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Will insurance cover Ozempic for fatty liver?

Although fatty liver disease is an off-label use of Ozempic, coverage may be possible
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By | Jun. 6, 2025 Medically reviewed by Chad Shaffer, MD
A health insurance card and stethoscope: Will insurance cover Ozempic for fatty liver?

Key takeaways

  • There’s early research showing that drugs like Ozempic (semaglutide) can benefit fatty liver disease.

  • Insurance plans are unlikely to cover Ozempic if it’s prescribed for fatty liver disease alone, since it isn’t an FDA-approved indication.

  • If your insurance doesn’t cover Ozempic, consider using a SingleCare coupon, filing an appeal for coverage, or talking with your healthcare provider about alternative treatments.

In this article:

Ozempic (semaglutide) is a glucagon-like peptide-1 receptor (GLP-1) agonist taken as a weekly injection that’s approved by the Food and Drug Administration (FDA) to improve blood sugar control in adults with Type 2 diabetes, reduce the risk of stroke and heart attack in adults with Type 2 diabetes and cardiovascular disease, and help with slowing the progression of kidney disease in people with Type 2 diabetes and chronic kidney disease. 

Although insurance plans may cover Ozempic to treat Type 2 diabetes, coverage for fatty liver disease might not be so straightforward. Several factors that can affect coverage include someone’s health history, specific insurance plan, and what it’s prescribed for. 

What causes fatty liver disease?

Fatty liver disease is the buildup of fat in the liver. It can be related to alcohol use or metabolic conditions such as Type 2 diabetes. The cause of non-alcoholic fatty liver disease (NAFLD), or metabolic dysfunction-associated steatotic liver disease, is still being studied, but someone’s family history, diet, and personal health history can affect the risk of developing this condition. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), factors that can increase the risk of NAFLD include:

  • Overweight or obesity
  • High cholesterol or triglycerides
  • Insulin resistance or Type 2 diabetes
  • Metabolic syndrome, which can include high blood pressure, high waist size, high triglycerides, low good cholesterol level, and high blood sugar 
  • Possibly genetics
  • Possibly a diet high in the sweetener fructose 

Michael Chichak, MD, medical director at MEDvidi, explains how fatty liver is associated with Type 2 diabetes and obesity: “Fatty liver disease is linked with diabetes and obesity due to insulin resistance, which is a prominent feature of NAFLD. The storage of fat in the liver increases due to obesity and diabetes, which further aggravates these diseases.”

Does Ozempic help treat fatty liver disease?

There are early studies suggesting that semaglutide, the active ingredient in Ozempic, can be used to treat NAFLD. A meta-analysis published in 2023 found that semaglutide was safe and effective for the treatment of NAFLD. In the same year, another review and meta-analysis screened 600 studies and analyzed eight of them to conclude that semaglutide could improve liver function tests and metabolic markers in people with NAFLD. Dr. Chichak explains, “Semaglutide and other GLP-1 receptor agonists have been useful in managing fatty liver disease because of weight loss and metabolic improvements. Clinical trials suggest that they might decrease liver fat and inflammation.” 

In addition to semaglutide, other GLP-1 medications such as Victoza (liraglutide) and exenatide may also have a beneficial effect on fatty liver.

RELATED: The expanding use of GLP-1s

All the published studies on GLP-1s and NAFLD suggest that more research is needed to better understand the effects these medications have on NAFLD. Dr. Chichak shares that, though many people take semaglutide without problems, treatment should always be initiated and monitored by a healthcare professional. “There may be some side effects, especially with the digestive system,” he says. 

Does insurance cover Ozempic for fatty liver disease?

Insurance plans may not cover Ozempic if it’s prescribed solely for fatty liver disease. Ozempic coverage depends on the insurance plan and the reason why it’s prescribed. 

Most major insurance plans, including some plans from United Healthcare and Blue Cross Blue Shield, cover Ozempic for its FDA-approved uses, such as for the treatment of Type 2 diabetes. Some plans, like those from Cigna, may require prior authorization before approving coverage. 

