How Do You Access GLP-1 Medications? A Step-By-Step Guide

Diabetes is a lot to manage, and you shouldn’t have to do it without support. GLP-1 and GLP-1/GIP medications can lighten that load, like by improving your glucose and A1C levels, supporting heart health, improving sleep and helping with weight loss. When a GLP-1 or GLP-1/GIP dual agonist can make that much of a difference on your wellbeing, getting access to one shouldn’t be out of reach. 

How to talk to your healthcare provider about a GLP-1

Step 1: Set goals that meet your personal needs and share those with your healthcare provider (HCP).

Ask yourself what’s most important to you and how a GLP-1 fits in with that. Are you most interested in weight loss or glucose benefits? Do you have financial considerations? Set goals that are realistic and meaningful. We recommend using the SMART goal method:

• [S]pecific: Clearly define what you want to accomplish by answering the who, what, where and why.

• [M]easurable: Identify exact numbers you can use to track your progress.

• [A]chievable: Be sure your goal is doable with your current resources.

• [R]elevant: Check if the goal is important to you and aligns with your overall vision.

• [T]imely: Set a clear deadline or target date,

Step 2: Ask your HCP about your options.

What to say: “I think a GLP-1 might be right for me. I’d like to learn more about my options.” 

Share your goals and let them know which areas of your health you’re most concerned about such as: 

• Your A1C or glucose levels have been  running above your target goal
• You’re interested in weight loss 
• You’ve had a heart attack or stroke
• You live with or are at risk of Chronic kidney disease (CKD)
• You live with or are at risk of liver disease (MASH or MASLD)
• You live with heart failure (HFpEF)
• You experience sleep apnea

This will help them identify which medication will best meet your health needs and what should be covered by your health insurance. 

Step 3: Get a prescription 

What to say: “Based on my current health concerns and our conversation, I’d like to request a prescription for [the GLP-11 of choice]. My preferred pharmacy is [your pharmacy name]. My insurance may require a prior authorization, can you help me with that?”

Be sure to fill your prescription with an approved pharmacy, like CVS, Walgreens, or Amazon Pharmacy).

What if insurance won’t cover your GLP-1?

If the pharmacy tells you that you aren’t covered, ask them to explain why. Some common reasons you may encounter include: 

• If you have a high deductible or high co-pay, manufacturer discount programs can help. Ask your pharmacist or check GoodRx for current options.
• If your plan only covers certain medications, ask your doctor to switch the prescription to one your plan will cover. For example, your insurance may cover Zepbound but not Ozempic. In this case, you’d need to go back to your HCP and ask them to swap out the medication for what’s covered
• If your diagnosis doesn’t meet the approved criteria for coverage, you may qualify for self-pay programs like LillyDirect or NovoCare. Talk to your HCP to learn about these options.

Expert tip: Not all GLP-1s are created equal. You’ve probably seen TV commercials for cheaper, compounded versions of GLP-1 medications that are available through third-party sellers. But they aren’t FDA-approved and come with real safety risks. Stick with FDA-approved options and patient assistance programs widely available. They’re worth the extra step.

You deserve access to GLP-1 or GLP-1/GIP medications. Advocate for yourself, be persistent and keep trying if you hit roadblocks along the way. Talk to your HCP about safe ways to access the GLP-1 or GLP-1/GIP that’s right for you. 

Want to learn more about GLP-1s and diabetes? GLP-1s aren’t one-size-fits-all, and there’s a lot to learn as you go. Explore our GLP-1 Hub for more on how these medications work, what they treat, and how to navigate them with your care team.

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