Veozah Cost Without Insurance: What You’ll Really Pay in 2026 (and How to Pay $0)
Veozah cost without insurance is about $566 a month at list price, and roughly $485 to $778 a month with a discount card — about $6,800 to $9,300 a year at full price. There’s no generic. But here’s the part most pages bury: if you’re uninsured, the company that makes Veozah may give it to you for $0. If you have job-based insurance, a savings card can bring your first month to $0 and refills to ~$30. The posted price is rarely what you actually pay.
Disclosure: The HRT Index is an independent comparison resource. Some clinician links are affiliate links; the manufacturer and patient-assistance links are not.
Your situation at a glance
| Your situation | Likely monthly cost | Best first move |
|---|---|---|
| No insurance | List price $566 (often $485–$778 with coupon) | Check Astellas Patient Assistance — you may pay $0 |
| Job-based (commercial) insurance | Astellas-reported average $42 | Check savings-card eligibility ($0 first month, ~$30 refills) |
| Medicare Part D | Astellas-reported average $55 | Check your plan + call Support Solutions |
| Medicaid | Astellas-reported average $2 | Check your state formulary + call Support Solutions |
| Paying cash with a coupon | About $485–$778 | Compare coupons after you’ve checked assistance |
Quick note: Veozah is nothormone replacement therapy (HRT). It’s a non-hormonal pill for hot flashes and night sweats — which is exactly why so many people choose it. More on cheaper options, including Lynkuet, further down.
Free; not an affiliate link — manufacturer’s official program
How much does Veozah cost without insurance in 2026?
Without insurance, Veozah (the brand name for a drug called fezolinetant) has a list price of $566 for a 30-day supply, according to the maker, Astellas. At real pharmacies, public coupon prices range from about $485 to $778 a month, depending on the pharmacy and discount used. There is no generic, which is the main reason the price stays high.
Three different numbers — and why people mix them up:
- List price — the “sticker.” Astellas lists this at $566/month for a 30-day prescription.
- Coupon cash price — what a discount card like GoodRx or SingleCare gets you at the register. GoodRx has shown a discount price near $485 and an average near $690. SingleCare lists an average near $778, with a $573 example at Kroger (30 tablets, ZIP 23666, March 2026).
- Manufacturer help — the savings card and the patient assistance program. These can bring your cost to $0 — but they have rules. This is the part people miss.
| Source | What it shows for a 30-day supply | What it actually tells you |
|---|---|---|
| Astellas (official) | $566 list price (uninsured) | The maker’s starting benchmark |
| Astellas (official) | $42 average out-of-pocket with commercial insurance | What insured people typically pay after coverage |
| Astellas (official) | $55 Medicare Part D · $2 Medicaid (average) | Government-plan averages |
| GoodRx | Discount near $485; average near $690 | A discount-card price; check the live price for your ZIP |
| SingleCare | ~$778 average; ~$573 Kroger example | A coupon estimate as of March 2026; varies by pharmacy |
Out-of-pocket means the final amount you actually pay. Commercial, Medicare, and Medicaid averages are Astellas-reported figures based on patient data through early 2025. Pharmacy coupon prices change often — check the live price before you fill.
Why two people can pay totally different prices for the same pill:Same drug, same day, two different prices — it happens constantly. What you pay depends on your pharmacy’s contract pricing, your plan’s formulary, prior authorization requirements, which discount card you use, and even your ZIP code. A 90-day fill can change the math too. The smartest first step isn’t to grab the lowest coupon — it’s to find out which help you qualify for.
Before you pay a cent, can you get Veozah for $0?
Yes — and this is the most important sentence on this page.
If you’re uninsured, the Astellas Patient Assistance Programprovides Veozah at no cost to people who meet the eligibility rules. Astellas states plainly that everyone who qualifies gets their prescription at no cost. You apply or call to find out — it isn’t automatic.
This is a different program from the $30 savings card you’ve probably seen advertised. The card is mainly for people with job-based insurance. The patient assistance program is for people without prescription coverage. Mixing them up is the single most common — and most expensive — mistake we see.
