require a prescription. You can't just walk into a pharmacy and pick them up. And for good reason! These injectable drugs can interact with other medications or health conditions. So, your doctor needs your full medical history to determine if semaglutide is a safe option for you.
To qualify for semaglutide for weight loss, you must:
- Have a BMI of 30 or higher (considered obese)
OR
- Have a BMI of 27 or above (overweight) and a weight-related health issue like diabetes, high blood pressure, or high cholesterol. 1
Once your doctor has decided that you are eligible for semaglutide, they may choose from a few different semaglutide brands. Each is FDA-approved to treat different conditions.
- Ozempic is prescribed to help manage blood sugar levels and reduce the risk of cardiovascular events in adults with type 2 diabetes.
- Wegovy is used to aid weight loss in patients dealing with obesity or who are overweight with weight-related health issues.
- Rybelsus is recommended for improving blood sugar control in adults diagnosed with type 2 diabetes. 2
Wegovy is the only one specifically prescribed for weight loss. But your doctor could potentially prescribe the others "off-label" for weight management too. Just know your insurance likely won't cover off-label use, so you'd pay out-of-pocket.
The bottom line? Talk to your doctor to see if semaglutide is suitable for you. They’ll check your medical history and determine if the benefits outweigh any risks. Then, you can discuss the next steps for getting a prescription and coverage.
Semaglutide Cost Without Insurance
The price tag for semaglutide drugs like Ozempic can be shocking. A one-month supply of Ozempic 2 mg costs an eye-watering $756 - completely out of reach for many. Unfortunately, other brand-name semaglutides like Rybelsus and Wegovy are equally unaffordable.
As the chart below illustrates, the monthly costs of these brand-name semaglutides are substantially higher at a U.S. retail pharmacy than at an online pharmacy like mailMymeds.
+ Rite Aid Pharmacy 05423
Strictly looking at the numbers, buying semaglutide from mailMymeds is significantly more affordable than purchasing from a standard U.S. retail pharmacy. And when you're taking these meds long-term, the costs add up fast. Let's break it down annually:
- Ozempic from a U.S. pharmacy: $9,075
- Semaglutide from mailMymeds: $3,468
The excessive price of semaglutide from a U.S. retail pharmacy is difficult to justify, especially when there are more affordable options available that work just as well.
Semaglutide Cost With Medicare
When it comes to getting coverage for semaglutide, things can get a little complicated for those on Medicare.
The first thing to know is that Medicare does not cover prescription medications for obesity or weight loss. 3 So, if your doctor prescribes Wegovy to help you lose weight, you'll be footing the bill out of pocket. However, Medicare has recently started offering free counseling sessions focused on losing weight through improved nutrition and increased physical activity. 4 Taking advantage of these sessions is a great, no-cost way to get guidance on weight loss.
Now, let's talk about Ozempic and Rybelsus. If your doctor prescribes either of these semaglutide meds specifically to manage type 2 diabetes, Medicare Part D will cover most or all of the cost. But if you're hoping to use Ozempic or Rybelsus off-label to drop a few pounds, you'll be paying out of pocket again. 5
The bottom line is Medicare coverage of semaglutide for weight loss is extremely limited right now. Unless you have a supplemental plan that includes it, you'll be paying out-of-pocket for these meds.
Tips for Saving Costs
Patient Assistance Program
If you meet certain eligibility criteria, you may qualify to receive semaglutides for free through Novo Nordisk’s Patient Assistance Program. 6 Currently, this program covers the following semaglutides:
- Ozempic (0.5 mg, 1 mg, 2 mg)
- Rybelsus (3 mg, 7 mg, 14 mg) 7
To qualify for this program, there are a few boxes you need to check:
- You must be a U.S. citizen or legal resident
- Your total household income must be at or under 400% of the federal poverty level
- You must have Medicare or no health insurance coverage
- You cannot be enrolled in or eligible for other government programs like Medicaid, Medicare Low Income Subsidy, or Veterans Affairs benefits 6
If you meet all the eligibility criteria, you can receive a year's supply of Ozempic or Rybelsus completely free of charge. Just remember, you do have to reapply annually and continue to meet the eligibility criteria. 6
Compounded Semaglutide
If you’ve been researching affordable semaglutide for weight loss, you may have come across compounded semaglutide. This medication offers a more budget-friendly alternative to the brand-name semaglutide products on the market. 8
So, what exactly is compounded semaglutide? Compounding is the process of creating a customized medication to meet the specific needs of a patient. A licensed compounding pharmacy makes the medication in accordance with federal and state regulations. 8
The main benefit of compounded medications like semaglutide is the cost savings compared to brand-name products. With a compounded medication, you avoid paying for expensive marketing and branding. 9 Instead, the specialized compounding pharmacy sends the medication directly to you. 8 By cutting out all the middlemen, compounded semaglutide can be a fraction of the cost of brand-name weight loss drugs.
Conclusion
If you qualify for semaglutide treatment, don't let the cost deter you from what could be a life-changing weight loss solution. There are options to make this medication more affordable and fit your budget.
Patient assistance programs are designed for those who meet certain requirements. If you qualify, you’ll be able to receive semaglutide at no cost. For those who don't qualify, using online pharmacies like mailMymeds can reduce the monthly cost by up to 40%. By exploring these cost-saving options, you can make semaglutide a more budget-friendly choice without compromising on your health goals.
The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical conditions, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.
