How to pay $25 using the Zepbound Savings Card: The Ultimate Guide

Zepbound (tirzepatide) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) for chronic weight management along with diet and exercise in adults with obesity or overweight with at least one other weight-related medical condition and obstructive sleep apnea (OSA) for adults with obesity.

Obesity and overweight are serious medical conditions that affect millions of Americans and can be associated with some of the common causes of death such as diabetes, stroke, and heart disease.

The average retail list price for this medication is $1,050 per month without insurance coverage. With the Zepbound Savings Card program, eligible patients can pay as little as $25 for their prescription. Understanding the eligibility criteria and the application process is essential for taking advantage of these potential savings. However, not all patients, including those with government insurance, qualify for the savings card and there are other ways for you to save on Zepbound which we have explained in this article.

Who is eligible to get Zepbound for $25?

The Eli Lilly Zepbound Savings Card program is intended to significantly reduce the out-of-pocket costs for eligible patients with commercial drug insurance coverage.

Call your insurance company (the phone number on the back of your insurance card) or visit their website to find out if your commercial insurance plan covers Zepbound and ask them the following questions:

• Does my insurance plan cover Zepbound?
• If Zepbound is covered, how much will I pay? This will depend on your drug plan’s copay.
• Does my doctor need to submit a prior authorization (PA) form?
• What is my deductible (the out-of-pocket cost I need to pay before my insurance starts paying)?
• Which pharmacies can I obtain the medication from?

Should your insurance provider deny coverage for this medication, appeal procedures are often available. Ask your insurance company about the appeal process. It may involve submitting additional documentation such as a letter of medical necessity for using Zepbound.

Commercial insurance with insurance coverage for Zepbound

Commercially insured patients with insurance coverage for Zepbound may pay as low as $25 for a 1-month or 3-month supply of Zepbound with the following limitations:

• Maximum monthly savings of up to $150 for a 1-month prescription
• Maximum monthly savings of up to $300 for a 2-month prescription
• Maximum monthly savings of up to $450 for a 3-month prescription
• Maximum annual savings of up to $1,950 per calendar year
• Prescriptions can be filled up to 13 times per calendar year

Commercial insurance without insurance coverage for Zepbound

Commercially insured patients without insurance coverage for Zepbound may pay as low as $650 for a 1-month supply of Zepbound with the following limitations.

• Maximum monthly savings of up to $469 for a 1-month prescription
• Maximum annual savings of up to $3,283 per calendar year
• Prescriptions can be filled up to 7 times per calendar year

Terms and conditions

1. You have a prescription from a licensed U.S. prescriber according to the FDA-approved product labeling
2. You are enrolled in a commercial drug insurance plan without coverage for Zepbound
3. You are not enrolled in government insurance plans such as Medicare, Medicaid, Medicare Part D, Medicare Advantage, Medigap, VA, DoD, TRICARE/CHAMPUS, or any state drug assistance program
4. You are a legal resident of the United States or Puerto Rico
5. You are at least 18 years of age.

Once approved for the savings card, inform the pharmacist of your Savings Card when purchasing the medication. If eligible, the card’s benefits should be applied immediately, providing you with instant savings on the medication.

For those ineligible, exploring other financial assistance programs, alternative medications, or generic options, can potentially help you save money.

Who is not eligible for the Zepbound Savings Card

The Zepbound Savings Card is not available to:

1. Individuals with government insurance: including Medicare, Medicaid, Medicare Part D, Medicare Advantage, Medigap, VA, DoD, TRICARE/CHAMPUS, or any state drug assistance program.
2. Individuals without commercial drug insurance coverage
3. Individuals residing in California or Massachusetts: due to state restrictions, this medication is not available to residents of California and Massachusetts.
4. Individuals who are not residents of the United States or Puerto Rico
5. Individuals without a valid prescription for an FDA-approved product labeling of Zepbound
6. Individuals with an insurance plan that participates in an alternate funding program (“AFP”), for example, ImpaxRx, SHARx, Script Sourcing, etc. Eli Lilly may change the eligibility requirements and terms and conditions at any time, so it is advisable to check their website for the latest information.

Steps to access the Zepbound Savings Card

If you believe that you are eligible for the savings card, you can follow these steps:

1. Go to the Zepbound Savings Card website
2. Choose the type of health insurance plan you have
3. Verify that you are eligible
4. Download your savings card
5. Go to a participating pharmacy with the Savings Card. Generally, Eli Lilly medicines are available from neighborhood pharmacies such as CVS, Walgreens, and specialty pharmacies.

If you encounter any issues or have questions during the application process, customer service representatives can assist and provide further guidance.

Alternative savings options

Even without the Zepbound Savings Card, there are other options to explore that can help reduce the cost of Zepbound.

Zepbound single-dose vials

Eli Lilly and Company are offering Zepbound 2.5 mg, 5 mg, 7.5 mg and 10 mg single-dose vials with home delivery options directly through LillyDirect, including to people with or without insurance who are ineligible for the savings card.  A 4-week supply of the Zepbound 2.5 mg single-dose vial is $399 and the Zepbound 5 mg, 7.5 mg and 10 mg single-dose vial is $549.

Compounded tirzepatide for weight loss

Compounded tirzepatide has the same active ingredient as the brand-name prescription drug, Zepbound. Buy compounded tirzepatide by signing up for a NiceRx Weight Loss Program membership. A licensed provider will determine if this prescription drug is appropriate for you.

