Understanding Tirzepatide Cost, Insurance, and Savings
Cost is one of the biggest concerns for patients considering Tirzepatide. Understanding the pricing landscape, insurance coverage options, and available savings programs can help you make an informed decision about affording your treatment.
Retail Pricing
Tirzepatide is available under two brand names, each with different approved indications:
Mounjaro
Approved for type 2 diabetes. List price is approximately $1,000–$1,100 per month without insurance, though actual prices vary by pharmacy and dose.
Zepbound
Approved for chronic weight management. Similar pricing range. Eli Lilly has introduced lower-cost vial options for certain doses.
Prices are approximate and subject to change. Always verify current pricing with your pharmacy.
Insurance Coverage
Insurance coverage for Tirzepatide varies widely depending on your plan, the approved indication, and your state's regulations.
Many commercial plans cover Mounjaro for type 2 diabetes, though coverage for Zepbound (weight management) is less common. Prior authorization is typically required. Check your plan's formulary or call the number on your insurance card.
Traditional Medicare generally does not cover anti-obesity medications. However, Mounjaro may be covered under Part D for type 2 diabetes. The Treat and Reduce Obesity Act, if passed, could change Medicare coverage for weight loss medications.
Coverage varies by state. Some state Medicaid programs cover GLP-1 medications for diabetes, while coverage for obesity treatment is more limited. Contact your state's Medicaid office for details.
Some employers are adding weight management medications to their benefit packages. Check with your HR department or benefits administrator about your specific coverage.
Savings Programs and Discounts
Several options exist to reduce your out-of-pocket costs:
Eli Lilly offers a savings card program for eligible commercially insured patients, which can significantly reduce copay costs. Eligibility requirements and savings amounts change periodically — check the manufacturer's website for current offers.
Lilly Cares is the manufacturer's patient assistance program for uninsured or underinsured patients who meet income requirements. Eligible patients may receive their medication at no cost.
Services like GoodRx, RxSaver, and SingleCare offer discount coupons that can lower the retail price. While the discount may not bring costs to insured levels, savings of 10–30% are common.
During periods of FDA-recognized shortage, compounding pharmacies may offer Tirzepatide at lower prices. Quality and regulation vary, so discuss this option carefully with your healthcare provider.
Steps to Take
- Check your insurance formulary — Call the number on your insurance card or log into your plan's website to check coverage for Mounjaro or Zepbound.
- Ask about prior authorization — Your provider's office may need to submit documentation showing medical necessity. Be prepared with your BMI, relevant diagnoses, and any previous weight management attempts.
- Explore manufacturer programs — Visit the manufacturer's website to check eligibility for savings cards or patient assistance programs.
- Compare pharmacy prices — Prices can vary significantly between pharmacies. Check both retail and specialty pharmacies, including mail-order options.
- Talk to your provider — Your healthcare team may have experience navigating insurance requirements and can help with appeals if coverage is initially denied.
Disclaimer: Pricing and coverage information in this article is for general guidance only and may not reflect current rates. Insurance coverage, manufacturer programs, and pharmacy prices change frequently. Verify all details with your insurer and pharmacy.
Need Help Navigating Costs?
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