Coverage for Ozempic also varies for people with Medicare and Medicaid. Medicare Part D may cover Ozempic when prescribed for Type 2 diabetes, but not for fatty liver disease alone. Medicaid plans cover drugs for Type 2 diabetes, like Ozempic, but prescription coverage with Medicaid varies by state. 

If you have one of the conditions that Ozempic is approved to treat, as well as fatty liver, your insurance plan may be more likely to cover the medication. Ozempic is FDA approved for the following:

  • Managing blood sugar in adults with Type 2 diabetes 
  • Reducing the risk of cardiovascular events like heart attack and stroke in adults with cardiovascular disease and Type 2 diabetes
  • Reducing the risk of lowered kidney function and end-stage kidney disease in adults with chronic kidney disease and Type 2 diabetes 

How to get insurance to cover Ozempic for fatty liver disease

Just like weight loss, fatty liver disease is considered an off-label use of Ozempic. Before covering Ozempic for an off-label use like fatty liver disease, your insurance company may require prior authorization. If so, your pharmacy will notify you and your healthcare provider that it can’t fill the prescription until the insurance company approves it. Your healthcare provider will take care of the process of submitting a prior authorization form to your health insurance company, essentially explaining why you need Ozempic. The insurance company will review the form and then determine whether it will cover Ozempic for you.  

Insurance companies may also require step therapy before approving coverage for Ozempic. Step therapy involves trying less expensive medications first and only approving Ozempic if those medications weren’t effective or tolerated.

How much does Ozempic cost without insurance?

The average cost of Ozempic without insurance is $1,379 per 1, 3 mL of 2 mg/3 mL auto-injector pen. One auto-injector pen contains four weekly doses, which should last a month. This means that a yearly supply of Ozempic can cost more than $16,500 without insurance. 

Medication prices fluctuate and vary by pharmacy and location. 

What to do if your health insurance doesn’t cover Ozempic

There are ways to save on Ozempic if your insurance plan doesn’t cover it for fatty liver disease.

Use a SingleCare coupon

A SingleCare Prescription Discount Card can be a valuable tool for managing drug costs without insurance. With the card or the SingleCare app, you can compare prices at local pharmacies and access coupons to use at the pharmacy that has the best price. With a SingleCare coupon for Ozempic, you may pay $822 instead of $1,379 for 1, 3 mL of 2 mg/3 mL auto-injector pen.

File an appeal

If your insurance provider doesn’t offer prior authorization or step therapy processes to get Ozempic coverage, you may still have a chance at coverage by filing an appeal. This involves submitting necessary documentation, with the help of your healthcare provider, to justify the need for the medication. The insurance company or a third party will review your case and inform you of their decision. 

Consider alternative treatments

Besides semaglutide and other GLP-1s that are still being studied for fatty liver disease, there are other well-studied and FDA-approved treatment options for NAFLD. The American Association for the Study of Liver Diseases (AASLD) recommends a healthy diet and regular exercise as the foundations of treating NAFLD. The group also explains that a healthy lifestyle can support liver health. Liver-protecting lifestyle factors include:

  • Weight loss in people who are overweight or have obesity: Even a loss of 3% body weight can improve mild fatty liver disease.
  • Healthy diet: Diets that decrease carbohydrates, sugars (especially added fructose in sodas), and saturated fats can help with weight and fatty liver management.
  • Exercise: Exercise can help with fatty liver, even if it doesn’t result in weight loss.
  • Bariatric surgery: Sometimes, bariatric surgery can help with fatty liver disease, especially if someone has a BMI of over 40 kg/m2.

There aren’t many medications that are approved to treat NAFLD, but research supports the benefits of diabetes medications such as pioglitazone and metformin on liver health. 

As of 2024, the FDA approved the medication Rezdiffra (resmetirom) for the treatment of nonalcoholic steatohepatitis (NASH) with moderate to advanced liver fibrosis. It’s the only medication currently approved to treat fatty liver disease.

Talk to your healthcare professional about the fatty liver treatment options that are best for you.