What will the whole thing cost?
Ask for the full price in writing. Compare what you would pay to start, to continue and to stop.
Which charges does the advertised price include?
- Care
- Visit fee or membership; follow-up and refill fees.
- Medicine
- Exact product, amount supplied and delivery charge.
- Tests
- What is proposed, where it happens and who pays.
- Leaving
- How long you must pay, how to cancel and whether you can get money back.
Ask the service to list every charge for starting and continuing care. Have them mark any charge that does not apply, so you can compare the complete bills.
Why do prices for the same drug differ?
List prices, cash offers, discount-card prices and insurance payments are different ways of pricing a drug.
List price is the maker’s published price. Self-pay is when you pay without using insurance. A copay is your share of the price when a plan covers a drug.
Ask which kind of price the quote uses.
What does a cash offer look like?
For semaglutide (Ozempic) injection, the introductory cash offer charges $199 per one-month supply for the first two supplies. It covers only certain starting strengths, meaning amounts of drug in the product.
The offer is for eligible new adult self-pay patients in the US and runs through December 31, 2026.
After those two supplies, each month costs $349 or $499; the amount of drug in the product determines the price.
Ask whether the offer includes the strength prescribed for you. These are example medicine prices; ask what your own drug and visits would cost.
Under this offer, the cash payment cannot count toward an insurance deductible, the amount paid before a plan starts sharing costs.
Will insurance pay?
Ask whether your plan covers the particular product for the reason it would be prescribed. Ask whether the clinician and pharmacy are covered too.
Medicare may pay for the same drug when it treats another condition, such as diabetes, instead of weight loss. Your plan must still agree to cover it.
The plan may check its formulary, its list of covered medicines. It may also require prior authorization, which means agreeing to pay before the pharmacy supplies the medicine.
What is the Medicare Bridge?
The temporary Medicare GLP-1 Bridge program helps cover the cost of certain weight-loss medicines. These are called GLP-1 drugs because they copy a body signal that helps control appetite and blood sugar.
Eligible people pay $50 for a monthly supply, starting July 1, 2026 and continuing through December 31, 2027.
Medicare Part D is the usual Medicare drug coverage. The Bridge uses a separate system to approve prescriptions and pay pharmacies, instead of your usual Part D plan’s payment system.
The $50 payment is excluded from the yearly Part D limit on what you pay for drugs. The Bridge offers people on low incomes no extra help toward this payment.
Ask the prescriber to check whether you and the prescribed product qualify, and how the pharmacy will arrange the Bridge payment.