Ozempic and a family of similar drugs have revolutionized the treatment of type 2 diabetes. Not only do these drugs have impressive positive impacts on blood glucose levels, but have also been proven to be effective for weight loss and provide other health improvements. Not surprisingly, many people have jumped on the bandwagon. However, this drug does come with a hefty price, and not all insurance companies are willing to foot the bill. The good news is that there may be options to get this high-demand medication and save substantially.

What Is Ozempic?

Ozempic is a semaglutide medication that has been approved by the U.S. Food and Drug Administration (FDA) as a treatment for type 2 diabetes. This injectable drug stimulates the pancreas and particular cells within the pancreas to tick up insulin production, which in turn controls blood glucose levels. At the same time, as a GLP-1 agonist, it mimics a naturally occurring digestive system hormone and prevents the liver from producing too much glucose.

Ozempic also signals to the brain that it’s full, and because of this, the drug has been shown to have powerful weight loss effects by decreasing appetite. This weight loss effect has led to a surge in its popularity as more people have started to take it for off-label uses. This uptick in popularity has also contributed to keeping the cost of Ozempic sky-high.

How Much Does Ozempic Cost?

Ozempic has shown promising results, such as dramatically reducing patient’s A1C levels, particularly at higher doses. However, one might wonder how much they can expect to pay to obtain it and its potentially life-changing results.

If you don’t have insurance, Ozempic might cost between $1,000 and $ 1,200 per month, which is upwards of $12,000 per year. This price may be out of reach for many Americans, which presents a barrier to those who need it most. In addition, this cost is not likely to decline anytime soon as Ozempic is patent-protected until 2031. This patent protection keeps lower-cost generic versions of the drug off the market and out of consumers’ hands.

What Factors Contribute To The High Cost of Ozempic?

There are many factors that drive the cost of Ozempic beyond simply colossal demand, both by those with type 2 diabetes and those battling obesity.

First, Ozempic can be delivered at numerous different doses, depending on one’s body and how resistant their disease has traditionally been to treatment. People may receive injections of 0.25 mg, 0.5 mg, and 1.0 mg per week. Higher doses mean more medication, which in turn drives higher costs. Most pharmacies do not offer discounts for buying Ozempic in bulk or volume.

Costs are also shaped by the fact that Ozempic is currently patent-protected, and no generics can be created at this time. Even though there are similar drugs, like Wegovy and Mounjaro, on the market, there is no direct competitor to Ozempic. Right now, this drug manufacturer has all of the market power.

Costs may depend on which pharmacy a person chooses to use as well. This raises the importance of comparison shopping, especially for people who don’t have insurance or are on a limited budget. Comparison shopping can be done by calling pharmacies or visiting sites like GoodRx. The price difference between different pharmacies can be shocking. Similarly, costs may be higher in rural or remote locations as they have higher distribution costs than urban areas. It’s not uncommon to see higher drug prices in high-cost-of-living regions, like New York and Chicago, either, since pharmacies in these metro areas have higher overhead costs.

Is Ozempic Covered by Medical Insurance?

Most health insurance plans cover it, but there are some caveats. The most important caveat is if it’s being used to treat type 2 diabetes or off-label for weight loss. Off-label uses are generally not covered by standard insurance companies and plans. On the other hand, patients who have been medically diagnosed with type 2 diabetes generally have their prescriptions covered, even if they sometimes need to jump through hoops with their insurance company.

However, even if insurance does cover Ozempic, it’s important to remember that patients typically have to pay co-pays and meet their annual deductible.

Medicare

The answer to Medicare coverage is a complicated yes and no. Medicare covers Ozempic if it has been prescribed to treat type 2 diabetes. This coverage happens under Medicare Part D, which is the drug coverage part of the program. However, Medicare doesn’t cover off-label use of Ozempic, such as for weight loss. This is due to the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2006, which forbade Medicare from covering any obesity treatments.

Medicaid

Medicaid is a state program, meaning that medication coverage varies dramatically from state to state. Even states that offer Ozempic coverage under Medicaid plans may put restrictions in place, such as limiting how much Ozempic a patient can receive per month. Also, patients may need to demonstrate that they have failed other treatment protocols before being offered costly prescriptions like Ozempic.

Private Insurance

Unfortunately, there is no straightforward answer when it comes to whether or not private insurance companies will cover Ozempic. Some companies do, and others don’t. Significant differences may exist across specific plans, even within the same insurance company.  This means that individuals need to be savvy and research their insurance coverage. If one struggles to find this information, they can go straight to the source, NovoCare. NovoCare, which the drug manufacturer Novo Nordisk operates, will tell consumers how much they likely need to pay based on their insurance information.

How Can You Get Ozempic Covered By Your Insurance?

Some insurance companies are reluctant to cover Ozempic because of its high cost. However, even if an insurance company is hesitant, there are steps that people can take to maximize the likelihood of getting their medication covered. These steps are outlined below:

  • Be an informed consumer. Know what the insurance company’s policies are on Ozempic and be prepared to use this information in phone calls and letters;
  • Bring your medical provider on board. Ozempic requires a doctor’s prescription. It is also helpful if your doctor is willing to advocate on your behalf if the insurance company says no;
  • Make sure that you have the necessary paperwork in place if your insurance company requires pre-authorization. This may include blood work that confirms your type 2 diabetes diagnosis and if you have trialed other treatment options;
  • Be ready and willing to appeal a denial decision. It’s important to know that appeals processes can be emotional and time-consuming.

Are There Ways To Save Money On Ozempic?

Ozempic can be a life-saving drug for many people, but it’s also pricey. The great news is that there are multiple ways that individuals can save money on Ozempic if they’re willing to put in time and legwork to figure out alternatives.

One of the most significant cost-saving opportunities is the Ozempic savings card offered by NovoCare, which is available to individuals with private or commercial insurance. This card can potentially take a patient’s monthly cost down to as little as $25 per month. However, it caps savings at a maximum of $150 per month, $300 for a two-month prescription, or $450 for a three-month prescription. However, do keep in mind that this program expires after 24 months. Lastly, there are manufacturer assistance programs for people who don’t have insurance as well.

Get Ozempic From Buy Canadian Insulin

There are other options, too, to save money on Ozempic. One affordable option that has been popular for many Americans is to buy Ozempic online from Canada through BuyCanadianInsulin.com. For example, a 2 mg or 4mg pen can be purchased for only $469.79 which is almost half the price of Ozempic sold in the United States. This represents a significant saving compared with what one can find at U.S. retail pharmacy locations.

The Buy Canadian Insulin provides Americans the ability to easily order Ozempic with a prescription online. Patients can even get a 10% discount on their first order with coupon code FIRST10, which is an additional saving on the already discounted Ozempic price. In addition, the exceptional customer service at buycanadianinsulin.com helps Americans answer questions through a toll-free number, email, and live chat. Orders are express shipped across the continental United States in temperature-controlled packaging in order to keep the medication cool for delivery.

Medical Insurance May Cover Ozempic

To date, Ozempic has shown great promise for those with type 2 diabetes who want to lower their blood sugar levels. However, the expensive price tag attached to this medication unfortunately means many have issues obtaining it. This financial barrier puts many individuals with this chronic condition at risk of developing further health complications.

While some forms of medical insurance cover a portion of the costs associated with Ozempic, many are uninsured or without insurance altogether. In these scenarios, Ozempic savings cards and/or Canadian sites such as BuyCanadianInsulin.com can help make ordering Ozempic more feasible.