Would you actually save money switching from insurance to cash-pay?
Enter the copay on your current pharmacy receipt and pick a program. We project your monthly and annual delta against the program's maintenance-dose price. The math is honest. If insurance is still cheaper, the calculator says so.
How this calculator works
The savings calculator does one piece of arithmetic.
- Your monthly copay. The dollar amount on your pharmacy receipt. If you fill 90 days at a time, divide by three.
- The program's monthly maintenance-dose price. Pulled from our weekly verification pass against the program you picked. The price includes the membership fee, the medication, any required monthly lab work, and shipping where bundled.
- Delta. Your copay minus the program price, displayed as a range because most programs quote a low-dose and high-dose number. We multiply by 12 for the annual projection.
If your copay is higher than the program's low end, the calculator says you would save money. If your copay is lower than the program's low end, the calculator says insurance is still cheaper and explains by how much. No fudging the comparison.
When cash-pay actually wins
Three buyer scenarios where the math typically favors cash-pay over insurance.
- High-deductible plan, not yet met. Your insurance is theoretical until you hit the deductible. A $1,200 monthly retail price reads as $1,200 out of pocket until you cross the threshold. Most compounded programs are under $200 a month, which is cheaper than the deductible run-up for someone on a single dose per month.
- Employer plan that excludes weight-loss indication.About a third of US large employers carve out GLP-1 weight-loss coverage even when they cover GLP-1 for type 2 diabetes. If your plan denies the PA for weight loss, your “insurance” price is the retail cash price. Switching to a cash-pay program is almost always a 60-80% saving.
- Marketplace plan with $400+ tier-3 copay. ACA marketplace formularies tend to put branded GLP-1 on the highest copay tier. If your monthly tier-3 copay is over $400, almost every compounded cash-pay program in the chart is cheaper.
When insurance still wins
Two scenarios where the math favors staying on insurance.
- Employer plan with the PA approved and a copay under $80. If your plan covers branded Wegovy or Zepbound on tier 1 or 2 with a copay below the cheapest cash-pay program in the chart, insurance wins. The calculator will display that result honestly.
- Medicaid or Medicare with cardiovascular indication. When Medicare covers Wegovy for established cardiovascular disease, the Part D copay is almost always lower than the cheapest telehealth program. Same logic for Medicaid coverage of type 2 diabetes GLP-1 in states with low or no copay.
Frequently asked questions
Why would I switch from insurance to cash-pay?
Two reasons in our reader feedback. First, insurance access is unstable. Plans drop GLP-1 from formularies year to year, employers carve out weight-loss coverage at renewal, and prior-authorization gets denied. Cash-pay is steady. Second, some cash-pay programs are now cheaper than the copay on a high-deductible plan. The calculator tells you whether that is true in your case.
What does maintenance dose mean?
GLP-1 dosing escalates over the first 4 to 6 months. You start on 0.25mg semaglutide or 2.5mg tirzepatide and titrate up to a clinical-target maintenance dose (1.7-2.4mg semaglutide, 10-15mg tirzepatide). Most programs price the starter dose lower than the maintenance dose. The calculator uses the maintenance number because it reflects what you actually pay long-term.
What if my copay is $0?
Then insurance is the cheapest option, full stop. The calculator will tell you so. The reason to still read the program-comparison data is that insurance coverage is not guaranteed to last. Knowing the cash-pay fallback before you need it (formulary change, plan loss, PA denial) is worth doing now.
How is the program price verified?
Every quarter we run an anonymous purchase-flow walkthrough on every program in the chart. We sign up, complete the intake, and observe what appears on the receipt. The maintenance-dose price comes from that walkthrough, not the program's homepage. The week of our most recent update is shown in the freshness stamp above.
What about compounded versus branded?
Compounded semaglutide and tirzepatide are mixed by 503A pharmacies and run a third to a quarter the price of branded Wegovy or Zepbound. The molecule is identical. The manufacturing pathway and regulatory exposure are not. If you switch from a branded prescription on insurance to compounded cash-pay, you save the most money but take on supply-chain risk (the active Lilly litigation against compounded tirzepatide pharmacies could force a halt).
Does the calculator account for shipping or labs?
Yes. Where a program bills labs monthly, the maintenance number includes the lab fee. Where a program folds shipping into the medication price (almost always the case), it is included. One-time onboarding fees are excluded because they amortize to a rounding error over a year.
Other calculators
- Cost comparison across all programs: every program ranked cheapest first for a given drug, insurance, and state.
- BMI and program qualifier: enter your height and weight, see which programs you qualify for.
- The full GLP-1 cost pillar page: how pricing works across the category, year-one vs ongoing math, hidden fees.
