What is Zepbound and other common questions about the new GLP-1.

Zepbound is a medication approved for the management of weight loss. You can get Zepbound in person or online, but you must have a prescription from a licensed healthcare professional.

Key takeaways

What is Zepbound?

Zepbound is a new medication from Eli Lilly approved by the FDA in 2023 for weight loss. It uses the as active ingredient, tirzepatide, as Eli Lilly’s type 2 diabetes medication Mounjaro. Tirzepatide works by targeting both the GLP-1 and GIP hormones. This dual action is believed to contribute to weight loss.

How does it work?

  1. GLP-1 Receptor Agonism:
    Zepbound acts as an agonist at the GLP-1 (glucagon-like peptide-1) receptor. GLP-1 is a hormone that is released in response to food intake and stimulates insulin secretion from the pancreas. By activating GLP-1 receptors, Zepbound enhances the release of insulin when blood sugar levels are high, which helps to lower blood sugar levels.
  2. GIP Receptor Agonism:
    Besides GLP-1, tirzepatide also activates GIP (glucose-dependent insulinotropic polypeptide) receptors. GIP is another incretin hormone that plays a role in managing blood glucose levels. It also promotes insulin release but has additional effects on energy metabolism and fat cells.
  3. Appetite Suppression:
    GLP-1 receptor agonists like Zepbound can delay gastric emptying, which means food stays in the stomach longer, potentially leading to a feeling of fullness. This can help reduce appetite and caloric intake, contributing to weight loss.
  4. Weight Loss:
    Through these mechanisms, Zepbound not only aids in controlling blood sugar levels but also supports weight loss. It is prescribed alongside a reduced-calorie diet and increased physical activity to achieve the best results for weight management.
  5. Chronic Treatment:
    It's important to note that Zepbound is intended for chronic use. Weight management and control of blood glucose levels are long-term health goals, and medications like Zepbound are designed to be part of an ongoing treatment plan.

Zepbound dosage

The recommended starting dosage is 2.5 mg injected once weekly. Your doctor will slowly increase your starting dose up to the recommended dose. To view a more detailed dosing guide refer to the prescribing information.

Is Zepbound effective for weight loss? How much can I lose?

Yes, Zepbound has been shown to be effective for weight loss. In a 72-week study of adults without diabetes, average weight loss was 15.0% (34 lbs) for 5 mg, 19.5% (44 lbs) for 10 mg, and 20.9% (48 lbs) for 15 mg. In a 72-week study of adults with diabetes, average weight loss was 12.8% (28 lbs) for 10 mg and 14.7% (33 lbs) for 15 mg.

How do you get Zepbound?

If you're eligible you could ask your doctor if Zepbound is right for you and if your insurance will cover it. See our complete guide on how to get Zepbound covered by insurance.

Who is eligible for Zepbound for weight loss?

Zepbound is FDA indicated for weight loss treatment, eligibility for weight loss treatment typically includes adults with:

  1. Obesity:
    Defined as a body mass index (BMI) of 30 kg/m² or greater.
  2. Overweight with Weight-Related Conditions:
    A BMI of 27 kg/m² or greater, in the presence of at least one weight-related condition such as: Asthma, Coronary artery disease, Dyslipidemia, GERD, High cholesterol, Hypertension, Metabolic syndrome, Non-alcoholic fatty liver disease, Obstructive sleep apnea, Osteoarthritis, Pre-diabetes, PCOS.
  3. Clinical Assessment:
    A healthcare provider's assessment that the benefits of the medication outweigh the potential risks for the individual patient.
  4. Lifestyle Intervention:
    Patients are generally required to have attempted weight loss through diet and exercise prior to starting medication.
  5. Commitment to Ongoing Management:
    Eligibility often includes a willingness to adhere to a continued lifestyle intervention program including diet and exercise while on the medication.
  6. Exclusion Criteria:
    There may be certain health conditions or situations where use of GLP-1 receptor agonists is not recommended or needs to be closely monitored, such as a history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia syndrome type 2, or in patients who are pregnant.

How much does Zepbound cost?

Lilly will sell Zepbound at a list price of $1,059.87 per month, about the same price as Mounjaro. Learn how to save on Zepbound with copay, coupons and more.

