Cost of Ozempic with Savings Card
For commercially insured patients, the Ozempic manufacturer savings card reduces out-of-pocket costs to as low as $25 per month, though Medicare and Medicaid patients are not eligible for this program. 1
Eligibility and Restrictions
- Commercial insurance patients can access manufacturer copay savings cards that significantly reduce out-of-pocket expenses, with programs available directly through the manufacturer's website 1
- Medicare patients are explicitly excluded from manufacturer copayment savings programs, which can result in substantially higher costs depending on their plan's formulary tier 1
- Medicaid patients typically have minimal copayments ($0-$5) once prior authorization is approved, making savings cards unnecessary for this population 1
Cost Without Savings Programs
- The average wholesale price (AWP) for Ozempic is approximately $1,619 per 30-day supply, representing the list price before any discounts or insurance coverage 1
- The National Average Drug Acquisition Cost (NADAC) is approximately $1,296 per 30-day supply, reflecting actual acquisition costs at the pharmacy level 1
Medicare-Specific Challenges
- Medicare patients face the highest out-of-pocket burden, with copayments potentially ranging from 5% to 25% of the drug cost depending on their plan's tier structure 1
- In some cases, Medicare patients have encountered copayments as high as $1,800 when semaglutide products are classified under specialty tier 5 formularies 1
- Medicare patients in the initial deductible phase may pay 100% of the drug cost until their deductible is met 1
Alternative Cost-Reduction Strategies
- Discount programs like GoodRx, CostPlus, and SingleCare may provide lower-cost alternatives for some patients, though availability varies by medication and location 1
- Financial navigation services and social workers can help patients identify assistance programs and strategize medication affordability 1
- For Medicare beneficiaries meeting specific income thresholds (income under $17,226 and assets under $9,470), the full subsidy program caps brand-name copays at $8.95, potentially reducing annual costs to under $50 1
Common Pitfalls to Avoid
- Do not assume all patients can access manufacturer savings cards—always verify insurance type before discussing expected costs, as Medicare and Medicaid patients face different cost structures 1
- Prior authorization requirements can delay treatment initiation and may result in claim rejections even with savings cards, requiring clinical documentation and appeals 1
- State laws may restrict the use of manufacturer copay assistance programs in certain jurisdictions 1