Alternative medications for weight loss

There are several alternative GLP-1 medications to consider. Speak with your healthcare professional to determine if any of these alternative options are appropriate for you:

• Saxenda (liraglutide)
• Wegovy (semaglutide) – same active ingredient as Ozempic
• Mounjaro (tirzepatide)

RELATED: Zepbound vs. Wegovy

Explore coverage for other insurance types

If you have government insurance that makes you ineligible for the Zepbound Savings Card, there may be other options for you to consider, depending on your insurance type.

I am enrolled in Medicaid

Coverage through Medicaid depends on the state you live in. Check your state’s Medicaid Preferred Drug List (PDL) to find out if Zepbound is covered.

I am enrolled in Medicare

Most Medicare plans do not cover anti-obesity medications such as Zepbound, except for some Medigap and Medicare Advantage plans. Contact your Medicare insurance provider’s customer service to check if Zepbound is covered.

I am enrolled in Veterans Affairs

Veterans Affairs may cover anti-obesity medications including Zepbound. Speak with your local Veterans Affairs provider to verify your coverage and options.

I am enrolled in government employee benefits

Speak with your insurance company if you are a city, state, federal municipality, or federal department government employee to determine your coverage options.

I am enrolled in TRICARE®

TRICARE® insurance may cover Zepbound and your healthcare provider can request a coverage review, which is the process that TRICARE® uses to determine if it will approve coverage. Speak with your TRICARE® provider or Military Treatment Facility regarding your options and coverage.

Prescription discount cards

Medication prices vary by pharmacy and you may find additional savings by using pharmacy comparison tools such as GoodRx or SingleCare which offer additional savings with prescription discount cards.

Advocacy & support organizations

If all of the above options fail and you need additional support, you can try reaching out to the leading obesity care and advocacy organizations:

• Obesity Action Coalition (OAC)
• American Diabetes Association
• Obesity Medicine Association (OMA)

Common questions about Zepbound

Here are answers to some of the most common questions about Zepbound.

What is Zepbound?

Zepbound contains the active ingredient tirzepatide. It is an injectable prescription anti-obesity medication that is used for weight loss and should be used with a low-calorie diet and increased physical activity.

According to the manufacturer’s website, people taking Zepbound lost up to 48 lbs as evidenced in a 17-month clinical trial, with people who dieted, exercised and took the medication.

The FDA had approved Zepbound along with diet and exercise for weight loss and weight management in adults with:

• a BMI (body mass index) of 30 or more, or;
• a BMI of 27 or more in addition to at least one weight-related health condition, such as high blood pressure, high cholesterol,  or type 2 diabetes

Who should not take Zepbound?

The manufacturer warns that Zepbound can cause tumors in the thyroid which includes thyroid cancer.

It is important to monitor possible symptoms while taking the medication. For example, shortness of breath, a swelling or lump in the neck, trouble swallowing, or hoarseness.

If you experience any of these symptoms while taking the medication, speak to your healthcare professional immediately.

• Do not use this medication if you or any of your family have a history of thyroid cancer which is called medullary thyroid carcinoma (MTC).
• Do not use this medication if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Do not use this medication if you have had a serious allergic reaction to this medication or any of the ingredients in this medication

What are Zepbound side effects?

Zepbound may cause serious side effects such as:

• kidney problems (kidney failure)
• severe stomach problems
• inflammation of the pancreas (pancreatitis)
• gallbladder problems
• changes in vision in people with diabetes type 2
• low blood sugar (hypoglycemia)
• depression
• thoughts of suicide

Common side effects of this medication may include:

• nausea
• diarrhea
• vomiting
• stomach (abdominal) pain
• constipation
• indigestion
• feeling tired
• injection site reactions
• belching
• allergic reactions
• heartburn
• hair loss

If you experience any side effects or adverse reactions while using this medication, you should immediately consult with your healthcare provider for immediate medical advice.

What can I do if the Zepbound Savings Card is not working?

If your Zepbound Savings Card is not working:

• look for instructions on the card or the paperwork that came with it
• if online activation is available, visit the card activation website
• follow the prompts

Alternatively, you can call the phone number on the card or the accompanying materials you received with the savings card.

How much is Zepbound with the savings card?

The cost of Zepbound varies depending on your commercial insurance coverage and whether it covers Zepbound. If your commercial insurance covers Zepbound, you can pay as little as $25 per month. If your commercial insurance does not cover Zepbound, you can pay as little as $650 for a 1-month supply. Find out from your commercial insurance company if they cover this medication.

Is Zepbound covered by Medicare?

Most Medicare plans do not cover anti-obesity medications. However, some Medigap and Medicare Advantage plans cover anti-obesity medications such as Zepbound. Contact your Medicare insurance provider’s customer service to determine if Zepbound is covered.

The bottom line

Zepbound (tirzepatide) is an expensive drug without adequate insurance coverage. Fortunately, Eli Lilly offers eligible commercially insured patients effective options to reduce out-of-pocket expenses when using the Zepbound Savings Card. Savings cards and discount cards are effective ways to save money on expensive medications.

Even if you are ineligible for the Zepbound Savings Card, there are several other options to save money on your weight loss medication, including the compounded version of Zepbound available through the NiceRx Weight Loss Program.

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U.S. Food and Drug Administration

• Federal regulatory agency for food and health-related products

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KFF (Kaiser Family Foundation)

• Nonprofit organization focusing on national health issues

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American Diabetes Association

• Nonprofit membership association that promotes efforts to prevent and cure diabetes and improve the well-being of diabetics

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