HSA/FSA
Can I Use My HSA or FSA for Semaglutide? Here’s What to Know
Let’s get the skinny on Ozempic, Wegovy, and Rybelsus.
October 7, 2024
Sam O'Keefe
Co-founder & CEO of Flex
Overview
Overview
Overview
Overview
You’ve likely heard the buzz around semaglutide.
The medication, commonly known by its brand names Ozempic, Wegovy, and Rybelsus, has made waves in the medical world for its potential to promote weight loss — a major draw for the nearly 42% of American adults who are affected by obesity.
But here’s the kicker: Cost.
The average retail price for the drugs can be over $1,300 per month, with Ozempic costing around $12,000 a year and Wegovy priced at over $16,000!
With such a hefty price tag and many insurance providers not covering the drug’s off-label use for weight loss, many people want to know if they can use their Health Savings Account (HSA) or Flexible Spending Account (FSA) to help pay for it.
So, can you use your HSA of FSA for semaglutide? Let’s find out.
What Is Semaglutide?
Semaglutide is part of a class of drugs that mimics a natural hormone in the body that helps regulate blood sugar. By stimulating insulin production and slowing digestion, it lowers blood glucose levels in people with Type 2 diabetes. The drug also reduces appetite, which is what piqued interest in its potential for weight loss.
Semaglutide is the active ingredient in three major drugs:
Ozempic
Wegovy
Rybelsus
Prescribed uses for semaglutide
Semiglutide, when used correctly, can help:
Lower blood sugar levels for Type 2 diabetics
Reduce the risk of heart attacks and strokes
Help with weight loss
Potentially manage other chronic conditions
What is the difference between Ozempic, Wegovy, and Rybelsus?
While all three drugs contain semaglutide, their dosage and intended uses vary.
Ozempic is an injection that is prescribed to help lower blood sugar levels in people with type 2 diabetes, and can lower the risk of cardiovascular events for people with type 2 diabetes and heart disease.
Wegovy is also administered via injection and is used for chronic weight management and to lower the risk of heart attack, stroke, and cardiovascular death. The primary difference between Ozempic and Wegovy is the dosage.
Rybelsus offers an oral version for diabetes treatment.
Can Semaglutide Be Used for Weight Loss?
Yes, and the FDA has approved Wegovy specifically for weight loss.
While Ozempic is not officially approved for weight loss, it shows promise and some doctors may prescribe it off-label (which means using an FDA-approved drug for an unapproved use to treat a medical condition).
How effective is semaglutide for weight loss?
Semaglutide has been highly effective for weight loss. Several studies have shown that patients lose between 15-16% of their total body weight over the course of the treatment (typically about 16 months). Of course, this varies depending on individual factors like lifestyle and existing medical conditions.
Who is Semaglutide for?
Semaglutide is typically prescribed to adults with a BMI of 30 or higher (the BMI category that is considered obese) or those with a BMI of 27 or higher who also have weight-related health conditions like high blood pressure or type 2 diabetes.
Who or what is it not for?
Semaglutide is not for people with a BMI lower than 30 (unless they have comorbidities) and isn’t recommended for short-term weight loss or cosmetic purposes. It's also not suitable for anyone with a personal or family history of thyroid cancer.
How Does Semaglutide Work for Weight Loss?
Semaglutide works by regulating appetite and slowing digestion, leading to reduced calorie intake. It triggers the brain’s satiety centers, helping people feel fuller faster and for longer. According to the FDA, semaglutide was the first new drug approved for chronic weight management since 2014, making it quite a breakthrough in obesity treatment.
How fast does semaglutide start working?
While you might notice the short-term effects within the initial 4 weeks, patients typically start seeing meaningful results within the first 4-8 weeks, although weight loss may continue for several months. Long-term effects appear after 20 weeks of use.
How long do you have to stay on semaglutide for weight loss?
Semaglutide is meant for long-term use. Stopping the medication may result in regaining the lost weight, which makes it crucial to incorporate lifestyle changes, such as exercise and a healthy diet, alongside the treatment.
What Are the Side Effects and Risks of Semaglutide?
As beneficial as it can be, semaglutide is not completely harmless. Common side effects include:
Nausea
Vomiting
Diarrhea
Stomach pain
Constipation
More serious risks include pancreatitis, gallbladder issues, and the potential for thyroid tumors. You should not take semaglutide if you have a personal or family history of medullary thyroid carcinoma (MTC) or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Be cautious about overdosing, as the FDA has warned of serious complications.
Can I Use My HSA or FSA for Semaglutide?
If your doctor prescribes Wegovy, then you can use your HSA or FSA to pay for it.
