Pennsylvania Medicaid GLP-1 Coverage: Wegovy, Zepbound

Does Pennsylvania Medicaid cover GLP-1s?

• Last change: January 1, 2026
• Other weight-loss drugs: Only non-GLP-1 weight-loss drugs are covered here
• Pennsylvania is among 41 Medicaid programs (counting DC) that offer no coverage of GLP-1s for weight loss today. 10 Medicaid programs do cover them.
• According to US reports, in January 2026, 13 state Medicaid programs had coverage for GLP-1s used for weight loss.

Sources: pa.gov, KFF 1 2.

A drug-by-drug look at Wegovy, Zepbound, Ozempic, and Mounjaro

GLP-1 drugs in Pennsylvania Medicaid

Medicine	Main use	In Pennsylvania 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: pa.gov.

Prior authorization rules

• For GLP-1s, State Medicaid programs usually require prior authorization
• Records: For diabetes, your records include a recent A1C and diagnosis. When weight loss is covered, you need your measured BMI and weight-related conditions.
• Who sends it: Your prescriber sends the request to your Medicaid plan.

Source: KFF.

How to check your plan

1. Check the drug on the state list: Pennsylvania Medicaid drug list
2. If a managed care plan runs your Medicaid, call the member number on your card.
3. A preferred drug is approved faster, so ask your prescriber which GLP-1 is preferred.
4. Save the approval or denial notice, because it tells you which rule applies.

Brand pages that apply in Pennsylvania

• 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 Pennsylvania Medicaid says no

• Request a state fair hearing when your plan rejects a drug for which you meet the rules.
• Manufacturer savings cards cannot be used with Medicaid.

If coverage says no

Medicine	Lowest self-pay	Manufacturer offer 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.