Does Medicare cover Ozempic?

Medicare Part D covers Wegovy and Zepbound for weight loss starting July 1, 2026. Ozempic is only covered when prescribed for type 2 diabetes, not weight loss.

Which states cover GLP-1 on Medicaid?

Coverage varies by state. As of 2026, approximately 17 states plus DC provide Medicaid coverage for GLP-1 weight loss medications, with 23 states requiring prior authorization.

How do I get prior authorization for Wegovy?

Your prescribing doctor submits a prior authorization request to your insurance plan, typically including your BMI, previous weight loss attempts, and any weight-related health conditions.

What if my insurance denies GLP-1 coverage?

You can appeal the denial through your insurance company's appeals process. Ask your doctor to write a letter of medical necessity explaining why GLP-1 treatment is appropriate for you.

Does Insurance Cover GLP-1 Medication?

A complete guide to Medicare, Medicaid, and private insurance coverage for GLP-1 weight loss medications in 2026. Find out what your plan covers and how to get approved.

Last updated: April 2026

Couple reviewing health insurance coverage options together

Medicare Part D Now Covers GLP-1 Medications

For the first time, Medicare Part D will cover anti-obesity medications for weight loss. This is a major shift that makes GLP-1 treatment accessible to millions of Medicare beneficiaries.

Starting July 1, 2026

Coverage begins mid-year for all Medicare Part D plans nationwide

$50/Month Copay

Maximum out-of-pocket cost for covered GLP-1 medications under Part D

Wegovy & Zepbound Covered

Both semaglutide (Wegovy) and tirzepatide (Zepbound) are included

BMI 30+ or 27+ with Comorbidities

Eligibility requires BMI of 30 or higher, or 27+ with weight-related conditions

How to Get Medicare Part D Coverage

Confirm you have Part D coverage

Check your Medicare card or call 1-800-MEDICARE to verify your Part D enrollment. Medicare Advantage plans with drug coverage (MA-PD) also qualify.

Ask your doctor about anti-obesity medication

Schedule an appointment with your primary care provider or a weight management specialist. They will evaluate whether a GLP-1 medication is appropriate based on your BMI and health history.

Your doctor contacts your Part D plan for coverage

Your prescribing physician submits the prescription and any required prior authorization to your Part D plan. Once approved, you can fill your prescription at a participating pharmacy.

State-by-State Medicaid Coverage

Medicaid coverage for GLP-1 weight loss medications varies significantly by state. Some states cover these medications for obesity treatment, while others limit coverage to Type 2 diabetes only. Use the filters below to find your state.

