HealthRX.com · Printable cost worksheet
Wegovy payment-route quote sheet
Write down your coverage type, the exact Wegovy form and strength, and the quote for each route NovoCare and Medicare publish, so you can compare the real monthly cost and what counts toward your deductible before the fill.
Your prescription and coverage
Wegovy form and strengthpill, pen or HD pen, and the dose
Coverage typecommercial only, any government program, both, or none
Indication on the prescription
Pharmacy and how it will be filledlocal pickup or home delivery
Published prices and terms
- April 2026 price guide, self-pay per month: pill $149 to $299 by strength; pen $349; HD pen 7.2 mg $399.[1]
- New patients pay $199 for each of 2 monthly fills of the 0.25 mg and 0.5 mg pens, through December 31, 2026.[1]
- With commercial insurance, pay as little as $25, with savings capped at $100 a month; government beneficiaries are excluded.[1]
- Self-pay spending does not count toward a deductible or out-of-pocket maximum.[2]
- Wegovy is not among the products on the Patient Assistance Program list dated 2026.[3]
- The Medicare GLP-1 Bridge, from July 1, 2026, has a $50 copay for a one-month supply for people who qualify.[4]
Quotes by route
| Route (insurance, savings offer, self-pay, Bridge) | Quoted monthly price | Counts toward deductible? | Offer end date | Quoted by and date |
|---|---|---|---|---|
Before you pay
- Quote matches the exact form and strength on the prescription
- Know whether the next refill price is different from the first
- Asked whether delivery or consultation fees are added
- Read the current terms on the day of the fill
- Receipt kept if you plan to use HSA or FSA money
Questions for the pharmacy or NovoCare
- Is this being processed as an insurance claim, a savings offer, a self-pay purchase or a Medicare Bridge claim?
- What will the price be when I move up to the next strength?
- When does this introductory price end for me?
- If my coverage changes, which route do I move to?
Sources for the facts on this sheet
- Novo Nordisk, NovoCare. Wegovy Price Guide: self-pay prices and copay with commercial insurance (US26NC00049, April 2026). Accessed 2026-10-18. https://www.novocare.com/content/dam/novonordisk/novocare/redesign/pdf/Wegovy_Price_Guide.pdf
- Novo Nordisk, NovoCare. Savings Offer Program for Wegovy (semaglutide) | NovoCare. Accessed 2026-10-18. https://www.novocare.com/patient/medicines/wegovy/savings-offer.html
- Novo Nordisk, NovoCare. Novo Nordisk Patient Assistance Program (PAP) Available Products (NNIPAP_11_01012026). Accessed 2026-10-18. https://www.novocare.com/content/dam/novonordisk/novocare/forms/PAP_Product_List.pdf
- Centers for Medicare & Medicaid Services, Medicare.gov. Weight loss drugs | Medicare. Accessed 2026-10-18. https://www.medicare.gov/coverage/weight-loss-drugs
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.