The Short Answer
Brand-name GLP-1s (Wegovy, Zepbound) cost $1,000-1,300/month without insurance. Most insurance doesn't cover them for weight loss.
Compounded versions through telehealth providers cost $150-400/month. That's how most cash-pay patients access treatment.
Lowest Compounded Price We've Found
Semaglutide through select telehealth providers. Tirzepatide starts around $250/month.
Brand-Name Prices (Retail)
| Medication | Monthly Cost | Notes |
|---|---|---|
| Wegovy (semaglutide) | $1,349/mo | FDA-approved for weight loss |
| Ozempic (semaglutide) | $968/mo | Approved for diabetes, off-label for weight |
| Zepbound (tirzepatide) | $1,059/mo | FDA-approved for weight loss |
| Mounjaro (tirzepatide) | $1,023/mo | Approved for diabetes, off-label for weight |
These are list prices. Some patients get brand-name covered through insurance (rare for weight loss indication) or use manufacturer savings cards (usually requires commercial insurance).
Compounded Prices (Cash-Pay)
Compounded medications use the same active ingredients, prepared by licensed compounding pharmacies. Here's what telehealth providers actually charge:
| Medication | Price Range | Savings vs Brand |
|---|---|---|
| Compounded Semaglutide | $146-299/mo | Save 78-89% |
| Compounded Tirzepatide | $250-400/mo | Save 62-76% |
Price varies by provider, dose, and whether they include consultation fees or charge separately.
What's Included (And What's Extra)
Watch out for hidden costs. Here's what to check:
Usually included:
- Medication (1 month supply)
- Syringes and alcohol swabs (if using vials)
- Shipping (most providers)
Sometimes extra:
- Initial consultation fee ($50-150 one-time)
- Monthly provider fee ($30-50/month)
- Lab work (some providers require it)
- Expedited shipping
Always check the total cost. A provider advertising "$149 medication" plus a $50 monthly fee is really $199/month. Compare apples to apples.
Annual Cost Comparison
| Option | Monthly | Annual |
|---|---|---|
| Brand Wegovy (no insurance) | $1,349 | $16,188 |
| Compounded Semaglutide (high end) | $299 | $3,588 |
| Compounded Semaglutide (low end) | $146 | $1,752 |
The difference between brand and compounded over a year: $12,600-14,400 in savings.
Can You Use HSA/FSA?
Yes. GLP-1 medications for weight loss are generally HSA/FSA eligible when prescribed by a licensed provider. This effectively gives you a tax discount (your marginal tax rate, often 22-35%).
Pro tip: If you have an HSA with investment options, using it for GLP-1 treatment preserves your cash for other uses. You're paying with pre-tax dollars either way.
Insurance Reality Check
Most insurance plans don't cover GLP-1s for weight loss. Here's the landscape:
Usually covered: Type 2 diabetes indication (Ozempic, Mounjaro)
Rarely covered: Weight loss indication (Wegovy, Zepbound)
Never covered: Compounded versions
If you have diabetes, you may be able to get brand-name covered. Otherwise, plan to pay out of pocket—and compounded is the practical path for most people.
Is It Worth It?
At $150-300/month, you're looking at $1,800-3,600 per year. That's real money. Here's how to think about it:
- Compare to other weight loss spending: Gym memberships, programs, supplements, meal delivery—these add up. GLP-1 often replaces multiple line items.
- Consider health cost savings: Weight loss can reduce spending on blood pressure meds, diabetes medications, and future medical costs.
- Factor in quality of life: For many people, the mental relief from silenced food noise is worth the cost alone.
The math works for most people who can afford it. The question is whether it fits your budget and priorities.
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