GLP-1 Copay Cap Estimator
Gauge what GLP-1 therapy will cost you each month. Enter the list price and your plan's post-deductible coverage to see insurer payment, remaining deductible applied, how much a copay card may knock off, and the cash you owe at the pharmacy counter.
Informational only. Confirm eligibility and actual copay card terms with your insurer and pharmacy.
Examples
- $1,050 list price with 50% coverage, $500 deductible left, and a $500 copay card ⇒ Patient responsibility after coverage: $525.00 USD • Insurer pays: $275.00 USD • Deductible applied this fill: $500.00 USD • Copay card applied: $500.00 USD • Coverage rate after deductible: 50.00%.
- $900 list price with 80% coverage, no deductible remaining, and no card ⇒ Patient responsibility after coverage: $180.00 USD • Insurer pays: $720.00 USD • Deductible applied this fill: $0.00 USD • Copay card applied: $0.00 USD • Coverage rate after deductible: 80.00%.
FAQ
Does this include prior authorization delays?
No. It assumes the medication is approved and priced at the listed amount without additional utilization hurdles.
What if my copay card exceeds my cost?
The calculator caps manufacturer assistance at the patient responsibility to avoid negative balances.
Can I adjust for state copay caps?
Yes. Enter the capped price as the list price and use your plan coverage percentage to see the net pharmacy cost under that cap.
Additional Information
- Result unit: USD for monthly patient responsibility, insurer payment, deductible applied, and copay assistance used.
- Defaults assume $0 deductible remaining and no copay card unless you enter values.
- Applies coverage percentage only after any deductible remaining is accounted for on the fill.