If your plan stops covering Zepbound or Wegovy for weight loss on January 1, you don't have to stop treatment. Both makers sell the same FDA-approved medication straight to self-pay patients: Zepbound for $299 to $449 a month by dose through LillyDirect, and Wegovy for $199 a month for new patients' first two months, then $349, through NovoCare. You'll need a prescription for either, and that's what Forva does: a licensed provider reviews your intake and, if it's appropriate, sends your prescription straight to LillyDirect or NovoCare. Before you switch, ask your plan whether a related condition still qualifies you for coverage.
Prefer one monthly price with the medication included? Forva also offers compounded semaglutide and tirzepatide when a provider decides they're appropriate. They aren't FDA-approved and aren't the same as Wegovy or Zepbound; more below.
Why are employers dropping GLP-1 coverage for 2027?
Cost. In a Business Group on Health survey reported by Reuters in June 2026, about 1 in 10 employers that cover GLP-1s for weight loss said they plan to drop them in 2027. Mercer found 5% of employers with more than 500 workers plan to do the same, and Cigna stopped covering them for its own employees in July 2026. Most people find out during open enrollment, so check your plan's 2027 drug list now.
What are your options when coverage ends?
| Option | What it costs | Good to know |
|---|---|---|
| Ask your plan about a covered condition | Your plan's usual copay | Wegovy is also approved to lower the risk of heart attack and stroke in adults with heart disease, and Zepbound to treat moderate to severe obstructive sleep apnea in adults with obesity. Some plans that drop weight-loss coverage still cover these uses with prior authorization |
| Zepbound through LillyDirect | $299 a month at 2.5 mg, $399 at 5 mg, $449 at 7.5 mg to 15 mg | The $449 price needs each refill within 45 days. Outside that, Lilly charges $499 at 7.5 mg and $699 at 10 mg and above |
| Wegovy through NovoCare Pharmacy | $199 a month for eligible new patients' first two months, then $349 | The Wegovy pill is $149 to $299 a month by dose |
| Foundayo, Lilly's GLP-1 pill | From $149 a month | Lilly's introductory prices on the lower doses run through December 31, 2026 |
| Medicare GLP-1 Bridge | $50 copay | Only for eligible Medicare Part D members, from July 2026 through December 2027 |
These are the manufacturers' prices as of October 2026, and they change. Check LillyDirect or NovoCare for the current price before you fill.
How does self-pay work through Forva?
Forva handles the prescription side for you. A licensed provider in your state reviews your intake and, if Zepbound, Wegovy or Foundayo is appropriate, writes your prescription and sends it straight to the manufacturer's self-pay pharmacy. From there:
- You pay the pharmacy directly for the medication, at the manufacturer's price with no markup from us. Its payment request usually arrives within about 72 hours of approval.
- Your care team stays with you. Message them in your patient portal with any question, and they'll connect you with your provider when you need to.
- Refills are coordinated for you, so your treatment stays on schedule.
All of that comes with the $99 monthly membership. Forva doesn't take insurance, so the membership works the same whatever your plan does.
Details are on the Zepbound page.
Can you keep your current dose?
Usually, yes. When you switch, a provider can typically continue your current dose if you share your pharmacy label and the date of your last dose, rather than restarting you at the lowest one. Plan the timing so you don't run out: with Zepbound, a gap of more than 45 days between refills moves the higher doses to Lilly's regular price. Switching GLP-1 providers covers it in detail.
Is compounded semaglutide or tirzepatide an option?
For some people, yes. Compounded semaglutide and tirzepatide are prepared by state-licensed 503A pharmacies for an individual patient when a provider decides they're appropriate. They are not FDA-approved, and they aren't the same as Wegovy or Zepbound. Here's how Forva's compounded plans work:
- One price, medication included. Provider care, the medication and shipping are in one plan price, with no separate membership.
- The same price at every dose. Your price doesn't go up as your dose does.
- Lower prices on prepaid plans. Compounded semaglutide is $199 every 4 weeks month to month and as low as $139 on a 48-week plan. Compounded tirzepatide is $299 month to month and as low as $239 on a 48-week plan.
The cost guides for compounded semaglutide and compounded tirzepatide have every plan, and which pharmacy fills your prescription covers where it's made.
What should you do before January 1?
- Read your plan's 2027 drug list or benefits letter. Open enrollment is when most changes show up.
- Ask about a covered condition. If you have heart disease, sleep apnea or another condition your medication is approved for, ask what prior authorization needs.
- Keep your last pharmacy label and note the date of your last dose.
- Set up self-pay before your last covered fill runs out, so there's no gap.
- Ask whether your HSA or FSA can pay for it. Using an HSA or FSA for GLP-1 treatment explains how.
What else should you know?
GLP-1 medications can cause side effects, most commonly nausea, vomiting, diarrhea and constipation, and carry serious risks. Labeling for FDA-approved semaglutide and tirzepatide products includes a boxed warning about thyroid C-cell tumors. Your provider reviews these risks before prescribing.
Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed.
Wegovy is a registered trademark of Novo Nordisk A/S. Zepbound is a registered trademark and Foundayo a trademark of Eli Lilly and Company. Forva Health is not affiliated with or endorsed by Novo Nordisk or Eli Lilly.
This article is for general information and is not medical advice. Eligibility and treatment decisions are made by a licensed provider.