How much does semaglutide cost, with and without insurance?

There is no single answer to 'what does semaglutide cost' — the honest answer depends on which product you mean, whether insurance is paying, and which telehealth desk you're looking at. Here's how the pricing actually breaks down, piece by piece.

The brand-name list price

Wegovy (semaglutide for weight management) and Ozempic (semaglutide for type 2 diabetes) are the same molecule sold as two FDA-approved brands with different labeled uses⁵. Both carry a list price that runs well over a thousand dollars a month before any discount or insurance is applied. Almost nobody actually pays that number — it's a starting point for negotiation between the manufacturer, insurers, and pharmacy benefit managers, not a realistic out-of-pocket figure for most patients. If you're quoted the list price directly, that's usually a sign no coverage or manufacturer discount has been applied yet.

What insurance changes

Whether your plan covers semaglutide for weight loss specifically — as opposed to diabetes — is the single biggest swing factor in what you'll pay, and it isn't automatic. Coverage for obesity medications varies enormously by employer plan design, and even Medicare has historically excluded weight-loss drugs from Part D coverage by statute, with policy proposals to expand that coverage still working through the fiscal and political process². Survey data suggests a meaningful share of people who have used a GLP-1 paid out of pocket specifically because their coverage didn't extend to it, and many describe it as unaffordable at listed rates¹. If your plan does cover it, expect a formulary tier copay — often a fixed amount rather than a percentage — but usually only after prior authorization, which we cover in full in our insurance coverage guide. Manufacturer savings cards can also lower a covered patient's copay further, though they typically exclude government-insured patients and have coverage-dependent caps.

The cash-pay market: compounded semaglutide

For people without coverage, the biggest price lever isn't a discount card — it's the difference between the brand and a compounded version made by a licensed pharmacy. Compounded semaglutide is not FDA-approved as a product, and pricing is set entirely by the telehealth provider and its pharmacy partner rather than a manufacturer list price, which is why cash-pay compounded programs run a fraction of the brand's list cost. We track live compounded pricing across providers on the compounded semaglutide board, and the fuller regulatory picture — including why that price gap exists — is in compounded vs brand-name GLP-1 and is compounded semaglutide legit?.

Why the number you see first often isn't the number you'll pay

This market runs on the teaser rate: a low first-month price that steps up once you're enrolled and less likely to shop around. A price quoted for the starting 0.25 mg dose is not the price at the 2.4 mg maintenance dose you'll likely reach after several months of titration — some providers charge more per month as the dose rises, others hold one flat rate through the whole schedule. We break down exactly how to read a quoted price, including stacked membership and consultation fees, in why GLP-1 prices move. The single most useful habit: ask for the price at the maintenance dose, not the starting dose, before you compare two providers.

How to compare quotes like a shopper, not a browser

Put a few numbers side by side before deciding anything: the maintenance-dose monthly price, any membership or telehealth consultation fee layered on top, whether shipping is included, and whether the price is locked for a defined period or subject to change. Our 5-minute provider checklist walks through the rest of what to verify beyond price — pharmacy accreditation, clinical screening, and cancellation terms matter as much as the sticker number. If you're weighing the brand against a compounded option specifically, Ozempic vs Wegovy vs compounded semaglutide lays out what's actually different beyond price. And if tirzepatide is also on your shortlist, see how much tirzepatide costs for the same breakdown on that molecule. Every provider's current pricing is tracked in our provider briefs; figures reflect each provider's published pricing at our last review, not a guarantee. This is market context, not medical or financial advice.