Does MassHealth Cover Ozempic

Does Massachusetts Medicaid cover GLP-1s?

• Last change: July 3, 2026
• Counting DC, 41 Medicaid programs do not cover weight loss GLP-1s; Massachusetts is one of them, while 10 programs cover these drugs.
• In January 2026, it was reported that GLP-1s for weight loss were covered by 13 state Medicaid programs across the US.

Sources: mass.gov, KFF.

Mounjaro, Wegovy, Zepbound, Ozempic: each drug listed

GLP-1 drugs in Massachusetts Medicaid

Medicine	Main use	In Massachusetts Medicaid	Every state
Wegovy	Weight loss	Ended July 2026	Wegovy and Medicaid
Zepbound	Weight loss	Ended July 2026	Zepbound and Medicaid
Foundayo	Weight loss	Ended July 2026	Not listed
Saxenda	Weight loss	Ended July 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: mass.gov.

Prior authorization rules

• Other approved uses: heart disease and a BMI over 27, MASH, sleep apnea and a BMI over 30
• For diabetes, your records must include your diagnosis and recent A1C. For weight loss where covered, you need your measured BMI and weight-related conditions.
• The request goes from your prescriber to your Medicaid plan.

Source: mass.gov.

Steps for checking your plan

1. Look for the drug on the state's list: Massachusetts Medicaid drug list
2. If a managed care plan runs Medicaid for you, call the member number on your card.
3. Which GLP-1 is preferred? Ask your prescriber, because drugs that get preferred status are approved faster.
4. Hold on to the notice you get when your request is approved or denied. It tells you which rule applies in your case.

Massachusetts brand pages

• 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 Massachusetts Medicaid's answer is no

• When your plan denies a drug and you meet the rules for it, ask for a state fair hearing.
• Manufacturer savings cards cannot be used with Medicaid, because states say their terms exclude government plans.

If coverage says no

Medicine	Lowest self-pay	An offer from the manufacturer if your plan does 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.