Find your state

Showing 51 of 51 states & territories

Medicaid GLP-1 coverage status by state. Select a row to view detailed coverage notes.
State	Status	Notes
	Not Covered	Alabama Medicaid does not cover GLP-1 medications for obesity; coverage is limited to Type 2 diabetes management with strict criteria.
	Prior Authorization Required	Denali KidCare and Alaska Medicaid cover GLP-1 drugs for Type 2 diabetes with prior authorization, but obesity coverage remains limited.
	Prior Authorization Required	Arizona Health Care Cost Containment System (AHCCCS) covers GLP-1 agonists for diabetes with prior authorization; weight-loss indications require additional review.
	Not Covered	Arkansas Medicaid covers GLP-1 medications only for Type 2 diabetes management and does not provide coverage for obesity treatment.
	Covered	Medi-Cal covers GLP-1 medications including semaglutide for both Type 2 diabetes and obesity treatment, with prior authorization required for weight management indications.
	Covered	Colorado Medicaid (Health First Colorado) covers GLP-1 agonists for eligible members with Type 2 diabetes and obesity, subject to prior authorization and BMI criteria.
	Covered	HUSKY Health (Connecticut Medicaid) covers GLP-1 medications for diabetes and has expanded coverage for obesity treatment with prior authorization requirements.
	Prior Authorization Required	Delaware Medicaid covers GLP-1 agonists for Type 2 diabetes with prior authorization; obesity-specific coverage requires documentation of comorbidities.
	Covered	DC Medicaid covers GLP-1 medications for both diabetes and obesity management with prior authorization, reflecting the district's expanded Medicaid benefit package.
	Not Covered	Florida Medicaid (Statewide Medicaid Managed Care) does not cover GLP-1 drugs for weight loss; coverage is restricted to Type 2 diabetes with prior authorization.
	Not Covered	Georgia Medicaid covers GLP-1 agonists only for Type 2 diabetes management; the state has not expanded coverage to obesity treatment indications.
	Covered	Med-QUEST (Hawaii Medicaid) covers GLP-1 medications for diabetes and has provisions for obesity treatment coverage with prior authorization for qualifying members.
	Not Covered	Idaho Medicaid covers GLP-1 drugs for Type 2 diabetes only and does not currently extend coverage to obesity or weight management indications.
	Covered	Illinois Medicaid covers GLP-1 agonists for both Type 2 diabetes and obesity treatment, with prior authorization required and BMI thresholds for weight-loss indications.
	Prior Authorization Required	Indiana Medicaid (Healthy Indiana Plan) covers GLP-1 medications for diabetes with prior authorization; obesity coverage is limited and requires physician documentation.
	Prior Authorization Required	Iowa Medicaid covers GLP-1 agonists for Type 2 diabetes with prior authorization; weight management coverage is under ongoing review by the Iowa Department of Health and Human Services.
	Not Covered	KanCare (Kansas Medicaid) limits GLP-1 coverage to Type 2 diabetes management and does not include obesity as a covered indication.
	Prior Authorization Required	Kentucky Medicaid (Medicaid Managed Care) covers GLP-1 medications for diabetes with prior authorization; obesity coverage eligibility varies by managed care organization.
	Prior Authorization Required	Louisiana Medicaid covers GLP-1 drugs for Type 2 diabetes with prior authorization and is evaluating expanded coverage for obesity treatment given the state's high obesity rates.
	Covered	Maine Medicaid (MaineCare) covers GLP-1 agonists for both diabetes and obesity treatment with prior authorization following the state's full Medicaid expansion.
	Covered	Maryland Medicaid covers GLP-1 medications for Type 2 diabetes and has extended coverage to obesity treatment with prior authorization and BMI criteria.
	Covered	MassHealth covers GLP-1 agonists for both diabetes management and obesity treatment, making it one of the more comprehensive state Medicaid programs for weight-loss drugs.
	Prior Authorization Required	Michigan Medicaid (Healthy Michigan Plan) covers GLP-1 drugs for Type 2 diabetes with prior authorization; obesity coverage is available for members meeting specific BMI and comorbidity criteria.
	Covered	Minnesota Medical Assistance covers GLP-1 agonists for diabetes and has approved obesity treatment coverage with prior authorization for eligible enrollees.
	Not Covered	Mississippi Medicaid covers GLP-1 medications only for Type 2 diabetes; the state has not expanded Medicaid and does not cover these drugs for obesity treatment.
	Prior Authorization Required	Missouri HealthNet covers GLP-1 agonists for Type 2 diabetes with prior authorization; obesity coverage was not included following the state's 2021 Medicaid expansion.
	Prior Authorization Required	Montana Medicaid (Healthy Montana Kids Plus) covers GLP-1 medications for diabetes with prior authorization; obesity coverage is limited under the current benefit structure.
	Prior Authorization Required	Nebraska Medicaid covers GLP-1 drugs for Type 2 diabetes with prior authorization; obesity-specific coverage is not currently included in the Nebraska Heritage Health benefit package.