Your health insurance may also cover the drug, but all plans are different when it comes to weight-management medications, so you’ll want to review the specifics of your plan. Wegovy has a resource to check.
How to get semaglutide without insurance
If your insurance doesn’t cover semaglutide, you can use your HSA or FSA funds, provided you have a prescription. Some telehealth services, including Weight Watchers, offer access to these drugs, but be wary of compounded drugs sold online. Make sure you get the real deal from a reputable source.
Why semaglutide qualifies for your HSA or FSA
Since Semaglutide is an FDA-approved medication, it qualifies as a medical expense under both HSAs and FSAs.
How Flex Can Help You Use Your HSA/FSA to Purchase Semaglutide
How to use your HSA/FSA to purchase semaglutide
Today, semaglutide is only available from major pharmacies and retailers like CVS, Rite Aid, and Amazon. Because prescriptions are qualified medical expenses, you can use your HSA or FSA debit card to pay for semaglutide directly at any pharmacy or retailer that accepts these cards (or you can pay out-of-pocket and submit for reimbursement).
Should it become available through other online retailers, Flex offers a simplified way to use your HSA or FSA to purchase this medication. Here's how:
Challenges with online retailers: Not all online retailers are set up to accept HSA or FSA payments. If you're trying to make a purchase through one of these vendors, you’ll know pretty quickly — your card will be declined at checkout.
How Flex solves this problem: If an ecommerce company has partnered with Flex, they can accept HSA/FSA cards without issue. Flex works behind the scenes to auto-substantiate purchases, meaning your payment will go through without the need for additional documentation or manual claims submission. No more out-of-pocket costs followed by a lengthy reimbursement process — Flex handles it for you!
With Flex, managing your medical expenses lets you focus on your health journey without worrying about whether your payments will go through. Should semaglutide become available through a wider range of retailers, Flex will be there to help make your HSA or FSA purchases seamless and stress-free.
Wallet-Friendly Weight Loss: You Can Use Your HSA/FSA For Semaglutide
Semaglutide is shaping up to be a game-changer for both diabetes management and weight loss, but the high cost and variable coverage by health insurance can be a barrier for many.
This is a great example of where HSAs and FSAs can be invaluable: If you qualify for a prescription, your health savings account can cover the gaps in healthcare to provide a more affordable option for your weight-loss journey.
You’ve likely heard the buzz around semaglutide.
The medication, commonly known by its brand names Ozempic, Wegovy, and Rybelsus, has made waves in the medical world for its potential to promote weight loss — a major draw for the nearly 42% of American adults who are affected by obesity.
But here’s the kicker: Cost.
The average retail price for the drugs can be over $1,300 per month, with Ozempic costing around $12,000 a year and Wegovy priced at over $16,000!
With such a hefty price tag and many insurance providers not covering the drug’s off-label use for weight loss, many people want to know if they can use their Health Savings Account (HSA) or Flexible Spending Account (FSA) to help pay for it.
So, can you use your HSA of FSA for semaglutide? Let’s find out.
What Is Semaglutide?
Semaglutide is part of a class of drugs that mimics a natural hormone in the body that helps regulate blood sugar. By stimulating insulin production and slowing digestion, it lowers blood glucose levels in people with Type 2 diabetes. The drug also reduces appetite, which is what piqued interest in its potential for weight loss.
Semaglutide is the active ingredient in three major drugs:
Ozempic
Wegovy
Rybelsus
Prescribed uses for semaglutide
Semiglutide, when used correctly, can help:
Lower blood sugar levels for Type 2 diabetics
Reduce the risk of heart attacks and strokes
Help with weight loss
Potentially manage other chronic conditions
What is the difference between Ozempic, Wegovy, and Rybelsus?
While all three drugs contain semaglutide, their dosage and intended uses vary.
Ozempic is an injection that is prescribed to help lower blood sugar levels in people with type 2 diabetes, and can lower the risk of cardiovascular events for people with type 2 diabetes and heart disease.
Wegovy is also administered via injection and is used for chronic weight management and to lower the risk of heart attack, stroke, and cardiovascular death. The primary difference between Ozempic and Wegovy is the dosage.
Rybelsus offers an oral version for diabetes treatment.
Can Semaglutide Be Used for Weight Loss?
Yes, and the FDA has approved Wegovy specifically for weight loss.
While Ozempic is not officially approved for weight loss, it shows promise and some doctors may prescribe it off-label (which means using an FDA-approved drug for an unapproved use to treat a medical condition).
How effective is semaglutide for weight loss?