Who it’s for
- No prescription insurance, or insurance won’t cover Veozah
- Valid prescription for Veozah
- Meets income eligibility rules
How to apply — what to have ready
Call VEOZAH Support Solutions at 1-866-239-1637, Mon–Fri, 8 a.m. to 8 p.m. Eastern. Have ready:
- Your prescription details (or prescriber’s info)
- Your insurance card, if you have any coverage at all
- The pharmacy price you were quoted
- Income documents, in case they ask
- Any denial or “needs approval” letter from your insurer
Script you can read out loud when you call:
“I was quoted $____ for Veozah and I don’t have prescription coverage. Can you tell me whether I should apply for Patient Assistance, use the savings card, or have my doctor request approval from my insurance? What do you need from me to start?”
That one question routes you to the right path in a single call. You’re not committing to anything — you’re just finding out what you qualify for. And it costs nothing to ask.
Free; not an affiliate link
Why the “$30 Veozah card” probably won’t work if you’re uninsured
The Veozah Savings Card can be great — but only for the right person. Astellas’s own terms say the card is for eligible patients with commercial (job-based or self-purchased) insurance, and that it is not valid for cash-paying patientsor for prescriptions paid by Medicare, Medicaid, or any other government program. If you’re uninsured, that “$30” headline almost certainly isn’t for you.
The trap, plain and simple: “$30” does not mean any uninsured person can walk in and pay $30. It means a person with commercial insurance may pay as little as $30 after the card is applied to their plan. Two very different things.
When the savings card actually helps
If you have commercial insurance, eligible patients may pay $0 for the first month and as little as $30 for each refill. Important details:
What about Medicare and Medicaid?
The card is off the table for both. But your plan may still cover Veozah. Astellas reports an average of about $55/month for Medicare Part D and about $2/month for Medicaid — though your exact cost depends entirely on your plan and state.
If you’re on Medicare and your cost is high, ask whether you qualify for Extra Help, the federal low-income subsidy. In 2026, Extra Help caps what you pay for each covered brand-name drug at $12.65at participating pharmacies. If you’re on Medicaid, ask your state’s program specifically whether Veozah is covered, and what documentation your prescriber should send.
Check whether the savings card works with your insurance →Free; manufacturer site; not an affiliate link
The cheapest way to actually fill Veozah (in the right order)
The cheapest path is almost never the lowest coupon you see first. Doing things in the right order can be the difference between $0 and $700.
Confirm the script is for Veozah / fezolinetant.
Names get garbled between office and pharmacy.
Pick your help based on your coverage.
Uninsured → patient assistance. Commercial insurance → savings card. Medicare or Medicaid → plan + Support Solutions.
Compare cash prices across GoodRx, SingleCare, Amazon Pharmacy, and your local pharmacy.
Only after step 2.
Ask for a 90-day quote too.
Sometimes it’s cheaper per month.
Confirm before every refill.
Prices and program terms change.
Script for the pharmacy counter:
“Can you run this three ways and tell me each price separately — through my insurance, with the manufacturer card if I’m eligible, and the cash price with this discount card? Please don’t combine programs unless the terms allow it.”
Pharmacies can do this. Asking gets you the real lowest number instead of whichever one pops up first.
The Veozah cash-pay map: find your situation
| Your situation | Likely monthly cost | Right program \u2713 / Won\u2019t help \u2717 | First action |
|---|---|---|---|
| No insurance | $566 list ($485–$778 cash) | ✓ Patient Assistance (may be $0) · ✗ the $30 savings card | Call Support Solutions before paying cash |
| Commercial insurance | ~$42 average | ✓ Savings card ($0 first month, ~$30 refills) · ✗ Patient Assistance | Check savings-card eligibility |
| Commercial plan denies the claim | Can revert to high cash | ✓ Call Support Solutions; ask doctor to appeal · ✗ assuming the card auto-covers it | Call Support Solutions + start an appeal |
| Medicare Part D | ~$55 average | ✓ Plan coverage + Extra Help if eligible ($12.65/brand drug in 2026) · ✗ the savings card | Check your plan’s formulary; ask about Extra Help |
| Medicaid | ~$2 average | ✓ State plan coverage · ✗ the savings card | Check your state’s formulary |
| Paying cash with a coupon | ~$485–$778 | ✓ A discount card (GoodRx/SingleCare) · ✗ stacking it with insurance or manufacturer card | Compare coupons after checking assistance |
| No prescriber / labs not set up | Drug cost is separate from visits + labs | ✓ A menopause clinician who’ll prescribe Veozah and track your labs · ✗ expecting a visit to lower the drug price | See clinician options below |
The hidden cost no one warns you about: required liver tests
Veozah comes with an FDA boxed warning (the agency’s most serious warning) for rare but serious liver injury, and the label requires liver blood tests before you start and again at months 1, 2, 3, 6, and 9.That’s six lab draws in your first year, plus the doctor visits to order and review them. Almost no “cost” page counts this — but it’s real money, and it’s not optional.
