Does Medi-Cal Cover Ozempic? Rules, PA Criteria, Plans

Does California Medicaid cover GLP-1s?

• Right now, 41 Medicaid programs, including DC, do not cover GLP-1s for weight loss. California is one of them, while 10 programs offer coverage.
• As of January 2026, 13 state Medicaid programs covered GLP-1s for weight loss in the US, per.

Sources: KFF.

Wegovy, Zepbound, Ozempic, and Mounjaro: one at a time

GLP-1 drugs in California Medicaid

Medicine	Main use	In California Medicaid	Every state
Wegovy	Weight loss	Ended January 2026	Wegovy and Medicaid
Zepbound	Weight loss	Ended January 2026	Zepbound and Medicaid
Foundayo	Weight loss	Ended January 2026	Not listed
Saxenda	Weight loss	Ended January 2026	Saxenda and Medicaid
Ozempic	Type 2 diabetes	Covered for type 2 diabetes	Ozempic and Medicaid
Mounjaro	Type 2 diabetes	Covered for type 2 diabetes	Mounjaro and Medicaid
Rybelsus	Type 2 diabetes	Covered for type 2 diabetes	Rybelsus and Medicaid
Trulicity	Type 2 diabetes	Covered for type 2 diabetes	Trulicity and Medicaid
Victoza	Type 2 diabetes	Covered for type 2 diabetes	Victoza and Medicaid

Sources: KFF.

Prior authorization rules

• Reports say state Medicaid programs usually require prior authorization for GLP-1s
• Your diabetes records include a recent A1C and your diagnosis. Where weight loss coverage applies: your measured BMI and conditions tied to your weight.
• Your prescriber sends the request to your Medicaid plan.

Source: KFF.

How to check your plan

1. In the California Medicaid drug list, search for the drug.
2. If a managed care plan runs your Medicaid, use the member number on your card to call and ask whether the drug requires prior authorization.
3. Ask your prescriber which GLP-1 is preferred, since approval is faster for preferred drugs.
4. Save the notice you receive, whether approval or denial; it shows which rule applies to you.

California brand pages to use

• Does Medicaid Cover Wegovy? Criteria, Copay, How to Appeal
• Does Medicaid Cover Zepbound? State-by-State Coverage
• Does Medicaid Cover Saxenda? Criteria, Copay, How to Appeal
• Does Medicaid Cover Ozempic? Criteria, Copay, How to Appeal
• Does Medicaid Cover Mounjaro? State-by-State Rules and PA
• Does Medicaid Cover Rybelsus? Criteria, Copay, How to Appeal
• Does Medicaid Cover Trulicity? Criteria, Copay, How to Appeal
• Does Medicaid Cover Victoza? Criteria, Copay, How to Appeal
• Does Medicaid Cover GLP-1? Criteria, Copay, How to Appeal
• Medicare GLP-1 Coverage
• Is GLP-1 Covered by Insurance? Criteria, Copay, Appeal

If California Medicaid says no

• If you meet the rules for a drug but your plan denies it, ask the state for a fair hearing.
• Manufacturer savings cards cannot be used through Medicaid because their terms exclude government plans.

If coverage says no

Medicine	Lowest self-pay	The manufacturer's offer when your plan will not cover it
Wegovy	$149 a month	Not listed
Zepbound	$299 a month	$299 a month
Foundayo	$149 a month	Not listed

Sources: foundayo.lilly.com, TrumpRx, NovoCare, CMS.