Medicaid GLP-1 coverage by state, 2026.
All 51 state Medicaid programs pay for a GLP-1 if you have type 2 diabetes, and only 19 pay for one to treat obesity, as of July 20, 2026. Every one of those 19 attaches conditions. Prior authorization, always. Find your state in the table.
The table below covers all 50 states and DC. Wegovy and Zepbound are listed separately because states treat them differently: a state can cover one and exclude the other. Click any state name for the full prior-authorization criteria, formulary position, and MCO details.
| State | Wegovy (obesity) | Zepbound (obesity) | Diabetes | BMI | Notes |
|---|---|---|---|---|---|
| Alabama | No | No | Yes | not published | Alabama Medicaid operates as fee-for-service with no MCO contracts for the general adult population. The state PDL excludes weight-loss GLP-1. Diabetes-indicated Ozempic and Mounjaro are covered with prior authorization and A1c documentation. |
| Alaska | No | No | Yes | not published | Alaska Medicaid is fee-for-service statewide with no contracted MCOs. The PDL follows the federal weight-loss exclusion. Diabetes coverage with PA is standard. |
| Arizona | No | No | Yes | not published | AHCCCS (Arizona's Medicaid program) does not cover GLP-1 for weight loss. Diabetes coverage requires PA with A1c threshold and prior trial of metformin. MCOs follow the AHCCCS PDL. |
| Arkansas | No | No | Yes | not published | Arkansas Medicaid is primarily fee-for-service with a PASSE program for high-need populations. The state PDL excludes weight-loss medications. T2D coverage requires PA with documented A1c. |
| California | No | Limited | Yes | not published | Adults lost weight-loss coverage on January 1, 2026: Medi-Cal Rx ended Wegovy, Zepbound and Saxenda for weight loss only, and prior approvals expired December 31, 2025. Coverage continues for members under 21 (EPSDT) and for cardiovascular, diabetes and MASH (a fatty liver disease) uses with prior authorization. |
| Colorado | No | No | Yes | not published | Colorado Health First (Medicaid) operates through Regional Accountable Entities rather than traditional MCOs. The state PDL does not include weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Connecticut | No | Limited | Yes | not published | Connecticut Medicaid (HUSKY Health) does not cover GLP-1s for weight loss on its own. It does cover them for four other reasons. Wegovy is covered to cut heart attack and stroke risk, and for MASH, a fatty liver disease. Zepbound is covered for moderate to severe sleep apnea, which means your sleep study scored 15 or higher and you are already on a CPAP machine. That one has been in place since July 1, 2025. Type 2 diabetes is the fourth route. All four need your doctor to get approval first. That is the prior authorization step. |
| Delaware | Limited | Limited | Yes | 30 + comorbidity | Delaware Medicaid covers Wegovy and Zepbound for weight loss. The state drug list effective July 6, 2026 puts both on the approved side at BMI 30 or higher with a weight-related condition. Your doctor has to get approval first. That request is called a prior authorization. Delaware runs Medicaid through private health plans, and each one words the rules a little differently. Call the number on your insurance card and ask for the exact criteria. |
| District of Columbia | No | No | Yes | not published | DC Medicaid excludes weight-loss drugs from its preferred drug list, so Wegovy and Zepbound are not covered for weight loss. GLP-1s for diabetes are covered: Ozempic and Trulicity are preferred, and some others need prior authorization (your doctor asks the plan to approve it first). |
| Florida | No | No | Yes | not published | Florida Medicaid does not cover GLP-1 for weight loss. Diabetes-indicated GLP-1 requires PA with documented step therapy through metformin and a sulfonylurea on most MCO formularies. PA denials are common. |
| Georgia | No | No | Yes | not published | Georgia Medicaid (through the Georgia Families MCOs) excludes weight-loss GLP-1 per the state PDL. Diabetes coverage requires PA with A1c at least 7.5 percent and documented metformin trial. |
| Hawaii | No | No | Yes | not published | Hawaii Med-QUEST follows the standard exclusion of weight-loss GLP-1. Diabetes coverage with PA is standard across the QUEST Integration MCOs. |
