How to Pay for Your GLP-1

Your GLP-1 or GLP-1/GIP prescription is filled, and now it’s time to pay for it. Your mind might be racing with questions: Does my insurance cover this? Can I afford this medication? Will I be able to keep paying for this prescription every month? Here’s what to know about paying for your prescription and what to do if cost or coverage gets in the way.

Do you need a prescription for a GLP-1?

Yes. All GLP-1 and GLP-1/GIP medications require a prescription, and only an HCP can prescribe one.

How to navigate insurance coverage

Check your insurance website for coverage details. Many insurance websites have a pharmacy benefits search engine, sometimes you can find medication coverage information on a page called a “medication checker” or “request an Rx.” It will always show you the price before you order, so don’t worry. 

You can enter a medication name to see its cost, which pharmacies carry it and whether your plan covers it. For example, if your HCP recommended Humalog or Lantus, that’s what you’d type into the search engine.

While each insurance website is a little different, here are some general steps to help you get started:

1. Find your insurance plan’s drug cost and coverage tool.
2. Search for the drug you want to check.
3. See if it’s covered

Your plan may only cover certain medications. If your insurance covers Zepbound but not Ozempic, for example, you’ll need to go back to your HCP and ask about switching to an option covered by your insurance.

Your diagnosis matters. Medications that were originally used mainly for diabetes are now approved for other health conditions too, sometimes for people who don’t have diabetes at all. Ozempic, for example, is FDA-approved for chronic kidney disease (CKD), and Zepbound is approved for weight loss and obstructive sleep apnea (OSA).

If your diagnosis doesn’t match one of the approved uses for the medication you were prescribed, talk to your HCP, healthcare team, or pharmacist. This mismatch is usually what’s behind insurance coverage issues.

“Covered” doesn’t always mean affordable. A high deductible or high co-pay can still make a covered medication expensive. Manufacturer discount programs (sometimes called coupons) can help. Ask your pharmacist or check the manufacturer’s website for options.

What if you don’t have coverage?

If your diagnosis doesn’t meet your insurance’s approved criteria, you may qualify for a self-pay program through LillyDirect or NovoCare. Talk to your HCP about whether one of these options fits your situation.

What about unapproved GLP-1 drugs?

You may have seen cheaper, compounded GLP-1s sold through third parties. They can be tempting, but they aren’t FDA-approved and carry real safety risks. With FDA-approved options and patient assistance programs both widely available, stick with an approved GLP-1 rather than an unapproved one.

For more on how these medications work and what to expect along the way, read more on our GLP-1 Hub.

This content was made possible by Lilly, an active partner of Beyond Type 1. Beyond Type 1 maintains editorial control over its content.