Getting a prescription
Semaglutide reaches patients under two different brand names with two different FDA approvals, and which one a clinic writes for decides almost everything about what you pay. Wegovy is approved for chronic weight management. Ozempic is approved for type 2 diabetes and is prescribed off-label for weight.
That distinction is not academic. It determines whether an insurer will consider the prescription at all, and it is the first thing to establish on a call.
What to know first
The evaluation is the same wherever it happens. What differs is which of the three semaglutide routes a clinic actually uses, and clinics rarely lead with that.
Height, weight, and history, screened against the label's contraindications, which include a personal or family history of medullary thyroid carcinoma or MEN 2. Wegovy's approval is written around BMI thresholds, so eligibility for the approved product is more specific than eligibility for a compounded one.
Ask directly: Wegovy, Ozempic, or compounded semaglutide. Programs advertising a low monthly figure are almost always built on the third, and a program quoting an insurance benefit is almost always describing the first.
Where a plan covers weight care at all, it usually covers the weight-indicated product and refuses the diabetes-indicated one for the same purpose. That check happens before the first prescription, not after.
Semaglutide steps up over several months, with dose changes roughly monthly at the start. How often you are seen during that period, and what each of those visits costs, sets the real annual figure.
The same molecule, three regulatory positions. This is the distinction that decides coverage, price, and what recourse exists if something goes wrong.
Novo Nordisk's semaglutide approved for chronic weight management, and the product a weight-care prescription is normally written for when a brand is used. It also carries a cardiovascular risk-reduction indication that the diabetes product does not.
The same molecule approved for type 2 diabetes, at different dosing. Prescribed off-label for weight very widely. The medicine is not the issue; the approval is, and insurers read it strictly.
Prepared by a compounding pharmacy and not an FDA-approved generic. Substantially cheaper, and not reviewed as a finished product for safety, efficacy, or manufacturing quality. Ask which pharmacy supplies it and whether it is a 503A or 503B facility.
For how it works, its side effects, and how it compares with the alternatives, see the semaglutide medication guide.
If a video visit suits you better than an office, the online programs prescribing it are compared on starting price at online semaglutide providers.
The spread here is wider than for any other GLP-1, because all three routes are in common use. Only 140 of the 428 listings here publish a price, and the number means little until you know which product it refers to.
The single largest factor, and larger for semaglutide than for tirzepatide because compounded semaglutide is so widely offered. A program fee that looks impossible against brand pricing is describing a compounded preparation.
Wegovy and Ozempic are priced and covered differently, and a plan that refuses one may pay for the other depending on the diagnosis on the prescription.
Semaglutide's maintenance dose is several steps above the starting dose, and per-dose pricing rises with it. An introductory figure quoted at the lowest dose does not describe month six.
Ask whether the monthly figure covers medication, visits, or both, and what happens to it if you pause treatment and restart later.
428 clinics we checked prescribe semaglutide, spread across 33 states.
Sources: FDA Wegovy prescribing information · FDA: concerns with unapproved GLP-1 drugs used for weight loss · NIDDK, Prescription Medications to Treat Overweight & Obesity. Eligibility and prescribing decisions belong to a qualified healthcare professional. This page is informational and is not medical advice.
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