South Carolina Medicaid GLP-1 Coverage: Wegovy, Zepbound
Not for weight loss. South Carolina Medicaid covers GLP-1s only for type 2 diabetes and other approved uses. South Carolina Medicaid stopped covering GLP-1s for weight loss in January 2026, a year after adding it. Diabetes use stays covered.
- For weight loss
- Ended January 2026
- For type 2 diabetes
- Covered
- Weight loss, KFF survey January 2026
- Not covered
Does South Carolina Medicaid cover GLP-1s?
- Right now, South Carolina is among the 41 Medicaid programs (counting DC) without coverage for GLP-1s used for weight loss; 10 cover them.
- In January 2026, coverage for GLP-1s used for weight loss was found in 13 state Medicaid programs across the US.
Sources: KFF.
Each drug on its own: Wegovy, Zepbound, Ozempic, Mounjaro
| Medicine | Main use | In South Carolina 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.
Rules covering prior authorization
- State Medicaid programs usually require prior authorization for GLP-1s
- For diabetes, you need records showing your diagnosis and recent A1C. For weight loss where covered: your measured BMI, along with weight-related conditions.
- Who submits it: Your Medicaid plan receives the request from your prescriber.
Source: KFF.
How to check your plan
- Look up the drug on the state's list: South Carolina Medicaid drug list.
- If your Medicaid is managed by a managed care plan, call the number on your member card. Ask if prior authorization is needed for the drug.
- Ask your prescriber which GLP-1 is preferred. Drugs that are preferred receive approval faster.
- Keep the approval or denial notice. It tells you which rule applies.
Which brand pages matter in South Carolina?
- 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
Upon a denial from South Carolina Medicaid
- Request a state fair hearing when your plan denies a drug for which you meet the rules.
- Manufacturer savings cards cannot be used with Medicaid, because their terms exclude government plans.
Sources: foundayo.lilly.com, TrumpRx, NovoCare, CMS.