What the monitoring involves:
- A baseline liver blood test before your first dose
- Tests monthly for the first 3 months
- Tests again at month 6 and month 9
- Checks: ALT, AST (liver enzymes), bilirubin, alkaline phosphatase
Stop Veozah and call your prescriber if you notice:
- New tiredness or low appetite
- Nausea or vomiting
- Itching
- Yellowing of skin or eyes
- Pale stools or dark urine
- Belly pain
| Cost piece | First-year estimate | Notes |
|---|---|---|
| Veozah (12 months) | $0 → ~$9,300 | Depends entirely on your path above |
| Liver labs (6 draws) | Cost of 6 blood tests | Often covered by insurance; ask the cash price if not |
| Prescriber visits | Initial + follow-ups | A self-pay menopause visit can run $150–$250 |
| Realistic year-one total | Drug cost + labs + visits | Budget for all three, not just the pills |
Questions worth asking before you start:
- Are these liver labs covered by my plan?
- Can I use a Quest or Labcorp drop-in location?
- Who orders the repeat tests?
- What happens if a result comes back high?
Who should not take Veozah — even if the price works
Price isn’t the only question. Veozah is contraindicated (meaning it should not be used) for people with known cirrhosis, severe kidney problems or end-stage kidney disease, or anyone taking a CYP1A2 inhibitor. Use this quick check before you fill anything.
| If this applies to you | Why it matters | What to ask your prescriber |
|---|---|---|
| Known cirrhosis (serious liver scarring) | Veozah is contraindicated — the liver can’t clear it safely | “Is there an option that’s safer for my liver?” |
| Severe kidney problems / end-stage renal disease | Contraindicated | “Given my kidney function, is Veozah safe for me?” |
| Taking a CYP1A2 inhibitor (e.g., ciprofloxacin, cimetidine, fluvoxamine) | Can push Veozah levels too high — contraindicated | “Do any of my medicines or supplements interact with Veozah?” |
| Baseline ALT, AST, or bilirubin at 2× normal or higher | The label says don’t start Veozah | “Can we recheck my liver numbers before deciding?” |
| New liver-injury symptoms after starting | Could signal liver injury | “Should I stop and get a liver test now?” (FDA says stop and call right away) |
One nuance for breast cancer survivors: hormone therapy isn’t a fit for everyone, which is part of why non-hormonal options appeal. But Veozah has not been studied in people with breast cancer who are taking hormone-blocking therapy. A newer option, Lynkuet, has been (more on that below). That’s a real difference to raise with your doctor — not a reason to panic, just a reason to ask. See our full Veozah online guide.
What to do if your insurance says no
If your plan denies Veozah, don’t assume the first “no” is the final answer. First, find out why it was denied — the fix depends on the reason.
Prior-authorization checklist for your doctor’s office:
- Diagnosis: moderate-to-severe vasomotor symptoms (the medical term for hot flashes and night sweats) due to menopause
- Treatments you’ve already tried
- Any reason hormones aren’t an option for you
- How severe and frequent your symptoms are
- Your liver-test plan
Script to find out what’s wrong:
“Can you tell me the exact reason Veozah was denied — prior authorization, step therapy, formulary exclusion, or a pharmacy error? And what does my doctor need to send to fix it?”
