Paying for GLP-1s in 2026: insurance, Medicare, Medicaid and savings cards
How to get the lowest price for Wegovy, Zepbound, the Wegovy pill or Foundayo, depending on how you are covered.
If you have commercial insurance
Coverage for weight-loss drugs depends on your plan. Many require prior authorization: your prescriber sends proof of your BMI and health conditions before the plan pays. If your plan covers the drug, the manufacturer's savings card can lower your copay to as little as $25 a month. The cards take up to $100 off per fill, with yearly limits ($1,300 for Zepbound, $1,000 for Foundayo). They cannot be used with Medicare, Medicaid or other government plans.
If your plan does not cover it, you can still pay the cash price. Cash purchases usually do not count toward your deductible.
If you have Medicare
Medicare Part D has long been barred from covering drugs used only for weight loss. The Medicare GLP-1 Bridge, which runs from July 1, 2026 to December 31, 2027, is an exception. It covers Wegovy (injection and pill), Foundayo and Zepbound KwikPen for a $50 monthly copay, if you meet one of these:
- BMI of 35 or more
- BMI of 30 or more with heart failure, uncontrolled high blood pressure or kidney disease
- BMI of 27 or more with a past stroke or heart attack, prediabetes or peripheral artery disease
Your prescriber must get approval and confirm you have had lifestyle counseling. You are not enrolled automatically, the Part D deductible does not apply, and the copay does not count toward your out-of-pocket limit. Separately, Part D plans can cover Wegovy when it is prescribed to lower heart risk in people with heart disease, and Zepbound for sleep apnea, because those are not weight-loss-only uses.
If you have Medicaid
Coverage is up to each state. About a dozen state Medicaid programs covered GLP-1s for weight loss in 2026, and several, including California, Pennsylvania, Utah and Massachusetts, dropped coverage. A federal program called BALANCE may let more states join from 2027.
If you pay cash
Buy directly from LillyDirect or NovoCare, through TrumpRx.gov, or at Costco, Amazon Pharmacy and GoodRx partner pharmacies. Prices start at $149 a month for the pills and $199 to $299 for the injections, and rise with the dose. Brand-name GLP-1s prescribed for a medical condition can usually be paid with an HSA or FSA.