Does Molina cover GLP-1s in 2026?
It depends on your state. Molina's criteria call Wegovy and Zepbound a benefit exclusion, and the California and New Mexico member agreements write weight-loss coverage back in, California's only for class III obesity.
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Does Molina cover Wegovy and Zepbound?
No on most plans. California covers both drugs with prior authorization for severe obesity. New Mexico lists Zepbound with prior authorization, not Wegovy.
Not on a Molina marketplace plan in a state whose member agreement lists weight loss drugs as non-covered. Molina writes a criteria document for Wegovy and one for Zepbound, and neither of them holds a single clinical rule. Every field that would carry a BMI number, an age limit, a step therapy rule or an approval length reads N/A. In their place sits one sentence, calling the drug a benefit exclusion for all indications. That sentence names three uses inside the exclusion: to lower cardiovascular risk, to treat liver disease, and to treat sleep apnea. Both documents make the answer depend on the state. So we read four 2026 member agreements. Texas and Florida list weight loss drugs under Non-Covered Drugs, with no exception attached. California and New Mexico are the exceptions, and each one is written into that state's own member agreement.
Source: Molina Marketplace Texas 2026 Formulary, 161 pages, formulary introduction and the ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants section. Read August 15, 2026.
The full Molina policy on Wegovy and Zepbound has the BMI bar, the step-therapy rule and what happens at renewal.
Does Molina cover Ozempic?
Yes, with prior approval. Molina pays for Ozempic once your prescriber gets the plan to sign off.
Yes. On Molina's ACA Marketplace plans, Ozempic is covered for type 2 diabetes. Ozempic is semaglutide, and it is listed under GLP-1 receptor agonists on the drug list. Molina publishes a separate drug list in each state, so the tier and the cost share can differ. On the 2026 Texas and Washington lists we checked, it sits at tier 3, with step therapy and a quantity limit. So a member generally has to try a preferred diabetes drug first. The FDA approved Ozempic for type 2 diabetes only, and Molina does not cover it for weight loss. The weight-loss semaglutide is Wegovy. Neither Wegovy nor the other weight-loss GLP-1s are on the Marketplace drug list.
Source: Molina Healthcare of Texas Marketplace 2026 Formulary (List of Covered Drugs), current as of July 1, 2026. Read August 27, 2026.
The full Molina policy on Ozempic has the BMI bar, the step-therapy rule and what happens at renewal.
Does Molina cover Mounjaro?
Yes on some plans. Molina publishes a different drug list for each plan it sells, so two people with the same insurer can get different answers.
Molina covers Mounjaro for type 2 diabetes, the use the FDA approved. The plan has to sign off, and quantity limits apply. Molina runs a separate Marketplace drug list and a separate Medicaid drug list in each state. So the tier, any step-therapy rule, and the exact limits differ by plan and by location. Mounjaro is not covered for weight loss. That use belongs to Zepbound, which Molina lists in a separate anti-obesity section and restricts. Check the drug list for your own state plan before you count on coverage.
Source: Molina Healthcare of Michigan Preferred Drug List (Formulary), August 2026 to October 2026. Read August 27, 2026.
The full Molina policy on Mounjaro has the BMI bar, the step-therapy rule and what happens at renewal.
Every insurer we have read
This is reference information, not medical or legal advice, and not a guarantee of coverage. GLP-1 coverage policies change often. Always confirm the current policy with your insurer using the number on your card before you rely on this page. If your experience differs from what is shown here, email hello@glpchart.com with the details and we will re-verify.