Tirzepatide is a once-weekly injectable drug that activates GIP and GLP-1 receptors; Zepbound is the brand approved for weight management and Mounjaro the brand for type 2 diabetes.
Who pays for tirzepatide in Nashville
| If you have | What applies | Source |
|---|---|---|
| TennCare | Zepbound preferred for obesity with prior authorization; BMI 30+, or 27+ with a weight-related condition | [1] |
| Medicare Part D | GLP-1 Bridge: Zepbound KwikPen only, $50 a month if eligible, through Dec 31, 2027 | [5] [6] |
| Job-based plan that covers Zepbound | Savings card can cut the cost to as little as $25 | [7] |
| No coverage | LillyDirect self-pay, $299 to $449 a month | [2] |
In Nashville, 12.7% of residents are 65 or older [4], so the Medicare row matters for many households. Note the form restriction: the Bridge excludes Zepbound vials [5].
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Self-pay prices, dose by dose
| Option | Price | What it covers | Checked |
|---|---|---|---|
| Zepbound 2.5 mg, LillyDirect self-pay (vial or KwikPen) | $299 a month [2] | Drug only, starting dose, 28-day month | Oct 17, 2026 |
| Zepbound 5 mg, LillyDirect self-pay | $399 a month [2] | Drug only | Oct 17, 2026 |
| Zepbound 7.5 to 15 mg, LillyDirect, refilled within 45 days | $449 a month [2] | Drug only; $499 (7.5 mg) or $699 (10 to 15 mg) outside the window | Oct 17, 2026 |
| Zepbound list price | $1,087 a month [8] | Before any discount | Oct 17, 2026 |
Lilly cut vial prices on December 1, 2025, from $349, $499 and $499 to $299, $399 and $449 [9]. TrumpRx lists Zepbound at $299 but sends buyers to LillyDirect, so it is not a separate, cheaper channel [8] [10]. See TrumpRx explained.
How the dose moves and why your bill does too
The label starts at 2.5 mg once a week for 4 weeks, then 5 mg, then increases in 2.5 mg steps no sooner than every 4 weeks. Maintenance doses for weight are 5, 10 or 15 mg, and 15 mg is the maximum [11]. Each step can change the price tier. For people with type 2 diabetes in Nashville, where 10.9% of adults have diagnosed diabetes [3], Mounjaro may be the version a doctor prescribes [12].
Compounded tirzepatide
Compounded tirzepatide is not FDA-approved and is not reviewed by FDA for safety, effectiveness or quality [13]. FDA's position since the shortage ended is that 503A pharmacies may not routinely make copies of approved drugs [14]. Tennessee's pharmacy board licenses the pharmacies that compound [15]. More on compounded tirzepatide.
Also see tirzepatide in Atlanta, Indianapolis and Chicago, plus the tirzepatide guide.
Side effects and warnings
Zepbound label highlights
In weight trials, nausea hit 25% to 29% of people on Zepbound depending on dose, versus 8% on placebo [16]. Stop and get care for severe, persistent stomach pain. Boxed warning: thyroid C-cell tumors in rats; not for people with a personal or family history of medullary thyroid carcinoma or MEN 2. Use backup birth control for 4 weeks after starting and after each dose increase if you take oral contraceptives [12]. Call 911 for a severe allergic reaction.
Questions people ask
Does TennCare cover Zepbound?
Yes, with prior authorization. TennCare's notice effective August 1, 2025 lists Zepbound and Wegovy as preferred obesity drugs for members with a BMI of 30 or higher, or 27 or higher with a weight-related condition [1].
How much is Zepbound in Nashville without insurance?
LillyDirect self-pay prices checked Oct 17, 2026: $299 for 2.5 mg, $399 for 5 mg and $449 for 7.5 to 15 mg when refilled within 45 days [2].
Is TrumpRx cheaper for Zepbound?
What is the maximum Zepbound dose?
15 mg once weekly. Weight maintenance doses on the label are 5, 10 or 15 mg [11].
Does Medicare cover tirzepatide for weight loss?
How does tirzepatide compare with semaglutide?
In the SURMOUNT-5 head-to-head trial, tirzepatide produced an average 20.2% weight loss at 72 weeks versus 13.7% for semaglutide [17].
Sources
17 cited
- TennCare provider notice: obesity management agents. OptumRx for TennCare, Aug 1, 2025.
- Zepbound self-pay pricing. Eli Lilly and Company (LillyDirect), accessed 2026-10-17.
- PLACES place data: Nashville-Davidson, TN. CDC PLACES (2025 release, BRFSS 2023), 2023 data, 2025 release.
- QuickFacts: Nashville-Davidson metropolitan government, Tennessee. U.S. Census Bureau, QuickFacts, V2025; ACS 2020-2024.
- Medicare GLP-1 Bridge: information for pharmacies. Centers for Medicare & Medicaid Services, accessed 2026-10-17.
- Weight loss drugs coverage. Medicare.gov (CMS), accessed 2026-10-17.
- Zepbound coverage and savings. Eli Lilly and Company, accessed 2026-10-17.
- TrumpRx.gov. TrumpRx.gov (US government), accessed 2026-10-17.
- Lilly lowers Zepbound vial prices on LillyDirect. Eli Lilly and Company, Dec 1, 2025.
- TrumpRx launches, offering cash-paying patients discounted drugs. Pharmacy Times, Feb 6, 2026.
- Zepbound label. DailyMed, NLM, Aug 2026.
- Mounjaro label. DailyMed, NLM, Aug 2026.
- FDA's concerns with unapproved GLP-1 drugs used for weight loss. US Food and Drug Administration, Oct 1, 2026.
- FDA clarifies policies for compounders as national GLP-1 supply begins to stabilize. US Food and Drug Administration, Apr 1, 2026.
- Tennessee Board of Pharmacy. Tennessee Department of Health, accessed 2026-10-17.
- Zepbound prescribing information. US FDA (accessdata.fda.gov), Apr 2026.
- Tirzepatide as compared with semaglutide for the treatment of obesity (SURMOUNT-5). New England Journal of Medicine (PubMed), May 11, 2025.
This page is general information, not medical advice. Talk with a licensed clinician about your own care.