Honest guide. No fluff. No misleading promises about CGHS covering GLP-1 drugs.
GLP-1 drugs (Mounjaro, Ozempic, Wegovy, Rybelsus) are not on the CGHS formulary. This means the drug cost is not covered cashless or by reimbursement under CGHS. However, CGHS covers several important related costs that can significantly reduce your total spending. This is the honest guide.
📍 Sector 69, Mohali · CGHS Desk: 0172 4120100 · Mon–Sat 10 AM–6 PM
GLP-1 drugs — Mounjaro (tirzepatide), Ozempic (semaglutide), Wegovy (semaglutide 2.4mg), and Rybelsus (oral semaglutide) — are not on the CGHS approved drug list as of April 2026. This means the drug cost is not covered either cashless or by reimbursement under CGHS. Any promise of CGHS coverage for the drug itself is incorrect. However, CGHS covers several important related costs that can significantly reduce your total spending on GLP-1 therapy management.
CGHS covers the specialist consultation with Dr. Bhansali (reimbursable with a Wellness Centre referral) and all monitoring tests — HbA1c, thyroid, kidney function, liver function, lipid profile, Echo, TMT, Vitamin B12 — at CGHS notified rates at Gini's in-house NABH-accredited lab. For CGHS patients, the monitoring cost savings are ₹4,000–6,000 per quarter.
With a Wellness Centre prescription, CGHS covers all monitoring costs associated with GLP-1 therapy at Gini's in-house lab. This is where significant savings are possible.
These costs must be paid privately. This is the honest part of the guide that most hospitals won't tell you clearly.
How to maximise your CGHS benefits while managing the drug cost privately.
Ask your CGHS Wellness Centre for a referral to Dr. Anil Bhansali (Endocrinology) at Gini Advanced Care Hospital, Sector 69, Mohali. This referral makes your consultation and monitoring tests reimbursable.
HbA1c, kidney function, liver function, lipid profile, thyroid (TSH), Echo, TMT — all covered at CGHS rates at Gini's in-house lab. This saves ₹4,000–6,000 per quarter compared to paying privately.
The drug cost is not covered by CGHS and must be paid privately. Dr. Bhansali will recommend the most cost-effective GLP-1 option for your clinical situation — not simply the most expensive.
Rybelsus (oral semaglutide) at ₹3,500–5,500/month is the most affordable GLP-1 and may be the right clinical choice for patients with T2D and moderate HbA1c elevation. Dr. Bhansali will assess whether it is appropriate for your metabolic profile.
When domestic generic versions of tirzepatide and semaglutide launch (expected 2026 at ₹3,000–5,000/month), CGHS patients may find this significantly more accessible — and there may be greater pressure for formulary inclusion at that point.
Total estimated monthly cost for a CGHS patient: ₹3,500–20,000 (drug) + monitoring largely covered by CGHS.
Honest answer: Currently, no. GLP-1 drugs are classified as specialty medicines and are not on the CGHS approved drug list. Reimbursement claims for non-formulary medicines are generally not approved unless:
If you were admitted to Gini for diabetic complications (DKA, hyperosmolar state, severe hypoglycaemia, acute kidney injury) and received GLP-1 therapy as part of your inpatient treatment, the drug cost may be claimable as part of the overall IPD bill. Our CGHS desk can advise on this case by case.
Call: 0172-4120100
CGHS patients: pay consultation fee at visit and claim reimbursement. Monitoring tests covered at CGHS rates. Drug cost paid privately. Our CGHS desk helps with all paperwork. Mon–Sat, 10 AM–6 PM.