Cost & coverage
Zepbound vs Wegovy in 2026: what they cost and who covers them
The approved GLP-1 drugs for weight loss are no longer just a $1,000-a-month question. Self-pay prices fell, Medicare started a temporary $50 program, and new pills arrived. Here is where prices and coverage stood on October 1, 2026.
By the RetaRadar editors · Published October 1, 2026
The approved options
- Zepbound (tirzepatide, Eli Lilly) — weekly injection, as a KwikPen, single-dose pen or vial.
- Wegovy (semaglutide, Novo Nordisk) — weekly injection, plus Wegovy HD 7.2 mg, approved March 19, 2026, and the once-daily Wegovy pill, approved December 22, 2025 (Novo Nordisk).
- Foundayo (orforglipron, Eli Lilly) — a daily pill approved on April 1, 2026 (FDA).
None of these is retatrutide, which is still in trials; see our retatrutide guide.
List price vs what people actually pay
The list price is what insurers are billed before rebates. A November 2025 White House fact sheet put Zepbound at about $1,086 a month and Ozempic/Wegovy at $1,000–$1,350 (White House). Few people pay that. The table shows the manufacturers’ own cash prices on October 1, 2026.
| Product | Self-pay price per month | Where |
|---|---|---|
| Zepbound KwikPen | $299 (2.5 mg), $399 (5 mg), $449 (7.5–15 mg) | Lilly |
| Zepbound vials | from $299 | LillyDirect |
| Wegovy pen | $349 (introductory offers on some doses) | NovoCare |
| Wegovy HD 7.2 mg | $399 | NovoCare |
| Wegovy pill | $149 (1.5 mg), $199 (4 mg), $299 (9 mg and 25 mg) | NovoCare |
The government site TrumpRx.gov also lists these drugs, with starting prices such as Zepbound from $299 and the Wegovy pill from $149 a month. Prices change; check the manufacturer before you buy.
With commercial insurance
Coverage depends on your employer’s plan. In KFF’s 2025 Employer Health Benefits Survey, 43% of firms with 5,000 or more workers covered GLP-1 drugs for weight loss, up from 28% in 2024; among firms with 200 to 999 workers it was 16% (KFF). If your plan covers the drug, manufacturer savings cards can bring the copay down to as little as $25 a month. If your plan does not cover it, the self-pay prices above usually apply.
Medicare
By law, Medicare Part D cannot cover drugs used only for weight loss. Wegovy and Zepbound can still be covered for other approved uses, such as reducing cardiovascular risk or treating obstructive sleep apnea (KFF).
The Medicare GLP-1 Bridge
From July 1, 2026 to December 31, 2027, CMS runs a temporary demonstration that covers Foundayo, Wegovy (injection and pill) and the Zepbound KwikPen for weight loss, with a $50 monthly copay (CMS). It runs outside Part D, needs prior authorization, and is open to people who meet one of these:
- BMI of 35 or more;
- BMI of 30 or more with heart failure with preserved ejection fraction, uncontrolled high blood pressure, or chronic kidney disease stage 3a or worse;
- BMI of 27 or more with prediabetes, a previous heart attack or stroke, or symptomatic peripheral artery disease.
People with type 2 diabetes, moderate-to-severe sleep apnea or MASH are not in the Bridge because Part D already covers those uses. KFF estimates that about 3.8 million beneficiaries could qualify (KFF).
Medicaid
Covering obesity drugs is optional for state Medicaid programs. KFF counted 13 states covering GLP-1s for obesity in January 2026, down from 16 in October 2025 after California, New Hampshire, Pennsylvania and South Carolina dropped coverage (KFF). A CMS model called BALANCE offers states a negotiated price of $245 for a 30-day supply (CMS).
Zepbound or Wegovy: which costs less?
- Lowest starting cash price: the Wegovy pill at $149 a month for the starting dose, and Zepbound at $299 for the starting KwikPen or vial.
- At maintenance doses: Zepbound KwikPen $449, Wegovy pen $349, Wegovy pill $299 a month (cash).
- On Medicare, for weight loss: the same $50 copay for any covered product in the Bridge, if you qualify.
- On employer insurance: whichever your plan’s formulary prefers, often with a $25 copay card.
Which drug is right is a medical decision for you and your clinician. Cheap, unapproved copies are not a substitute; see what the FDA says about fake and compounded GLP-1s.