Does Insurance Cover Wegovy?

If you are considering taking Wegovy for weight loss, you may be wondering whether your insurance will cover the cost. Wegovy is a prescription medication that is used to help adults who are overweight or have obesity lose weight and keep it off. Here, we’ll take a closer look at whether insurance typically covers Wegovy, what you can expect to pay out of pocket, and some frequently asked questions about insurance coverage for this medication.

Does Insurance Cover Wegovy?

The short answer is that it depends on your insurance policy. Some insurance companies may cover the cost of Wegovy, while others may not. Even within the same insurance company, coverage can vary depending on the specific policy you have. Before you start taking Wegovy, it’s a good idea to check with your insurance provider to see if the medication is covered.

If your insurance covers Wegovy, the amount you pay out of pocket will depend on your specific plan. Some insurance plans may cover the entire cost of the medication, while others may require you to pay a portion of the cost in the form of a copay or coinsurance.

What Is a Copay?

A copay is a fixed amount that you pay for a prescription medication. The amount of your copay will depend on your insurance plan. For example, your insurance plan may require you to pay a $20 copay for each prescription of Wegovy that you fill.

What Is Coinsurance?

Coinsurance is a percentage of the cost of a prescription medication that you are responsible for paying. For example, your insurance plan may require you to pay 20% coinsurance for each prescription of Wegovy that you fill. This means that if the cost of the medication is $100, you would be responsible for paying $20.

What Will Wegovy Cost Out of Pocket?

If your insurance covers Wegovy, you can expect to pay some amount out of pocket. The amount you pay will depend on your specific insurance plan. Some plans may cover the entire cost of the medication, while others may require you to pay a copay or coinsurance.

Without insurance, the cost of Wegovy can be quite high. The medication is typically priced around $1,300 for a one-month supply. However, many manufacturers offer coupons that can help reduce the cost of the medication. For example, Novo Nordisk, the manufacturer of Wegovy, offers a savings card that can reduce the cost of the medication to as little as $25 for eligible patients.

FAQ About Insurance Coverage for Wegovy

Question
Answer
Does Medicare cover Wegovy?
Yes, Medicare typically covers Wegovy for eligible patients.
Does Medicaid cover Wegovy?
The coverage of Wegovy may vary by state Medicaid programs. You should check with your state Medicaid agency to see if the medication is covered.
Does private insurance cover Wegovy?
Many private insurance plans cover Wegovy, but coverage can vary by plan. You should check with your insurance provider to see if the medication is covered.
What if my insurance doesn’t cover Wegovy?
If your insurance doesn’t cover Wegovy or if you don’t have insurance, there may be other options to help reduce the cost of the medication. You can check with the manufacturer for coupons or savings cards, or you can contact prescription assistance programs like RxAssist or NeedyMeds.
Do I need a prescription for Wegovy?
Yes, Wegovy is a prescription medication and can only be obtained with a prescription from a healthcare provider.

Conclusion

If you are considering taking Wegovy for weight loss, it’s important to check with your insurance provider to see if the medication is covered. Even if your insurance covers Wegovy, you may still be responsible for paying a copay or coinsurance. However, many manufacturers offer coupons or savings cards that can help reduce the cost of the medication. With this information in mind, you can make an informed decision about whether Wegovy is the right weight loss option for you.