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How much is zepbound with savings card?

How much is zepbound with savings card?

Navin Khosla NowPatientGreen tick
Created on 16 Jul 2024
Updated on 16 Jul 2024

If you’re considering taking Zepbound, a medication used to treat a certain medical condition, you may be wondering about the cost. Luckily, there is a Zepbound Savings Card available that can help you save money on your prescriptions. In this article, we will explore the details of the Zepbound Savings Card program and discuss how much you can expect to pay for Zepbound with the card.

What is Zepbound?

Zepbound is a new medication manufactured by Eli Lilly that has gained attention for its potential as a weight loss drug. It is a cutting-edge drug that has shown promising results in body weight reduction in clinical trials. The drug joins a list of six other similar prescription drugs that are FDA-approved (Food and Drug Administration). Like Novo Nordisk’s Ozempic and Wegovy containing the active ingredient semaglutide.

Zepbound targets specific mechanisms in the body to promote weight loss and contains the same active ingredient called tirzepatide. Zepbound activates receptors of hormones secreted from the intestine, such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which reduce appetite and food intake.

Zepbound is indicated for chronic weight management in adult patients with obesity with a BMI (body mass index) of 30+, or who are overweight with a BMI of 27+ with weight-related medical health conditions. Weight-related conditions may include high blood pressure (hypertension), type 2 diabetes, obstructive sleep apnea, cardiovascular disease or high cholesterol. It is typically prescribed in conjunction with a low-calorie diet and increased physical activity to help people lose weight and maintain weight loss. The most common side effects of Zepbound include nausea, diarrhea, vomiting, constipation, stomach (abdominal) pain, indigestion, and injection site reactions.

Understanding the Zepbound Savings Card

The Zepbound Savings Card is a program offered by Lilly, the manufacturer of Zepbound. It is designed to help eligible patients save on the cost of their Zepbound prescriptions. The card offers potential savings for both commercially insured patients with coverage for Zepbound and those without coverage.

Eligibility criteria

To be eligible for the Zepbound Savings Card, you must meet certain criteria. These criteria include:

  • Being prescribed Zepbound consistent with FDA-approved product labeling
  • Being enrolled in a commercial drug insurance plan
  • Not being enrolled in any state, federal, or government-funded healthcare program, such as Medicaid or Medicare
  • Being a resident of the United States or Puerto Rico
  • Being 18 years of age or older
  • Savings for Commercially Insured Patients with Coverage

If you have commercial drug insurance that covers Zepbound, you may be eligible to pay as little as $25 for a 1-month, 2-month, or 3-month prescription fill of Zepbound. The actual amount you pay may depend on the duration of your prescription and the specific terms of your insurance coverage. It’s important to note that the Zepbound Savings Card has a maximum monthly and annual savings limit, which may vary depending on the duration of your prescription.

Savings for Commercially Insured Patients without Coverage

For patients with commercial drug insurance that does not cover Zepbound, the Zepbound Savings Card offers savings of up to $563 off a 1-month prescription fill. The actual amount you pay may vary based on the duration of your prescription and the terms of your insurance coverage. Like commercially insured patients with coverage, commercially insured patients without coverage also have a maximum monthly and annual savings limit.

Additional terms and conditions

It’s essential to review and understand the terms and conditions of the Zepbound Savings Card program. These terms and conditions may include details about card eligibility, card activation, maximum savings limits, and the expiration date of the card. It’s important to note that the Zepbound Savings Card program may be subject to changes or termination by Lilly at any time.

How to access the Zepbound Savings Card

To access the Zepbound Savings Card, eligible patients need to enroll in the program. Enrollment can be done online by visiting the Zepbound Savings Card website. The website will guide you through the enrollment process, where you will be required to provide relevant information to confirm your eligibility. Once enrolled, you can start using the Zepbound Savings Card to save on your Zepbound prescriptions.

Checking your Insurance Coverage

Before starting Zepbound treatment, it’s essential to check your insurance coverage to understand what costs you may be responsible for. You can do this by contacting your insurance company or visiting their website. The back of your insurance card usually provides the contact information for your insurance company.

Key questions to ask your Insurance Company

When contacting your insurance company, there are some key questions you may want to ask to understand your coverage for Zepbound. These questions include:

  • Does my insurance plan cover Zepbound?
  • What is the copay or coinsurance amount for Zepbound?
  • Are there any prior authorization requirements for Zepbound?
  • Are there any limitations on the quantity or duration of Zepbound prescriptions that are covered?
  • Are there any specific pharmacies I need to use to fill my Zepbound prescriptions?

Need for prior authorization

In many cases, insurance plans require prior authorization before approving coverage for Zepbound. Prior authorization is a coverage request that your doctor submits on your behalf, providing the necessary information required by your insurer. It’s important to understand the information your doctor may need for the prior authorization form and any questions you may want to ask about Zepbound during the process. A doctor discussion guide can be useful in preparing for your conversation with your doctor.

Coverage for different insurance types

The coverage for Zepbound may vary depending on the type of insurance plan you have. Let’s explore how Zepbound coverage may apply to different insurance types:

Commercial insurance

For individuals with commercial insurance through an employer or other private plan, coverage for Zepbound may vary. If your commercial insurance plan covers Zepbound, you may be eligible for savings through the Zepbound Savings Card program. The amount you pay will depend on the terms of your insurance coverage and the Zepbound Savings Card program.

If your commercial insurance plan does not cover Zepbound, you may still be eligible for savings through the Zepbound Savings Card program. The program offers savings for commercially insured patients without coverage, helping to reduce the out-of-pocket cost of Zepbound.

Medicaid insurance

Coverage for Zepbound under Medicaid insurance plans depends on the specific state you reside in. Each state has its own Medicaid Preferred Drug List (PDL), which provides information on the coverage of medications, including Zepbound. If your state’s Medicaid insurance plan does not cover Zepbound, your doctor may be able to submit an appeal on your behalf. It’s important to consult with your doctor and explore all available options if you believe Zepbound is the right medication for you.

Medicare insurance

Most Medicare insurance plans do not cover anti-obesity medications like Zepbound. However, some Medigap and Medicare Advantage insurance plans may offer coverage for these types of medications. If you have one of these insurance plans, it’s recommended to contact the Medicare customer assistance number to inquire about Zepbound coverage.

Veterans Affairs Insurance

Coverage for Zepbound under Veterans Affairs (VA) insurance may be available. It’s advisable to discuss your coverage and options with your local VA provider. They can provide more information on how Zepbound is covered and guide you through the process.

TRICARE® Insurance

TRICARE® insurance plans, which provide healthcare coverage for military personnel and their families, may cover Zepbound. Your TRICARE network provider or Military Treatment Facility can provide information on your coverage and options for Zepbound.

Government employee benefits

If you’re a government employee, your insurance coverage may vary depending on your employer. It’s recommended to contact your insurance company to inquire about your coverage options for Zepbound and other anti-obesity medications.

Conclusion

The Zepbound Savings Card program offers eligible patients the opportunity to save on the cost of Zepbound prescriptions. Whether you have commercial insurance with or without coverage for Zepbound, the savings card can help reduce your out-of-pocket expenses. It’s crucial to review the eligibility criteria, terms, and conditions of the program to ensure you meet the requirements and understand how to maximize your savings. Additionally, checking your insurance coverage and understanding the details of your plan can help you navigate the cost of Zepbound treatment effectively. Remember to consult with your healthcare provider for personalized medical advice and recommendations regarding your medical problems and treatment options.

Sources

Medical Disclaimer

NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information on this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.

The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.

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