Are there coupons available for Zepbound?

Zapbound has announced a Savings Card which could reduce your costs.

  • Commercial insurance with coverage for Zepbound:
    If you have commercial insurance with coverage for Zepbound, you may be eligible to pay as little as $25 for a 1-month or 3-month prescription with the Zepbound Savings Card.
  • Commercial insurance without coverage for Zepbound:
    If you have a commercial insurance plan but Zepbound is not covered, you could save up to $563 for a 1-month prescription of Zepbound.

Learn how to save on Zepbound with copay, coupons and more.

Does insurance cover Zepbound?

Coverage may vary, and their website suggests that there is a savings card program for those with commercial insurance. See our complete guide on how to get Zepbound covered by insurance.

What are common side effects of Zepbound?

Examples of most common side effects include:

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

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Wegovy unless your doctor recommends it.

Wegovy may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

What are serious side effects of Zepbound?

Zepbound may cause serious side effects, but these are more rare.

Serious side effects that have been reported with this drug include:

Severe stomach problems

Kidney problems (kidney failure)

Gallbladder problems

  • pain in your upper stomach (abdomen)
  • yellowing of skin or eyes (jaundice)
  • fever
  • clay-colored stools

Inflammation of your pancreas (pancreatitis)

Serious allergic reactions

  • swelling of your face, lips, tongue or throat
  • fainting or feeling dizzy
  • problems breathing or swallowing
  • very rapid heartbeat
  • severe rash or itching

Low blood sugar (hypoglycemia). Symptoms can include:

  • shaking
  • sweating
  • feeling hungry
  • dizziness
  • increased heart rate

Changes in vision in patients with type 2 diabetes

Depression or thoughts of suicide

See "Serious Side effects explained" for more details.

Is There an Over-the-Counter Version of Zepbound?

Currently, there are no over-the-counter GLP-1 receptor agonist medications available. You must get a prescription for Zepbound from a licensed healthcare professional.

Is Zepbound available now?

Yes, Zepbound was made available by Eli Lilly in November of 2023.

Serious Side effects explained

Learn more about some of the side effects Zepbound may cause.

Severe stomach problems
Stomach problems, sometimes severe, have been reported in people who use ZEPBOUND. Tell your healthcare provider if you have stomach problems that are severe or will not go away.

Kidney problems (kidney failure)
Diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems. It is important for you to drink fluids to help reduce your chance of dehydration.

Gallbladder problems
Gallbladder problems have happened in some people who use ZEPBOUND. Tell yourhealthcare provider right away if you get symptoms of gallbladder problems which may include:

  • pain in your upper stomach (abdomen)
  • yellowing of skin or eyes (jaundice)
  • fever
  • clay-colored stools

Inflammation of your pancreas (pancreatitis)
Stop using ZEPBOUND and call your healthcare provider rightaway if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.

Serious allergic reactions
Stop using ZEPBOUND and get medical help right away if you have any symptoms of a serious allergic reaction including:

  • swelling of your face, lips, tongue or throat
  • fainting or feeling dizzy
  • problems breathing or swallowing
  • very rapid heartbeat
  • severe rash or itching

Low blood sugar (hypoglycemia)
Your risk for getting low blood sugar may be higher if you use ZEPBOUND withmedicines that can cause low blood sugar, such as a sulfonylurea or insulin. Signs and symptoms of low bloodsugar may include:

  • dizziness or light-headedness
  • blurred vision
  • anxiety, irritability, or mood changes
  • sweating
  • slurred speech
  • hunger
  • confusion or drowsiness
  • shakiness
  • weakness
  • headache
  • fast heartbeat
  • feeling jittery

Changes in vision in patients with type 2 diabetes
Tell your healthcare provider if you have changes in vision during treatment with ZEPBOUND.

Depression or thoughts of suicide
You should pay attention to any changes in your mood, behaviors, feelings, or thoughts. Call your healthcare provider right away if you have any changes to your mental health that are new, worse, or worry you.

Your GLP-1 coverage,
denied approved

Doctor talking to patient about GLP-1 (semaglutide) injectable medications like ozempic, wegovy, and mounjaro.

Frequently asked questions

How does Honest Care help with insurance denials?