Cheaper alternatives to Veozah for hot flashes
There are cheaper options — but they are not interchangeable, and the right one depends on your health history. The closest non-hormonal alternative is Lynkuet (elinzanetant), which can cost as little as $25/month with commercial insurance. Low-dose generic medicines used off-label, like paroxetine and venlafaxine, can cost as little as $4–$35/month. Don’t switch medicines on your own — bring this table to your prescriber.
| Option | FDA-approved? | Cost without insurance | Liver monitoring | Worth knowing |
|---|---|---|---|---|
| Veozah (fezolinetant) | Yes (2023) | ~$485–$778/mo; $0 possible with help | Yes — boxed warning; baseline + months 1,2,3,6,9 | First of its kind non-hormonal NK3 blocker |
| Lynkuet (elinzanetant) | Yes (Oct 2025) | List ~$625/mo; as low as $25/mo insured (via BlinkRx) | Baseline + 3 months only; no boxed warning | Studied in HR-positive breast cancer on hormone-blocking therapy; also improves sleep; not for use in pregnancy |
| Brisdelle (paroxetine 7.5 mg) | Yes | Brand-priced (example: ~$51 for 30) | No | Only FDA-approved low-dose paroxetine made for hot flashes |
| Off-label generics (paroxetine, venlafaxine, gabapentin) | No (off-label use) | Often $4–$35/mo with a discount card | No | Cheap, but off-label — your clinician decides fit |
| Menopausal hormone therapy (HRT) | Yes (for hot flashes) | Often low drug cost; see our HRT cost guide | No | Most effective per menopause specialists — but not safe for everyone |
You can read more in our guide to non-hormonal options for menopause and our 2026 HRT cost breakdown.
Not sure if Veozah, a cheaper drug, or HRT fits you?
Take our free 60-second matching quiz — we’ll flag non-hormonal options too.
Take the free matching quiz →How to get Veozah prescribed — and the labs managed — without the runaround
Veozah is prescription-only, and your prescriber has to order the required liver tests, so the practical hurdle isn’t just paying for it — it’s having a clinician who’ll prescribe it and track the monitoring. If your own doctor already does that, you’re set. If you don’t have one, a menopause-focused telehealth provider can step in. Midi Healthis the option we’d point you to first, because Midi lists Veozah by name among the non-hormonal medicines it prescribes for hot flashes.
Why Midi fits this situation
- Midi lists Fezolinetant (VEOZAH®) by name under its non-hormonal prescriptions for hot flashes.
- Available in all 50 states.
- Self-pay: $250 first visit / $150 follow-ups; in-network with most major PPO plans (coverage varies).
- Generally uses Labcorp for bloodwork — handy, since Veozah needs liver tests tracked over your first year.
- Chief Clinical Officer Dr. Mindy Goldman is a nationally recognized expert in menopause care for women with a history of breast cancer.
“When I was diagnosed with triple negative breast cancer, it was so relieving for me to have Midi on my side, showing me I have options and helping me come up with solutions.”
Affiliate link · visit cost is separate from medication cost
| What Midi says | Status |
|---|---|
| Prescribes Veozah (fezolinetant) by name | Stated by Midi and confirmed on Midi’s site |
| Available in all 50 states | Stated by Midi |
| Self-pay $250 first visit / $150 follow-ups | Stated by Midi |
| Generally uses Labcorp for bloodwork | Stated by Midi |
| Can’t treat Medicaid / Medi-Cal, even self-pay | Stated by Midi — important limit |
| Not covered by Medicare (self-pay only, no claims) | Stated by Midi — important limit |
| Will prescribe Veozah to you specifically | Not guaranteed — the clinician decides after reviewing your history |
Two limits to know up front: Midi cannot treat Medicaid or Medi-Cal patients, even as self-pay, and it is not covered by Medicare(Medicare beneficiaries can be seen as self-pay, but can’t submit any claims). If that’s you, the patient assistance route plus a local in-network clinician is your better path.
A quick word on other telehealth names: Sesame offers lower-cost menopause visits and same-day prescriptions, which can work for getting an initial script — just confirm the clinician will also manage the ongoing liver monitoring. And to be straight with you: hormone-only providers aren’t the right call for a non-hormonal drug like Veozah, so we’re not steering you there on this page. See our Midi Health review for full details.
How we keep this page accurate
We built this page from primary sources: the drug maker’s official pricing and program terms, the FDA’s labeling and safety communications, public coupon tools for the cash-price range, and providers’ own pages.
