Weight loss medications range from under $100 per month for older oral drugs to over $1,000 per month for newer injectable options at full list price. What you actually pay depends on the type of medication, whether you have insurance coverage, and whether you qualify for savings programs or alternative pharmacy options.
Injectable GLP-1 Medications
The newest and most popular weight loss drugs are GLP-1 receptor agonists, sold under brand names like Wegovy (semaglutide) and Zepbound (tirzepatide). These are the medications behind most of the recent headlines, and they’re also the most expensive. Zepbound’s list price runs $499 to $1,086 per 28-day supply, depending on dose. Mounjaro, the same drug prescribed for type 2 diabetes, carries a similar list price of around $1,080 for a 28-day supply. Wegovy falls in a comparable range.
These drugs require dose escalation, meaning you start on a lower (cheaper) dose and gradually increase over several months. With Zepbound, for example, the starting 2.5 mg dose lists at $499, while higher maintenance doses of 10 mg, 12.5 mg, and 15 mg all list at $699 through Eli Lilly’s self-pay program. So your first few months will cost less than your ongoing monthly expense, but maintenance is indefinite. Most people regain weight after stopping these medications, which means budgeting for years of refills, not just a few months.
Oral Weight Loss Medications
Older prescription options are significantly cheaper. Qsymia, a combination pill, has a retail price of around $37 and costs about $98 per month through the manufacturer’s pricing. That price stays flat across the starter phase, titration, and long-term maintenance refills. Phentermine, one of the most commonly prescribed weight loss drugs, is available as a generic and typically costs less than brand-name alternatives like Qsymia. Contrave, another brand-name oral option, generally falls between these extremes. These medications produce more modest weight loss than GLP-1 injectables, but the price difference is dramatic.
Compounded Versions
Compounded versions of tirzepatide (the active ingredient in Zepbound) have been available through specialty pharmacies at $250 to $500 per month, a fraction of the brand-name cost. These are custom-mixed by compounding pharmacies rather than manufactured by the original drug company. Compounded semaglutide has been available at similar price points. However, availability of compounded versions depends on the FDA’s shortage status for the brand-name drug. When the shortage is resolved, compounding pharmacies may lose the legal basis to produce these copies, so this option can be unpredictable.
What Insurance Typically Covers
Insurance coverage for weight loss medications is inconsistent. Many commercial plans cover GLP-1 drugs but require prior authorization, which means your doctor has to document that you meet specific criteria before the insurer will approve the prescription. The standard thresholds are a BMI of 30 or higher, or a BMI of 27 or higher with at least two weight-related health conditions such as high blood pressure, high cholesterol, type 2 diabetes, sleep apnea, or cardiovascular disease.
Even with approval, your copay varies widely by plan. Some insurers cover these drugs generously; others place them on high-cost specialty tiers with copays of several hundred dollars per month. A growing number of employer plans have explicitly excluded weight loss medications to control costs. If your plan does cover the drug, manufacturer copay cards can reduce your out-of-pocket cost to as little as $25 per month for Wegovy, and Zepbound offers similar programs. These savings cards are available through each drug’s website and work alongside eligible commercial insurance.
Medicare currently does not cover GLP-1 medications for weight loss. A demonstration program launching July 1, 2026, will provide access to Wegovy and Zepbound for eligible Medicare Part D beneficiaries at a fixed $50 copay, but only for those with a BMI of 35 or higher (or 30 or higher with certain conditions). Until that program begins, Medicare enrollees pay entirely out of pocket.
Telehealth and Subscription Fees
Many people access weight loss prescriptions through telehealth platforms rather than traditional doctor visits. These services charge a monthly subscription on top of the medication cost. GoodRx’s weight loss telehealth program, for instance, charges $39 per month at its introductory rate, rising to $119 per month at standard pricing. Medications are billed separately. Other platforms like Ro, Hims, and Found charge comparable subscription fees ranging roughly from $50 to $200 per month, depending on what’s included. When calculating your total cost, add the platform fee to whatever you’re paying for the drug itself.
Total Monthly Cost by Scenario
Your real monthly expense varies enormously based on your situation:
- Oral medications without insurance: Roughly $37 to $150 per month, depending on the drug.
- GLP-1 injectable with good insurance and a copay card: As low as $25 per month.
- GLP-1 injectable with insurance but no copay card: $50 to $500+ per month depending on your plan’s cost-sharing tier.
- GLP-1 injectable without insurance (brand name): $499 to $1,086 per month at list price, or $299 to $699 through Zepbound’s self-pay vial program.
- Compounded GLP-1 without insurance: $250 to $500 per month while available.
If you’re using a telehealth platform, add $39 to $200 per month for the subscription. Some platforms bundle the consultation fee into the medication price, so check whether you’re looking at an all-in cost or just the drug.
Keeping Costs Down
The single biggest cost saver is getting insurance coverage approved. If your plan covers weight loss medications, start by asking your doctor to submit a prior authorization with documentation of your BMI and any related health conditions. Once approved, apply for the manufacturer’s savings card, which can drop your copay to $25.
If you don’t have coverage, Zepbound’s self-pay vial program offers lower doses at $299 per month and maintenance doses at $699, roughly 35% below the standard list price. Compounded versions remain cheaper when available, but verify that any compounding pharmacy you use is accredited and licensed in your state. For people who don’t specifically need a GLP-1 drug, older oral medications like phentermine or Qsymia offer meaningful weight loss at a fraction of the cost, and they’re worth discussing with your provider if budget is a primary concern.