GLP-1 Annual Out-of-Pocket Cost Calculator

INTWISDEX decision tools

GLP-1 Annual Out-of-Pocket Cost Calculator

Build a one-year cash budget from your verified medication quote, full refill payments, consultations, lab tests, membership, shipping and supplies. No drug prices or coverage decisions are assumed.

Use amounts you actually expect to pay. If your pharmacy quote already includes a copay, deductible payment or savings-card benefit, do not add it again. This tool does not simulate claims, benefit approval, deductible resets or plan spending caps.

CurrencyUS dollarsBritish poundsNo currency conversion.

Quote contextSelf-pay / no coverageInsured out-of-pocket quoteMedicare / public-program quoteUK private / other quoteContext only; it does not change the calculation or establish program eligibility.

Medication billing basisFull refill payments by days supplied12 calendar-month medication payments

Budget period365 days364 days / 52 weeks366 days / leap-year comparison

Days supplied per medication fillUse the pharmacy label or written quote. This is not a dosing interval.

Already-paid medication supply at the start (days)Its purchase price is outside this future cash budget. Applies only to days-supply billing.

Regular out-of-pocket medication amount per fill/paymentEnter a verified quote, after applicable benefits. No default price.

Number of initial payments at a different priceUse for verified introductory pricing or known early higher payments.

Amount for each of those initial paymentsRequired when the initial-payment count is above zero. Zero is a valid amount.

Other out-of-pocket costs

Blank cost fields mean zero. Leave included services at zero to avoid counting them twice.

Membership fee per billed month

Membership months billed

Cost per consultation / follow-up

Number of separately billed visits

Cost per separately billed lab panel

Number of separately billed lab panels

One-time onboarding fee

Additional supplies cost per medication payment

Shipping cost per medication payment

Other yearly out-of-pocket costs

Optional insurance premium per calendar monthShown separately; this is generally not solely attributable to GLP-1 care. Enter zero to exclude it.

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Method, assumptions and limits

Full-payment method: fills = round up [(budget days − already-paid supply days) / days supplied]. Payments occur on day 1 plus the prepaid supply and each fill interval. All fills are paid in full; unused supply carries past the budget period. No fractional refill is charged.

Why the distinction matters: with no starting supply, 28-day fills require 13 payments for 364 days, but a 365-day window includes a 14th payment on day 365. That last fill leaves 27 days of supply after the window. Calendar-month billing always uses 12 payments. The assumptions describe a budget, not instructions to refill early, change dosing or bypass pharmacy rules.

Medication totals use the initial quote for the entered number of payments and the regular quote thereafter. Membership, visit and lab counts are entered separately. Optional premiums are reported separately and added only to the including-premium total. No manufacturer maximum, insurer cap, deductible or reimbursement is automatically applied.

For covered services, out-of-pocket costs can include deductibles, copays and coinsurance; non-covered costs may also be paid directly. Confirm your own terms. Sources: HealthCare.gov out-of-pocket costs, CMS coverage glossary. Source review: October 19, 2026. Prices remain your inputs.

Before you pay

• Get the exact formulation, days supplied, quote date and price conditions in writing.
• Check maintenance pricing after any introduction, saving limit or enrollment deadline.
• Ask whether medication, visits, labs, shipping and supplies are included in the membership.
• Confirm coverage and cash-payment treatment with your own plan; do not assume an uncovered payment counts toward a deductible or cap.

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The calculator code does not submit or save your inputs. Advertising and analytics elsewhere on the site follow our privacy policy.

Method and interface checked October 19, 2026. Next scheduled review: January 19, 2027. Written and maintained by The Health Architect, a non-clinician researcher. Research and correction standards.

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