We help patients fight insurance coverage denials so they can get access to the medications and treatments they deserve. We currently specialize in insurance coverage denials for Ozempic, Mounjaro, Wegovy and Zepbound.

If you are denied coverage for Ozempic, Mounjaro, Wegovy or Zepbound, Honest Care can help fight your denial by submitting an ‘appeal’ to your insurance. An appeal is a formal request to your health insurance company to overturn their denial and grant coverage on your behalf. An appeal generally consists of a formal letter, addressed to your insurance, explaining why a medication should be covered on your behalf and why your insurance’s initial denial should be overturned.

You have the right to appeal to your insurance’s coverage denial. Honest Care simplifies the appeals process by writing an appeal letter and supporting documents on your behalf making your best arguments for medication coverage, following your completion of our proprietary GLP-1 denial assessment.

Should I appeal if my insurance denied coverage?

If your insurance denied coverage for Ozempic, Mounjaro, Wegovy or Zepbound, you have the legal right to ask your insurance to reconsider the coverage denial by sending an ‘appeal’.  Unfortunately coverage denials too often go unchallenged. A study from September 2023 found that 69% of people who were denied coverage by their insurance didn’t know they could appeal, and 85% of people never tried to appeal.

We believe it always makes sense to appeal. Here is why:

Appeals work: According to a study analyzing data from several U.S. states, patients who appealed directly to their insurance provider (an internal appeal) experienced a success rate between 39-59%.

Denials are often issued by mistake: A computer almost always makes the initial decision to deny medication coverage. This results in denials that don’t actually consider your personal health situation or denials made by mistake. In the case of Ozempic, Mounjaro, Wegovy and Zepbound, incorrectly entered information about your BMI, labs including A1c, your health conditions and diagnoses, your medication history and current medication use can all lead to an automatic denial. When you appeal, your information is reviewed by a real person.

Doctors review appeals, not computers: Having a doctor consider your unique circumstances makes submitting an appeal a powerful process for overturning denials getting covered.

You deserve the best care: You have the legal right to fight the treatment you need. As a part of the Affordable Care Act, all health insurance plans are required to allow their members to appeal their coverage decisions. This spans all insurance coverage - whether you are insured through your employer, purchased an insurance plan through your state marketplace, or are insured through a government program like Medicare or Medicaid.

How does Honest Care’s appeal service work?

We currently offer appeal services for Ozempic, Mounjaro, Wegovy and Zepbound. After purchasing Honest Care and completing your online denial assessment, you can expect to receive your appeal letter within 2 business days.

1. Online denial assessment‍: Complete the online assessment at your convenience that gather all the necessary appeal evidence for your insurance. The assessment reviews your medication history, including any GLP-1s, weight loss or diabetes medications you have taken, your health conditions and diagnoses, your past weight loss, diet and exercise attempts, and details on your insurance coverage and denial.

2. Case evaluation & appeal strategy: One of our dedicated appeal specialist will review your assessment and insurance denial and identify your best appeal arguments for coverage. This will include an evaluation of your medication history, medical diagnoses, weight loss attempts and clinical research studies that strength your appeal case.

3. Appeal letter & supporting documents: Your assigned appeal writer will compose a professional appeal letter addressing your denial reason and detailing your case for coverage. We’ll create a supporting evidence report that further justifies your appeal letter, to send your insurance along with your appeal.

4. Specialist Consultation & Support: After you receive and review your appeal letter & evidence, your dedicated appeal specialist will be available to answer your questions. They will be available to make updates to your appeal, if required. You will also have the option to schedule a phone or video call at a time of your convenience to you speak to your dedicated appeal specialist.

5. Send your appeal: You can submit your appeal yourself or have your doctor submit your appeal on your behalf. Most insurance companies accept appeals by mail or fax. Instructions on how to submitted appeal will be included within the written explanation on why you initially denied medication coverage, sent at the time at you were denied.

Why we offer a Money Back Guarantee policy?

We believe every insurance denial should be appealed and every patient should fight for access to the best treatments, because access to great healthcare is a human right.

Our Money Back Guarantee is designed to help you overcome any obstacles or questions you have about appeals and exercise your legal right to fight for the coverage you deserve. Obstacles such as -"What if I appeal and still don’t win coverage?", "I don’t know how to appeal" and “I’m not sure what to say in my appeal.”

