Semaglutide costs between roughly $130 and $1,865 per month depending on the brand, your insurance, and whether you use a compounded version. Without insurance or discount programs, the brand-name injectable forms (Ozempic and Wegovy) carry list prices of about $1,000 to $1,350 for a 28-day supply. Most people end up paying significantly less through insurance, manufacturer savings programs, or pharmacy discount cards.
Brand-Name List Prices
Semaglutide is sold under three brand names, each approved for different uses but containing the same active ingredient. The monthly cost varies by brand, not by dose. Here’s what each costs at list price:
- Ozempic (injectable, for type 2 diabetes): $998 to $1,028 per pen, regardless of whether you’re on the 0.25 mg, 0.5 mg, 1 mg, or 2 mg dose. Average cash price at pharmacies runs about $1,396.
- Wegovy (injectable, for weight management): list price of about $1,350 for a 28-day supply of four pens, adding up to roughly $16,200 per year. Average cash price is around $1,865.
- Rybelsus (oral tablet, for type 2 diabetes): list price near $998 to $1,028 for a 30-day supply. Average cash price is about $1,355 for the 14 mg tablets.
One detail that surprises many people: the price stays the same as your dose increases. Semaglutide treatment starts at a low dose and gradually increases over several months, but Novo Nordisk prices each pen or tablet box identically regardless of strength. Your costs won’t jump when your doctor raises your dose from 0.5 mg to 1 mg, for example.
What You’ll Actually Pay With Insurance
If you have commercial (employer-based or marketplace) insurance that covers semaglutide, your copay could be as low as $25 per month with a manufacturer savings card. Novo Nordisk offers a Wegovy savings program that caps out-of-pocket costs at $25, with up to $100 in monthly savings applied automatically. For Ozempic, similar savings programs exist for commercially insured patients.
The catch is that your plan has to cover the drug in the first place. Many commercial insurance plans cover Ozempic for type 2 diabetes without much pushback, but Wegovy for weight loss is more inconsistent. Some plans require prior authorization, proof that you’ve tried diet and exercise first, or a minimum BMI threshold before they’ll approve coverage. If your plan doesn’t cover Wegovy at all, you’ll face the full cash price or need to use a discount program.
Medicare and Medicaid Coverage
Medicare Part D covers semaglutide for type 2 diabetes (Ozempic and Rybelsus) under its standard benefit. Weight loss is a different story. Federal law has historically excluded drugs used for “anorexia, weight loss, or weight gain” from Part D coverage. That means Medicare won’t cover Wegovy purely for obesity.
There’s one important exception: since March 2024, Wegovy has been FDA-approved to reduce the risk of major cardiovascular events in people who have obesity or overweight combined with established cardiovascular disease. Medicare Part D can now cover Wegovy for that specific combination of conditions. The Centers for Medicare and Medicaid Services has also proposed reinterpreting the weight-loss exclusion to allow broader obesity coverage, but that change hasn’t taken effect yet.
Medicaid coverage is even more limited. Only 13 state Medicaid programs covered GLP-1 medications for obesity treatment as of January 2026. Several states that previously offered coverage, including California, Pennsylvania, and New Hampshire, have since pulled back due to budget pressures. If you’re on Medicaid, your state likely does not cover semaglutide for weight loss, though coverage for type 2 diabetes is more widely available.
Discount Programs and Cash-Pay Options
If you don’t have insurance coverage, several pathways can bring the monthly cost down substantially. GoodRx offers an introductory price of $199 per month for the first two fills of Wegovy injections, then $349 per month for ongoing fills. For certain lower doses (1.5 mg and 4 mg), Novo Nordisk runs a limited-time offer of $149 per month. The standard self-pay price through the manufacturer’s savings program is $349 per month for most injectable doses and $399 per month for the highest dose (7.2 mg).
For Rybelsus tablets, cash-pay options through discount pharmacies bring the price down to roughly $349 for a 30-day supply of 30 tablets, compared to the $1,355 average retail price.
Compounded Semaglutide
Compounding pharmacies have offered their own versions of semaglutide at dramatically lower prices, typically between $129 and $497 per month. These are not FDA-approved products. They’re mixed by pharmacies using bulk semaglutide and may differ in formulation, purity, and concentration from the brand-name versions.
The FDA has taken enforcement action against some compounding pharmacies, and the legal landscape around compounded semaglutide continues to shift. Some telehealth companies pair compounded semaglutide with online consultations for a bundled monthly fee. If you’re considering this route, the cost savings are real, but so are the tradeoffs in terms of regulatory oversight and product consistency.
Monthly Cost at a Glance
- With good commercial insurance + savings card: $0 to $25
- Commercial insurance without savings card: varies widely by plan, often $50 to $300+
- Manufacturer self-pay program (Wegovy): $149 to $399
- GoodRx or pharmacy discount cards: $199 to $349
- Full cash price, no discounts: $998 to $1,865
- Compounded semaglutide: $129 to $497
The biggest factor in what you’ll pay isn’t the dose or the pharmacy. It’s whether your insurance covers the drug and, if not, which discount pathway you use. Checking your specific plan’s formulary and comparing pharmacy prices through tools like GoodRx before filling your prescription can save you hundreds of dollars each month.