Check insurance before you pay cash. Here's exactly how.

Every cash price on this site can be beaten by the right coverage — and quietly crushed by the wrong assumption that you have it. The fifteen-minute homework, in order.

Step 1: Commercial insurance — the five questions

Call the number on your card (or check the formulary in your member portal) and ask, in this order:

1. "Does my plan cover GLP-1 medications for weight management?" Many plans cover them for type 2 diabetes but exclude weight-loss use entirely — the single most common surprise.
2. "Which ones are on formulary — Wegovy, Zepbound, or both — and at what tier?" Tier decides your copay.
3. "What does prior authorization require, and who submits it?" Typical requirements: a BMI threshold, documented comorbidities, sometimes a step-therapy history. Your prescriber files it; navigation services (LifeMD, WW Clinic, Calibrate) exist largely to fight this paperwork for you.
4. "What's my copay after the deductible — and before it?" A "$25 copay" behind a $3,000 unmet deductible is not a $25 month.
5. "Is there a quantity limit or a coverage end date?" Some plans reauthorize every 6–12 months.

Write the answers down with the date and the rep's name. If the answer is a clean yes with a workable copay, coverage beats every cash number we track — stop reading, start the prior auth.

Step 2: Medicare — the $50 Bridge

Since July 1, 2026, participating Part D plans cover Wegovy (pen and pill), Foundayo, and the Zepbound KwikPen at a flat $50/month copay through 2027 — below every cash price on our index. It has real fine print (participation varies, prior auth applies, the $50 doesn't count toward your deductible or out-of-pocket cap, and Ozempic/Mounjaro for weight loss are excluded). The full mechanics: our Bridge guide.

Step 3: Medicaid — state-by-state, mostly narrow

Medicaid coverage of GLP-1s for weight loss varies by state and is the exception rather than the rule; diabetes indications are covered far more often. Check your state's preferred drug list, and note that several telehealth programs (LifeMD among them) don't accept government insurance at all — their membership models sit outside it.

Step 4: HSA/FSA — the quiet discount on cash

If you do end up paying cash, prescription medications are HSA/FSA-eligible expenses, and several programs we track (Calibrate, Cora, AgelessRx on the longevity side) explicitly accept those cards. Paying with pre-tax dollars is effectively a discount equal to your marginal tax rate — real money at $349/month.

When cash genuinely beats coverage

• High deductible, early in the year: the Wegovy pill at $149 cash can undercut months of deductible-rate billing.
• Coverage denied or excluded: the entire True-Cost Index exists for you — start with the Savings Wizard.
• Off-formulary drug: if your plan covers only one of the two and your prescriber prefers the other, compare that copay to the other drug's cash price before appealing.

Coverage details are plan-specific and change at renewal; your insurer's written answer beats anything on this page. Pricing journalism, not medical or benefits advice — disclosure.