in 25 days Kaiser Permanente — Kaiser Northwest's Zepbound criteria move to the rev 9/10/2026 document — cite that version in an appeal from this date. No criterion changes: the two-oral step, the 6-month semaglutide trial, the BMI thresholds and the 12-month approval all carry over, so nothing you have to do to qualify is different See the changelog
WalletNoise

Ozempic® tablets (oral semaglutide) — 9 mg

Your cheapest verified route right now

verified price

$299 /month

NovoCare Pharmacy self-pay

Verified Oct 5, 2026 · novocare.com

Per year at 12 fills
$3,588
Medicaid coverage of GLP-1s for obesity is state-by-state (13 states as of Jan 2026). See the Medicaid policy page for the current picture and your appeal rights.
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Ozempic® tablets (oral semaglutide) has no manufacturer titration schedule in the corpus, so there is nothing here to price a climb against. WalletNoise will not assume one — a projection built on a guessed schedule is worse than no projection.

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    NovoCare Pharmacy self-pay

    $299/mo
    • Novo's direct channel. Free home delivery. Intro offers for new patients are time-limited.

    Verified Oct 5, 2026 · novocare.com

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Not your situation?

The same dose, priced the other ways it can be paid for. Most people arrive unsure which of these they are in — and it changes the answer more than anything else on this page.

Paying cash — uninsured, or not using insuranceCommercial plan that covers itCommercial plan — denied or excludedMedicare

Fighting a denial instead?

Coverage criteria and appeal routes, from the payers' own documents:

Aetna (CVS Health)Blue Cross Blue Shield Federal Employee Program (FEP)CVS CaremarkElevance Health / Anthem (CarelonRx)Express Scripts (Evernorth / Cigna)HumanaKaiser PermanenteMedicaid (state-by-state)Medicare (Part D + GLP-1 Bridge)Optum Rx (UnitedHealthcare)