We offer a Money Back Guarantee for all our customers. If you're not satisfied with our service, you can request a refund no questions asked. To be eligible, contact support@findhonestcare.com with your order details and the reason for dissatisfaction. Refunds are processed to the original payment method within 5 to 10 business days.

What is included in Honest Care’s appeal packet?

Your appeal packet will include two main documents: 1) Your appeal letter and 2) Your supporting evidence. You can review a sample Honest Care appeal that includes an abridged appeal letter and evidence for demonstration.

How can working with a regular doctor increase your chance of insurance coverage compared to telehealth?

Working with your regular doctor can increase your chance of insurance coverage in several ways, including:

  • When your insurance plan is making a decision on whether to cover your GLP-1 prescription, they will want to review your medical history and recent labs results. Your doctor already has this information within your patient chart, and if you don’t have recent labs, your doctor can order new labs during your appointment. Most online, telehealth-based GLP-1 clinics do not have access to your full medical history in your patient chart, which limits their ability to achieve insurance approval.
  • In the event your insurance plan initially denies coverage for your GLP-1, this decision can be appealed by your doctor by writing a “Letter of Medical Necessity” and sending it your insurance company. Writing an effective letter requires a doctor to have a real relationship with their patient. Online, telehealth-based GLP-1 clinics find it challenging to write effective "Letters of Medical Necessity" given their lack of personal relationships with patients.
  • Insurance plans are increasingly flagging and scrutinizing GLP-1 prescriptions written by online, telehealth-based GLP-1 clinics. Working with a regular doctor can help avoid this additional scrutiny.

Can the Honest Care Report be shared with telehealth doctors?

Yes - your Honest Care Report can be submitted to any doctor, including doctors working with online, telehealth-based GLP-1 clinics. Taking the Honest Care Assessment before engaging with a telehealth services presents several advantages, including helping you save money.

By using Honest Care before engaging with a telehealth company, you’ll find out how likely you are to get a GLP-1 prescription and will receive guidance on any recommended steps to take before your GLP-1 appointment. This can save you money by avoiding paying subscription fees until you’re fully prepared for your telehealth appointment.

Who is eligible for GLP-1s?

There are nearly 10 GLP-1 medications available in the United States. Currently three of those medications, Zepbound®, Wegovy® and Saxenda®, are FDA-indicated for weight-loss assistance. The FDA indicates that people with a BMI ≥ 30 kg/m2 OR people with a BMI ≥ 27 kg/m2 who have been diagnosed with at least 1 weight-related condition are eligible for GLP-1s.

All other GLP-1 medications, including Ozempic® and Mounjaro®, are currently FDA-indicated for people diagnosed with Type 2 diabetes.

I already know I’m eligible for GLP-1s based on FDA-guidelines. How can Honest Care help me with eligibility?

While FDA-guidelines are critical for understanding GLP-1 eligibility, there are a number of other factors to consider for determining GLP-1 eligibility.

Additional eligibility criteria that Honest Care takes into account include:

  • Weight-related conditions by importance in Prior Authorization (PA) - insurance plans often take certain conditions more seriously than others when determining GLP-1 eligibility.
  • Medication step therapy - many insurance plans only consider patients eligible for GLP-1 coverage only after trying lower-cost weight loss assistance medications first.
  • Ethnicity-based BMI guidelines for determining whether a patient is overweight by ethnicity.

What is Prior Authorization (PA)? Does Honest Care help with insurance?

Prior Authorization (PA) is a process run by insurance plans to determine how necessary a medication is. Most insurance plans require Prior Authorization (PA) before approving coverage for GLP-1s.

After your GLP-1 prescription is written, your insurance plan will notify your doctor if a PA is required and ask your doctor for additional documentation on why your medication is necessary.

If a PA is required, your insurance plan will ask your doctor to submit detailed information on your diet and exercise history, your past weight loss attempts, weight loss medications you previously tried, and any unique challenges that you face that make a GLP-1 medically necessary.

The Honest Care Report includes evidence requested by most insurance plans and can be submitted to your insurance during the PA process. During your appointment, your doctor can attach your Honest Care Report to your health record so it is submitted as supporting evidence to your insurance if Prior Authorization is required.