How do you get Wegovy covered by insurance?

Official answer

by Drugs.com

Is Wegovy covered by insurance?

To find out if Wegovy is covered by your insurance plan, call them and ask if this medicine is already covered under your plan and what the cost (or tier) is. A tier is the dollar level of copay you may be expected to pay, and can vary among insurance carriers.

If you do not have insurance, contact Novo Nordisk, the manufacturer, 1-888-809-3942 (Monday-Friday, 8:00 am-8:00 pm ET) to determine if you qualify for a Wegovy Savings Copay Card or patient financial assistance program. They also have an online form you can fill out and they will check your insurance for you.

Insurance coverage for weight-loss medications in the U.S. is not widely available, but you may be able to get assistance to pay for this medicine.

How much is Wegovy with insurance?

If your insurance covers some or all of the cost of Wegovy, the price will depend upon how your insurance classifies Wegovy and the level or tier of your benefit. You can call your insurance to determine the cost and your copay.

If you have commercial insurance, and your doctor prescribes this medicine, it may be more affordable to gain access with a Wegovy Savings Copay Card supplied from Novo Nordisk, the manufacturer. Eligible commercially insured patients may pay as little as $25 per 28 day supply (1 box of injectable pens) with a maximum savings of $200 per prescription fill. Copay cards are not typically eligible to patients with government sponsored insurance such as Medicare, Medicaid or TriCare.

If you have a yearly insurance deductible, you may need to meet your deductible before your insurance would pay for any part of your medicine. Ask your insurance company if you have any out-of-pocket costs before medicines are covered. Once your yearly out-of-pocket costs are met, your insurance should pay for some or all of your medicine.

How much is Wegovy without insurance?

The cost for Wegovy subcutaneous solution is around $1,430 for a supply of 4 injectable pens that contains a month's supply of medicine. Price can vary depending on the pharmacy you visit. Prices are for cash paying customers only and are not valid with insurance plans.

If you pay cash for your prescriptions OR your commercial insurance does not cover the cost of Wegovy, you may be able to save up to $500 per 28-day supply of Wegovy by calling the NovoCare at 1-888-793-1218 (Monday-Friday, 8:00 am-8:00 pm ET).

If Wegovy is not covered by your insurance, and you have run out of other options, consider these actions:

You can ask your insurance which other weight loss maintenance products are covered, if any. Discuss these different options with your doctor and if any may be a reasonable alternative to Wegovy.

Contact NovoCare at 1-888-793-1218 (Monday-Friday, 8:00 am-8:00 pm ET) to learn about any financial assistance programs you may qualify for.

The Wegovy price guide is based on using the Drugs.com discount card which is accepted at most U.S. pharmacies, and may help you save money.

What insurance companies cover Wegovy?

To see if your insurance company covers Wegovy, call them directly yourself. You can usually find the phone number on the back of your insurance card.

You can also call Novo Nordisk or check your coverage immediately online, with a form you fill out. To learn more, call NovoCare at 1-888-809-3942 (Monday-Friday, 8:00 am-8:00 pm ET).

Does Wegovy require a prior authorization?

Your insurance may say you require a “prior authorization form” to be filled out by your doctor and sent into the insurance company as part of the insurance approval process.

Prior authorization is sometimes required for certain medications if you have not tried other “first-line” options, either because these medicines are more expensive or have certain safety concerns.

Once the form is received, your insurance company will determine if you are eligible and contact you.

Is Wegovy generic yet?

Wegovy is only available as a brand name drug and a generic version is not yet available. A generic option is not expected until about 2026 to 2031, but can vary based on patent restrictions.

See also: Generic Drug FAQ

Who is eligible for Wegovy?

Wegovy (semaglutide) injection is approved for adults and adolescents 12 years and older to be used with a reduced calorie diet and increased physical activity for chronic weight management.

In adults, eligible patients should have an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition, such as hypertension (high blood pressure), type 2 diabetes mellitus, or high cholesterol (hyperlipidemia).

In adolescents 12 years and older, eligible patients should have an initial BMI at or above the 95th percentile for age and sex (based on growth charts used by your doctor).

Wegovy is classified as a glucagon-like peptide-1 (GLP-1) receptor agonist and is given as a self-administered subcutaneous (under the skin) injection once weekly.

This is not all the information you need to know about Wegovy (semaglutide) for safe and effective use and does not take the place of your doctor’s directions. Review the full Wegovy information and discuss this information and any questions you have with your doctor or other health care provider.

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