Does Medicaid Cover Semaglutide? Wegovy and Ozempic by State
Every state Medicaid program covers GLP-1s for type 2 diabetes. For weight loss, 10 states cover them as of November 2026, most with prior authorization.
- States covering weight loss
- 10
- Covered for type 2 diabetes
- Every state
- States covering in January 2026
- 13
- Prior authorization
- Typical
Wegovy in brief
Half-life about 1 week: after 7 d, half is gone; five half-lives (35 d) leave about 3%.
In STEP 1 over 68 weeks, 14.9% of body weight came off, against 2.4% on placebo.
The maker's price page lists monthly prices in US dollars, including the list price and self-pay offers.
Sources: FDA label (DailyMed), healthsystemtracker.org, prnewswire.com 1 2.
Does Medicaid cover semaglutide?
| Medicine | Approved for | Medicaid covers it in | More |
|---|---|---|---|
 Ozempic | Type 2 diabetes, heart risk, and kidney disease that occurs in people with type 2 diabetes | Every state | By state |
 Wegovy | Weight loss, heart risk and MASH liver disease | 10 states | By state |
 Rybelsus | Type 2 diabetes and heart risk | Every state | By state |
Right now, weight-loss GLP-1s are covered in these states: Delaware, Kansas, Michigan, Minnesota, Mississippi, Missouri, North Carolina, Tennessee, Virginia, Wisconsin.
Sources: Novo Nordisk pricing, NovoCare, TrumpRx, rx.costco.com.
The published policy
- Yes, coverage is required for diabetes GLP-1s
- In October 2025, 16 states had coverage for weight loss
- In January 2026, 13 states had coverage for weight loss
- You must get prior authorization
- Changes in 2026:
- Since January 2026, Michigan has had coverage under tighter rules (effective January 1, 2026)
- Pennsylvania's coverage ended during January 2026, with an effective date of January 1, 2026
- Utah's pilot ended during June 2026, with an effective date of June 30, 2026
- Wisconsin: Prior authorization is needed for coverage (starting July 1, 2026)
- Massachusetts: coverage ended during July 2026, and the change took effect July 3, 2026
- Rhode Island: The end came in October 2026, with an effective date of October 1, 2026
Read the policy itself: KFF.
Sources: KFF, michigan.gov, pa.gov, medicaid-documents.dhhs.utah.gov.
Prior approval checklist
- You must get prior authorization
- Records needed: your measured height and weight, weight-related conditions, and the diet and activity program that you tried.
- The prior authorization is filed by your prescriber, not by you.
Source: KFF.
If you are denied: how to appeal
| Denial reason | What to send or ask |
|---|---|
| Criteria not met | Ask your prescriber to send it again, adding your measured BMI and every weight-related condition listed in your chart |
| The drug is not on the plan's list | Ask for a formulary exception. Also ask which GLP-1 your plan prefers instead. |
- Get the notice of denial from your Medicaid plan; it shows which rule was not met.
- Your prescriber can use chart notes to file the prior authorization again.
- You may ask for a state fair hearing when the plan still denies the request.
State and plan variation
| State | For weight loss | For type 2 diabetes | Prior authorization |
|---|---|---|---|
| Alabama | Not covered | Covered | Not listed |
| Alaska | Not covered | Covered | Not listed |
| Arizona | Not covered | Covered | Not listed |
| Arkansas | Not covered | Covered | Not listed |
| California | Ended January 2026 | Covered | Not listed |
| Colorado | Not covered | Covered | Not listed |
| Connecticut | Not covered | Covered | Not listed |
| Delaware | Covered with prior authorization | Covered | Required |
| District of Columbia | Not covered | Covered | Not listed |
| Florida | Not covered | Covered | Not listed |
| Georgia | Not covered | Covered | Not listed |
| Hawaii | Not covered | Covered | Not listed |
| Idaho | Not covered | Covered | Not listed |
| Illinois | Not covered | Covered | Not listed |
| Indiana | Joining BALANCE, start date not set | Covered | Not listed |
| Iowa | Not covered | Covered | Not listed |
| Kansas | Covered with prior authorization | Covered | Required |
| Kentucky | Not covered | Covered | Not listed |
| Louisiana | Not covered, law allows coverage from 2027 | Covered | Not listed |
| Maine | Not covered | Covered | Not listed |
| Maryland | Not covered | Covered | Not listed |
| Massachusetts | Ended July 2026 | Covered | Required |
| Michigan | Covered, tighter rules since January 2026 | Covered | Required |
| Minnesota | Covered with prior authorization | Covered | Required |
| Mississippi | Covered | Covered | Not listed |
| Missouri | Covered with prior authorization | Covered | Required |
| Montana | Not covered | Covered | Not listed |
| Nebraska | Not covered | Covered | Not listed |
| Nevada | Not covered | Covered | Not listed |
| New Hampshire | Ended January 2026 | Covered | Not listed |
| New Jersey | Not covered | Covered | Not listed |
| New Mexico | Not covered | Covered | Not listed |
| New York | Not covered | Covered | Not listed |
| North Carolina | Covered with prior authorization | Covered | Required |
| North Dakota | Not covered | Covered | Not listed |
| Ohio | Not covered | Covered | Not listed |
| Oklahoma | Not covered | Covered | Not listed |
| Oregon | Not covered | Covered | Not listed |
| Pennsylvania | Ended January 2026 | Covered | Not listed |
| Rhode Island | Ended October 2026 | Covered | Required |
| South Carolina | Ended January 2026 | Covered | Not listed |
| South Dakota | Not covered | Covered | Not listed |
| Tennessee | Covered with prior authorization | Covered | Required |
| Texas | Not covered | Covered | Not listed |
| Utah | Pilot ended June 2026 | Covered | Required |
| Vermont | Not covered | Covered | Not listed |
| Virginia | Covered with strict service authorization | Covered | Required |
| Washington | Not covered | Covered | Not listed |
| West Virginia | Not covered | Covered | Not listed |
| Wisconsin | Covered with prior authorization | Covered | Required |
| Wyoming | Not covered | Covered | Not listed |
Sources: KFF, medicaidpublications.dhss.delaware.gov, events.in.gov, kdhe.ks.gov.
Other routes when coverage says no
Sources: Novo Nordisk pricing, NovoCare, TrumpRx, rx.costco.com.