Semaglutide has been highly effective for weight loss. Several studies have shown that patients lose between 15-16% of their total body weight over the course of the treatment (typically about 16 months). Of course, this varies depending on individual factors like lifestyle and existing medical conditions.
Who is Semaglutide for?
Semaglutide is typically prescribed to adults with a BMI of 30 or higher (the BMI category that is considered obese) or those with a BMI of 27 or higher who also have weight-related health conditions like high blood pressure or type 2 diabetes.
Who or what is it not for?
Semaglutide is not for people with a BMI lower than 30 (unless they have comorbidities) and isn’t recommended for short-term weight loss or cosmetic purposes. It's also not suitable for anyone with a personal or family history of thyroid cancer.
How Does Semaglutide Work for Weight Loss?
Semaglutide works by regulating appetite and slowing digestion, leading to reduced calorie intake. It triggers the brain’s satiety centers, helping people feel fuller faster and for longer. According to the FDA, semaglutide was the first new drug approved for chronic weight management since 2014, making it quite a breakthrough in obesity treatment.
How fast does semaglutide start working?
While you might notice the short-term effects within the initial 4 weeks, patients typically start seeing meaningful results within the first 4-8 weeks, although weight loss may continue for several months. Long-term effects appear after 20 weeks of use.
How long do you have to stay on semaglutide for weight loss?
Semaglutide is meant for long-term use. Stopping the medication may result in regaining the lost weight, which makes it crucial to incorporate lifestyle changes, such as exercise and a healthy diet, alongside the treatment.
What Are the Side Effects and Risks of Semaglutide?
As beneficial as it can be, semaglutide is not completely harmless. Common side effects include:
Nausea
Vomiting
Diarrhea
Stomach pain
Constipation
More serious risks include pancreatitis, gallbladder issues, and the potential for thyroid tumors. You should not take semaglutide if you have a personal or family history of medullary thyroid carcinoma (MTC) or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Be cautious about overdosing, as the FDA has warned of serious complications.
Can I Use My HSA or FSA for Semaglutide?
If your doctor prescribes Wegovy, then you can use your HSA or FSA to pay for it.
Your health insurance may also cover the drug, but all plans are different when it comes to weight-management medications, so you’ll want to review the specifics of your plan. Wegovy has a resource to check.
How to get semaglutide without insurance
If your insurance doesn’t cover semaglutide, you can use your HSA or FSA funds, provided you have a prescription. Some telehealth services, including Weight Watchers, offer access to these drugs, but be wary of compounded drugs sold online. Make sure you get the real deal from a reputable source.
Why semaglutide qualifies for your HSA or FSA
Since Semaglutide is an FDA-approved medication, it qualifies as a medical expense under both HSAs and FSAs.
How Flex Can Help You Use Your HSA/FSA to Purchase Semaglutide
How to use your HSA/FSA to purchase semaglutide
Today, semaglutide is only available from major pharmacies and retailers like CVS, Rite Aid, and Amazon. Because prescriptions are qualified medical expenses, you can use your HSA or FSA debit card to pay for semaglutide directly at any pharmacy or retailer that accepts these cards (or you can pay out-of-pocket and submit for reimbursement).
Should it become available through other online retailers, Flex offers a simplified way to use your HSA or FSA to purchase this medication. Here's how:
Challenges with online retailers: Not all online retailers are set up to accept HSA or FSA payments. If you're trying to make a purchase through one of these vendors, you’ll know pretty quickly — your card will be declined at checkout.
How Flex solves this problem: If an ecommerce company has partnered with Flex, they can accept HSA/FSA cards without issue. Flex works behind the scenes to auto-substantiate purchases, meaning your payment will go through without the need for additional documentation or manual claims submission. No more out-of-pocket costs followed by a lengthy reimbursement process — Flex handles it for you!
With Flex, managing your medical expenses lets you focus on your health journey without worrying about whether your payments will go through. Should semaglutide become available through a wider range of retailers, Flex will be there to help make your HSA or FSA purchases seamless and stress-free.
Wallet-Friendly Weight Loss: You Can Use Your HSA/FSA For Semaglutide
Semaglutide is shaping up to be a game-changer for both diabetes management and weight loss, but the high cost and variable coverage by health insurance can be a barrier for many.
This is a great example of where HSAs and FSAs can be invaluable: If you qualify for a prescription, your health savings account can cover the gaps in healthcare to provide a more affordable option for your weight-loss journey.
Flex is the easiest way for direct to consumer brands and retailers to accept HSA/FSA for their products. From fitness and nutrition, to sleep and mental health, Flex takes a holistic view of healthcare and enables consumers to use their pre-tax money to do the same.