	Prior Authorization Required	Nevada Medicaid covers GLP-1 agonists for diabetes with prior authorization and is actively reviewing expanded obesity coverage following the state's full Medicaid expansion.
	Prior Authorization Required	NH Medicaid (Granite Advantage Health Care Program) covers GLP-1 medications for diabetes with prior authorization; obesity treatment coverage requires meeting clinical criteria.
	Covered	NJ FamilyCare covers GLP-1 agonists for both Type 2 diabetes and obesity, with prior authorization required and clinical criteria including BMI thresholds for weight-loss indications.
	Covered	New Mexico Medicaid (Centennial Care) covers GLP-1 medications for diabetes and obesity treatment with prior authorization for qualifying enrollees.
	Covered	New York Medicaid covers GLP-1 agonists including semaglutide for both diabetes and obesity treatment, with prior authorization required for weight management indications.
	Prior Authorization Required	NC Medicaid covers GLP-1 drugs for Type 2 diabetes with prior authorization; following the 2023 Medicaid expansion, the state is evaluating obesity treatment coverage.
	Prior Authorization Required	North Dakota Medicaid covers GLP-1 agonists for diabetes with prior authorization; obesity-specific coverage is not part of the current ND Medicaid benefit structure.
	Prior Authorization Required	Ohio Medicaid covers GLP-1 medications for Type 2 diabetes with prior authorization; obesity coverage is available under select managed care plans with clinical documentation.
	Prior Authorization Required	SoonerCare (Oklahoma Medicaid) covers GLP-1 agonists for diabetes with prior authorization following the state's 2021 Medicaid expansion; obesity coverage is limited.
	Covered	Oregon Health Plan covers GLP-1 medications for both Type 2 diabetes and obesity treatment, with prior authorization required and criteria based on BMI and comorbidities.
	Prior Authorization Required	Pennsylvania Medicaid (MA Program) covers GLP-1 agonists for diabetes with prior authorization; obesity treatment coverage eligibility depends on the managed care organization.
	Covered	Rhode Island Medicaid (Medicaid) covers GLP-1 medications for diabetes and obesity with prior authorization, reflecting the state's comprehensive Medicaid expansion benefit package.
	Not Covered	South Carolina Healthy Connections (Medicaid) covers GLP-1 drugs for Type 2 diabetes only and does not include obesity as a covered treatment indication.
	Prior Authorization Required	South Dakota Medicaid covers GLP-1 agonists for diabetes with prior authorization; obesity-specific coverage is not currently part of the state's Medicaid formulary.
	Not Covered	TennCare covers GLP-1 medications for Type 2 diabetes management only; obesity treatment is not a covered indication under the current TennCare benefit package.
	Not Covered	Texas Medicaid does not cover GLP-1 drugs for obesity; coverage is restricted to Type 2 diabetes with prior authorization, and the state has not expanded Medicaid.
	Prior Authorization Required	Utah Medicaid covers GLP-1 agonists for Type 2 diabetes with prior authorization; obesity coverage is limited under the state's partial Medicaid expansion (Utah Medicaid Expansion).
	Covered	Vermont Medicaid (Green Mountain Care) covers GLP-1 medications for both diabetes and obesity with prior authorization, consistent with the state's expansive Medicaid benefit philosophy.
	Prior Authorization Required	Virginia Medicaid (Cardinal Care) covers GLP-1 drugs for Type 2 diabetes with prior authorization; obesity coverage is available under select managed care plans following the 2019 Medicaid expansion.
	Covered	Apple Health (Washington Medicaid) covers GLP-1 agonists including semaglutide for both Type 2 diabetes and obesity treatment with prior authorization and clinical criteria.
	Prior Authorization Required	West Virginia Medicaid covers GLP-1 medications for diabetes with prior authorization; obesity coverage is under review given the state's high rates of obesity and diabetes.
	Prior Authorization Required	BadgerCare Plus (Wisconsin Medicaid) covers GLP-1 agonists for Type 2 diabetes with prior authorization; obesity-specific coverage is not included in the current benefit structure.
	Not Covered	Wyoming Medicaid covers GLP-1 drugs for Type 2 diabetes management only; the state has not expanded Medicaid and does not cover these medications for obesity treatment.

State-Level Coverage Guides

Detailed GLP-1 insurance coverage breakdowns for each state, including Medicaid rules, private carrier stances, and local provider availability.

Private Insurance Coverage

Most major private insurance carriers cover GLP-1 medications for Type 2 diabetes, and an increasing number now cover weight loss indications. Coverage varies by plan and employer, so check with your specific carrier for details.

Aetna

Aetna covers GLP-1 medications for Type 2 diabetes on most plans. Weight loss coverage varies by employer-sponsored plan and typically requires prior authorization with documented BMI criteria.