Virginia Medicaid GLP-1 Coverage: Wegovy, Zepbound
Yes. Virginia Medicaid covers GLP-1s for weight loss with prior authorization. Virginia Medicaid covers weight-loss GLP-1s only with service authorization: BMI 40 or more, or 35 or more with two chronic conditions, after trying a non-GLP-1 drug.
- For weight loss
- Covered with strict service authorization
- For type 2 diabetes
- Covered
- Prior authorization
- Required
- Weight loss, KFF survey January 2026
- Covered
Does Virginia Medicaid cover GLP-1s?
- Virginia is now among the 10 states where GLP-1s are covered for weight loss.
- Coverage for GLP-1s used for weight loss was reported across the US at 13 state Medicaid programs in January 2026.
Sources: KFF 1 2, vamedicaid.dmas.virginia.gov.
Every drug on this list: Wegovy, Zepbound, Ozempic, Mounjaro
| Medicine | Main use | In Virginia Medicaid | Every state |
|---|---|---|---|
 Wegovy | Weight loss | Covered with strict service authorization | Wegovy and Medicaid |
 Zepbound | Weight loss | Covered with strict service authorization | Zepbound and Medicaid |
 Foundayo | Weight loss | Covered with strict service authorization | Not listed |
 Saxenda | Weight loss | Covered with strict service authorization | 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
- Weight rule: a BMI of 40 or higher, or 35 when you have two chronic conditions
- Step therapy: Non-GLP-1 drug first
- Your diabetes records consist of your diagnosis and your recent A1C. Your measured BMI and weight-related conditions appear in the records when weight loss is covered.
- Your prescriber files the request with your Medicaid plan.
Source: vamedicaid.dmas.virginia.gov.
Check your plan
- Look for the drug on Virginia Medicaid's state drug list.
- When a managed care plan runs your Medicaid, call the member number on your card and ask whether the drug needs prior authorization.
- Since drugs with preferred status are approved faster, ask your prescriber which GLP-1 has that status.
- Save the notice you get about approval or denial. It shows which rule applies to you.
Which brand pages apply in Virginia
- 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 Virginia Medicaid says no
- Ask for a state fair hearing if your plan turns down a drug you qualify for.
- With Medicaid, manufacturer savings cards are not allowed because their terms exclude government plans.
Sources: foundayo.lilly.com, TrumpRx, NovoCare, CMS.