How much does Rybelsus cost?

As a GLP-1 receptor agonist, Rybelsus (semaglutide) is part of a class of drugs that has made headlines for its ability to manage blood sugar and help people lose weight as well as for having steep price tags. And like many other brand-name medications, the price can vary dramatically depending on your insurance, pharmacy, and more. Ahead, experts explain what you can really expect to pay for Rybelsus and how to save.

What factors affect the cost of Rybelsus?

Rybelsus can have wildly different price tags, and one of the biggest factors going into what you’d actually pay is why the medication was prescribed in the first place. “Insurance coverage for Rybelsus is usually limited to its F.D.A. approval, which is for treating type 2 diabetes,” says Dr. Jennifer Brown, M.D., an obesity medicine specialist at Rainelle Medical Center in West Virginia. “If it’s prescribed for off-label uses, like weight loss, it’s generally not covered by insurance plans.”

Here’s a breakdown of some other key factors that may affect how much Rybelsus costs:

• Insurance plan: Whether or not you’re covered — and what kind of plan you have — can drastically impact your monthly cost.
• Dosage: Rybelsus comes in 3 mg, 7 mg, and 14 mg tablets. Depending on your insurance coverage, your copay may increase with higher doses.
• Pharmacy pricing: Prices can vary between retail pharmacies, mail-order services, and online options.
• Manufacturer discounts: Novo Nordisk, the manufacturer of Rybelsus, offers savings programs that can help bring down costs for eligible patients (more on that later).

How much is Rybelsus without insurance?

Without insurance, the out-of-pocket cost for a 30-day supply of Rybelsus is $997.58. This is similar to other GLP-1 weight-loss medications like Ozempic (semaglutide) and Zepbound (tirzepatide), which both cost around $1,000 monthly.

How much is Rybelsus with insurance?

If you have health insurance, the cost of Rybelsus will vary based on your specific plan and whether or not the medication is being prescribed for type 2 diabetes, says Brown. But according to the manufacturer, people with commercial insurance can pay as little as $10 for a one-, two-, or three-month prescription.

Does insurance cover Rybelsus?

Not to sound like a broken record, but: It depends. “Most insurances will cover Rybelsus for the treatment of type 2 diabetes if the patient is deemed an appropriate candidate,” says Dr. Megan Horsham, M.D., an internal medicine doctor in Camp Hill, Pennsylvania. This typically means you’ve been diagnosed with type 2 diabetes and haven’t been able to manage blood sugar through diet and exercise alone. While Rybelsus may be prescribed off-label for weight loss (there are no oral GLP-1s approved for weight loss right now, only injections), many plans won’t cover the medication in that situation and you’ll likely be responsible for the full out-of-pocket cost.

Does Medicaid cover Rybelsus?

Medicaid coverage varies by state, says Horsham, but it does typically cover Rybelsus for type 2 diabetes management. That said, some Medicaid plans may require prior authorization, meaning your doctor must get approval before the Rybelsus prescription is covered. Some may also require what’s known as step therapy, which involves trying lower cost alternatives before moving to a more expensive option like Rybelsus, says Brown. “This can make accessing Rybelsus more challenging for some patients.”

Does Medicare cover Rybelsus?

According to Horsham, most Medicare Part D plans (these have prescription drug coverage and are run by private insurance companies) do cover Rybelsus, but often with conditions attached, like requiring prior authorization. What’s more, “those on Medicare often face a $2,000 annual deductible before any costs for Rybelsus [or any other drugs] are covered” says Brown.

Is there a generic version of Rybelsus?

Currently, there is no generic version of Rybelsus or its active ingredient semaglutide. “This absence of generics contributes to high costs for patients,” Brown says.

How to save on Rybelsus without insurance

Because of how much Rybelsus costs without insurance, it can be tough for some people to afford this medication. Fortunately, if you don’t have insurance or your plan doesn’t cover Rybelsus, you’ve got options. Here are ways to lower out-of-pocket costs:

Telehealth prescription services

Instead of going to a physical doctor’s office, try doing virtual appointments via video, phone, or an app. “Telemedicine has emerged as a valuable tool in addressing the challenges associated with accessing medications like Rybelsus,” says Brown. “With the rise of virtual consultations, patients can discuss their weight management strategies and explore treatment options from the comfort of their homes.” Beyond convenience, telehealth can also lower overall costs — especially if it’s an online clinic like WeightWatchers. Members pay a set monthly fee for access to clinicians who can evaluate your needs and, if appropriate and you medically qualify, prescribe GLP-1 medications like Rybelsus.

Get a 90-day supply

People taking Rybelsus typically start with the lowest 3 mg dose, then increase it based on their health needs and how their body responds. Once you know your long-term maintenance dose, you can save money by getting three months of it at a time, says Horsham. And getting a 90-day prescription through a mail-order pharmacy may also offer additional savings compared to going the traditional brick-and-mortar route.

Rybelsus savings card

Novo Nordisk, which manufactures Rybelsus, offers a savings program that may lower your cost to as little as $10 per month if you qualify. Eligibility requirements include having a valid prescription and being enrolled in a commercial insurance plan, not a federal or state program like Medicare or Medicaid. Talk to your doctor to determine whether you qualify.

The bottom line

Rybelsus’s price can range from $10 to $997.58 per month, depending on your insurance, pharmacy, and what the medication is being prescribed for. While most insurers cover GLP-1s like Rybelsus for type 2 diabetes, it’s generally not covered if prescribed for an off-label use like weight loss. For those paying out of pocket, tools like discount cards, manufacturer savings programs, and telehealth platforms can help reduce costs. If you're considering this medication, talk to your doctor and insurance provider to understand your best options and make an informed decision.