Does Medical Insurance Cover Ozempic

Does Medical Insurance Cover Ozempic?

Ozempic is a prescription drug that is often prescribed to adults with type 2 diabetes. It helps manage the effects of the disease, and frequently also has weight loss as a side effect, which is why most patients are interested to know how much the Ozempic cost. This injectable medication stays effective for an entire week, and it’s conveniently packaged to make injection easier than ever. If you’ve been wondering whether or not Ozempic is covered by medical insurance, here’s a guide to help you find out.

What Is Ozempic?

Ozempic is an injectable prescription drug designed to help with the effects of type 2 diabetes. It has two functions, to help manage blood sugar levels, and to reduce the risk of heart attacks or strokes in people with diabetes.

The active ingredient in this drug is Semaglutide, and there is no generic version available.

Ozempic should be administered once a week since it’s a long-acting drug. It’s only approved for adult use, and it’s not yet known if the medication is effective for people who have experienced pancreatitis.

This medication comes with many doses stored in one pen with a tiny needle tip. The injection is easy and relatively painless with this tool. The injection is subcutaneous or under the skin into the fatty tissue rather than the more difficult intramuscular option.

It’s possible to inject the drug anywhere with a layer of fat. Popular options are the abdomen, thigh, and upper arm. 

How Does Ozempic Work?

Ozempic is classed as a Glucagon-like peptide-1 receptor agonist (GLP-1RA), which is a drug that is used to treat type 2 diabetes. It is used to help control blood sugar and appetite, just like the real hormone.

Ozempic helps reduce the amount of sugar released into the bloodstream by your liver. It also encourages your body to produce more insulin, especially after meals. Finally, it slows the digestive process and lowers your appetite. That means sugars are introduced to your bloodstream more slowly, so you can avoid a spike in your blood sugar.

This particular medication is also long-lasting, so it only needs to be administered once a week. The long-lasting formula is more convenient and lets users avoid more frequent injections. 

Each preloaded pen delivers a specific dose upon injection. The dosage options are 0.25 mg, 0.5 mg, or 1 mg per injection. Your doctor should prescribe one of these options, according to your needs.

Who Should Use Ozempic? 

Ozempic is designed for adults with type 2 diabetes with insulin resistance. It is aimed at those who haven’t responded well to other diabetes treatments, and especially at those who are at high risk of cardiovascular issues. 

It helps lower blood sugar and also often has weight loss as a side effect. Some doctors prescribe it to help patients lose weight. 

How Much Does Ozempic Cost Without Insurance?

Ozempic is a relatively new drug and was approved for use in the United States in 2017. The average retail price is estimated to be about $999.19 per carton without insurance. The cost is similar to comparable drugs in the GLP-1RA family. 

What is the right dosage? One factor that will determine the overall Ozempic cost is the dosage your doctor has prescribed. If you are taking a small dose every week, you will have a lower monthly cost, because you will use up less of the medication.

Since there is no generic version of this drug, there’s no alternative available at a lower cost. However, insurance can potentially reduce the cost of this medication. 

Is Ozempic Covered by Insurance?

The monthly Ozempic cost prescription can be high, so make sure to discuss insurance coverage with your doctor before you pursue treatment with this drug. 

Ozempic is covered by some insurance plans, but not all. One of the easiest ways to quickly check your copay for this medication is through the NovoCare website. You can get an estimated cost according to your insurance information either through their online tool or over the phone. All you need to do is provide your insurance information.

If you are currently on Ozempic, make sure to check for coverage at the start of each year to see if your plan will continue to cover the medication. Every insurance plan is different, so keep an eye out for changes to your policy.


Most Medicare Part D or Medicare Advantage programs do cover Ozempic. The former is designed to cover prescription drugs purchased at a pharmacy. 

Check your specific plan’s formulary to see the exact list of prescriptions covered by the plan. It could be helpful to talk to someone to confirm whether or not Ozempic is covered by insurance.

Private Insurance  

Whether or not private insurance covers Ozempic depends on the specific plan you have. Novo Nordisk offers a coupon through their website that could help you afford the cost of this medication in combination with your insurance. 

You may also want to contact your insurance company or take a look at the formulary for your insurance plan. Plans vary greatly, even within the same company, so be sure that you are looking at the right plan. An expert’s knowledge can be useful here.

What’s the Most Affordable Way to Buy Ozempic?

If your insurance doesn’t cover Ozempic, there are options to help make the cost more manageable. Online sources for buying medication can help you save money, and they often have significant discounts. We at PharmaServe don’t charge taxes. 

Reputable online medication services will require a valid prescription and have licensed pharmacists available to chat with you about any concerns. Look for a secure website with safety certificates, so you can feel comfortable using your credit card with the company.

Consider buying medications in bulk—to save money and ensure you have a stockpile that will serve as a buffer for you, this also tends to get you better discounts. You can usually buy up to a 3-month supply at one time, and that also lets you save on any shipping and processing fees.

PharmaServe is a pharmacy referral service that is proud to offer affordable options for prescription medications like Ozempic.

To learn more about the services we provide, you may visit our website or contact us at PharmaServe today.

Dr. Conor Sheehy, PharmD, BCPS is a practicing clinical pharmacist that works in primary care. He supports other members of the healthcare team including physicians, mid-level providers, nurses, and other clinical staff. He also likes to use his drug knowledge to inform his patients and the public about the benefits and risks they can expect from their medications. His clinical specialties include: anticoagulation, diabetes management, and psychiatric care.

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