The first thing most patients see when they look up CGRP medications is the list price. Aimovig: $700 per month. Ajovy: $680 per month. Emgality: $690 per month. Vyepti: $1,400 per infusion.
These numbers are alarming, and they cause a lot of patients to conclude that CGRP therapy is out of reach. That conclusion is usually wrong — but reaching the real price requires understanding how the system actually works.
What commercially insured patients actually pay
For patients with commercial (employer-sponsored or marketplace) insurance, the real-world cost of CGRP medications after proper insurance coordination is typically $0–5 per month.
Here's how that math works:
Step 1: Insurance coverage with prior authorization. Commercial insurance plans cover CGRP biologics, but almost all require prior authorization first. Once PA is approved, insurance pays the bulk of the list price — bringing the patient's responsibility down to their plan's copay or coinsurance, which is typically $30-100 per month for specialty medications.
Step 2: Manufacturer savings cards. Every major CGRP manufacturer — AbbVie (Ubrelvy), Eli Lilly (Emgality), Amgen (Aimovig), Teva (Ajovy), Lundbeck (Vyepti) — offers a savings card or copay assistance program for commercially insured patients. These programs cover the remaining copay after insurance, bringing the patient's total out-of-pocket to $0-5 per month.
The savings cards are legitimate manufacturer programs designed to reduce barriers to access. They're not tricks or fine-print traps. They work consistently for commercially insured patients.
The catch: getting from list price to $0-5 requires successfully completing prior authorization AND enrolling in the manufacturer savings program. Each of these steps has its own friction, paperwork, and follow-up. Most patients who are told they'll pay $0-5 never actually get there because the process breaks down somewhere in between.
This coordination is one of the core things Wellday handles.
What Medicare and Medicaid patients pay
If you have Medicare or Medicaid, the picture is more complicated.
Medicare Part D covers CGRP medications, but manufacturer savings cards do not work with Medicare. Copays under Part D vary by plan and formulary tier — some plans cover CGRP biologics at a low tier with manageable copays; others put them on high tiers with significant cost-sharing. The Medicare Extra Help program can assist low-income patients.
Medicaid coverage varies significantly by state. Some state Medicaid programs cover CGRP biologics with minimal barriers; others require step therapy through multiple traditional medications first.
If you have Medicare or Medicaid, the conversation with your clinician should include a specific assessment of your plan's coverage and what assistance programs might apply to your situation.
What cash-pay patients pay
For patients without insurance, or with insurance that won't cover CGRP medications, cash-pay options exist but are more expensive.
Some manufacturers offer patient assistance programs (PAPs) for uninsured or underinsured patients. Eligibility is typically income-based. AbbVie, Amgen, Eli Lilly, and Teva all have PAPs — the specific programs and eligibility criteria change, so checking directly with the manufacturer is the best approach.
GoodRx and similar discount programs offer some reduction from list price for generic medications, but CGRP biologics are still under patent and discounts are minimal.
For cash-pay patients, oral gepants (Ubrelvy, Nurtec) are sometimes more accessible than injectable biologics. Older preventive medications — topiramate, propranolol, amitriptyline — are generic and inexpensive, though with different efficacy and side effect profiles.
The real cost of not getting treatment
There's another cost worth naming: the cost of undertreated migraine.
Chronic migraine patients miss an average of 4+ workdays per month. Episodic patients lose significant productivity during attacks. Emergency room visits for severe migraines can cost thousands of dollars. The indirect economic cost of migraine in the US is estimated at over $36 billion annually.
For patients who would benefit from CGRP therapy and have commercial insurance, the actual out-of-pocket cost is typically less than a streaming subscription. The barrier isn't price — it's the friction of getting through prior authorization and savings card enrollment.
What Wellday's services cost
Wellday's cost is separate from medication cost:
- Building your migraine profile: Free
- Clinical consultation and care plan: $119 (one-time)
- Wellday Relief (occasional migraines): $19/month
- Wellday Prevention (frequent migraines): $69/month
Your medication is handled separately through your pharmacy and insurance. For most commercially insured patients, CGRP medication adds $0-5 per month on top of your Wellday subscription after we coordinate prior authorization and savings card enrollment.
If you want to understand what your specific situation would look like, build your free migraine profile — it's free, takes five minutes, and tells you exactly what to expect before you commit to anything.