New York Medicaid GLP-1 Coverage: Wegovy, Zepbound
Not for weight loss. New York Medicaid covers GLP-1s only for type 2 diabetes and other approved uses. New York Medicaid does not cover GLP-1s for weight loss. GLP-1s are covered for type 2 diabetes and other approved uses, usually with prior authorization.
- For weight loss
- Not covered
- For type 2 diabetes
- Covered
- Weight loss, KFF survey January 2026
- Not covered
Does New York Medicaid cover GLP-1s?
- New York is among the 41 Medicaid programs, including DC, where GLP-1s used for weight loss have no coverage at present; 10 programs do cover them.
- The January 2026 findings showed that state Medicaid programs covered weight-loss GLP-1s in 13 cases across the US.
The drugs: Wegovy, Zepbound, Ozempic, and Mounjaro
| Medicine | Main use | In New York Medicaid | Every state |
|---|---|---|---|
 Wegovy | Weight loss | Not covered | Wegovy and Medicaid |
 Zepbound | Weight loss | Not covered | Zepbound and Medicaid |
 Foundayo | Weight loss | Not covered | Not listed |
 Saxenda | Weight loss | Not covered | 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 and requirements
- State-run Medicaid programs often require prior authorization for GLP-1s, according to
- For diabetes, the records are your diagnosis and recent A1C. For weight loss where it is covered, you need your measured BMI and weight-related conditions.
- Who sends it: Your prescriber submits the request to your Medicaid plan.
Source: KFF.
How to check your plan
- Look for the drug on the state's list: New York Medicaid drug list.
- Your Medicaid may be managed by a managed care plan. If so, call the member number on your card and ask whether prior authorization is required for the drug.
- Preferred drugs receive approval faster, so ask your prescriber which GLP-1 is preferred.
- Save the approval or denial notice. It gives the rule that applies to your case.
Which brand pages apply in New York?
- 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 New York Medicaid says no
- If the rules show that you qualify for a drug but your plan denies it, ask for a state fair hearing.
- With Medicaid, you cannot use manufacturer savings cards: those cards' terms exclude government plans.
Sources: foundayo.lilly.com, TrumpRx, NovoCare, CMS.