What we verified ():
- Veozah list price for the uninsured: $566/month (Astellas)
- Average out-of-pocket: $42 commercial, $55 Medicare Part D, $2 Medicaid (Astellas-reported, patient data through early 2025)
- Savings-card terms: $0 first month, ~$30 refills, $4,000/year cap, the $1,250-over-two-months limit if a commercial claim isn’t approved, and the exclusion of cash-pay and government plans (Astellas)
- Patient Assistance: $0 Veozah for qualifying uninsured patients; 1-866-239-1637, Mon–Fri 8 a.m.–8 p.m. ET (Astellas / VEOZAH Support Solutions)
- Boxed warning and liver-test schedule: baseline, then months 1, 2, 3, 6, 9 (FDA Drug Safety Communication, Dec 16, 2024; FDA label)
- Contraindications: cirrhosis, severe renal impairment or end-stage renal disease, and CYP1A2 inhibitors (FDA label)
- Lynkuet: list price ~$625/month and ~$25/month insured via BlinkRx (Bayer; FDA approval Oct 24, 2025); OASIS-4 breast-cancer results (NEJM, 2025)
- Midi lists Fezolinetant (VEOZAH®) for hot flashes; pricing $250/$150; all 50 states; no Medicaid/Medi-Cal; not Medicare-covered (Midi Health)
Prices and policies change, and coupon prices vary by pharmacy and ZIP code. We re-verify on a set schedule — always confirm the live price before you fill.
Frequently asked questions about Veozah cost without insurance
- How much does Veozah cost without insurance?
- Without insurance, Veozah’s list price is about $566 a month, and public coupon prices range from roughly $485 to $778 a month. The exact amount depends on your pharmacy, the discount used, your ZIP code, and whether you qualify for manufacturer assistance.
- Can uninsured patients get Veozah for free?
- Yes — eligible uninsured patients can get Veozah at no cost through the Astellas Patient Assistance Program. Eligibility isn’t automatic, so call 1-866-239-1637 or apply through VEOZAH Support Solutions before paying a cash price.
- Can I use the Veozah Savings Card without insurance?
- Generally no. Astellas’s terms state the savings card is for eligible commercially insured patients and is not valid for cash-paying patients or for Medicare, Medicaid, or other government plans. Uninsured patients should use the patient assistance program instead.
- Is Veozah covered by Medicare?
- Sometimes. Astellas reports an average Medicare Part D cost of about $55/month, but coverage and restrictions vary by plan. Medicare patients cannot use the commercial savings card, but may qualify for the federal Extra Help subsidy, which caps covered brand-name drugs at $12.65 in 2026.
- Is Veozah covered by Medicaid?
- It depends on your state. Astellas reports an average Medicaid cost of about $2/month, but every state program is different. Medicaid patients also cannot use the commercial savings card.
- Is there a generic for Veozah?
- No. As of 2026, Veozah is brand-name only — there is no generic version, which is the main reason it’s expensive.
- Is Veozah the same as HRT?
- No. Veozah is a non-hormonal medicine for moderate-to-severe hot flashes and night sweats due to menopause. The FDA describes it as a neurokinin 3 (NK3) receptor antagonist — a pill that calms the brain signals behind hot flashes — not hormone therapy.
- Does Veozah require blood tests?
- Yes. The FDA label requires a liver blood test before you start and again at months 1, 2, 3, 6, and 9. Budget for those labs and the visits to order them as part of your real cost.
- What’s a cheaper alternative to Veozah?
- The closest non-hormonal alternative is Lynkuet (elinzanetant), as low as $25/month with commercial insurance. Low-dose paroxetine and venlafaxine used off-label can run $4–$35/month with a discount card, and hormone therapy is cheaper for people who can safely take it — all decisions for your clinician.
- Can an online menopause provider prescribe Veozah?
- Yes. Some telehealth menopause providers prescribe non-hormonal options. Midi Health lists Veozah by name among the medicines it prescribes for hot flashes. The clinician decides whether it’s right for you after reviewing your history.
- What if Veozah is still too expensive after everything?
- Ask your clinician about an insurance appeal, the patient assistance program, and cheaper non-hormonal or hormonal options. Don’t stop or switch medicines without medical guidance.
Still weighing your options?
Veozah can be reachable — sometimes free — once you know which path is yours. The hardest part is usually just figuring out where you fit.
Still not sure which menopause treatment is right for you?
Take our free 60-second matching quiz. We’ll point you toward hormonal and non-hormonal options based on your situation — and flag when something like Veozah, Lynkuet, or another path may make the most sense.
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