| Idaho | No | No | Yes | not published | Idaho Medicaid is primarily fee-for-service. Weight-loss GLP-1 is excluded. Diabetes coverage requires PA with A1c documentation. |
| Illinois | No | No | Yes | not published | Illinois Medicaid does not cover GLP-1s for weight loss. The state drug list effective July 1, 2026 has none on it. The Medicaid health plans exclude them too. If you read that Illinois added coverage in 2024, that was the state employee plan. Different program, easy to mix up. Type 2 diabetes is the one path still open. Ozempic and Mounjaro get covered there, but your doctor has to get the plan to approve it first. That step is called prior authorization. |
| Indiana | No | No | Yes | not published | Indiana Medicaid (Hoosier Healthwise and Healthy Indiana Plan) excludes weight-loss GLP-1. Diabetes coverage requires PA with step therapy through metformin. |
| Iowa | No | No | Yes | not published | Iowa Health Link MCOs follow the state PDL exclusion of weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Kansas | Limited | Limited | Yes | 30 | KanCare, which is Kansas Medicaid, covers Wegovy, Zepbound and Saxenda for weight management. The number that matters is BMI 30. Kansas pulled Zepbound (April 2024) and Wegovy (June 2025) out of its stricter BMI 40 review, so 30 is the bar for both. Your doctor has to get KanCare to approve it first. That is what prior authorization means. The same applies to a GLP-1 for type 2 diabetes. |
| Kentucky | No | No | Yes | not published | Kentucky Medicaid follows the standard weight-loss exclusion. Diabetes coverage with PA is standard across the six contracted MCOs. |
| Louisiana | No | No | Yes | not published | Healthy Louisiana MCOs follow the state PDL exclusion of weight-loss GLP-1. Diabetes coverage requires PA with documented step therapy. |
| Maine | No | Limited | Yes | not published | MaineCare does not cover Wegovy for weight loss alone. It is covered for heart protection: BMI over 27 plus a prior heart attack, stroke or symptomatic peripheral artery disease (poor leg circulation), and the request must not be for weight loss only (PDL effective January 1, 2026). Zepbound is covered only for obstructive sleep apnea. |
| Maryland | No | Limited | Yes | not published | Maryland Medicaid states plainly that Wegovy is not covered when the only indication is chronic weight management (transmittal PT 35-25, effective September 15, 2024). It is covered for adults 18 and over with established cardiovascular disease who are overweight or obese and do not have diabetes. MCOs must follow the same criteria. |
| Massachusetts | No | No | Yes | not published | MassHealth ended coverage of weight-loss drugs on July 3, 2026 (Pharmacy Facts 271): Wegovy, Zepbound and Saxenda are no longer covered for obesity or overweight. GLP-1s remain covered for heart protection (BMI over 27 with established cardiovascular disease), MASH (a fatty liver disease) and sleep apnea (BMI over 30). |
| Michigan | Limited | Limited | Yes | 40 | Michigan Medicaid covers Wegovy and Zepbound for weight loss, but it tightened the rules twice, on January 1, 2026 and again on July 1, 2026. Your doctor has to get approval before you start, the step known as prior authorization. You now need a starting BMI of 40 or higher. You also have to try five other weight-loss drugs on the state's list and have them fail. That is the slow part, so ask your doctor to start it early. |
| Minnesota | Limited | Limited | Yes | 30 alone, or 27 with a comorbidity | Minnesota Medicaid covers Wegovy and Saxenda for weight loss at BMI 30 or higher. Zepbound is covered too, but it is nonpreferred, so the plan will want you to try Wegovy or Saxenda first. Either way your doctor has to ask the plan to approve it first. That is prior authorization. Same goes for the diabetes drugs. |
| Mississippi | Limited | Limited | Yes | 30 | Mississippi Medicaid covers GLP-1s for weight loss. This is new. Coverage started July 1, 2026. The drug list updated July 16, 2026 approves Zepbound, Foundayo, Wegovy and Saxenda at BMI 30 or higher. Your doctor has to get the plan to sign off first. That request is the prior authorization. |
| Missouri | No | Limited | Yes | 30 | MO HealthNet does not cover Wegovy for weight loss. Its own prior-authorization form (2575-053, April 2026) says so outright. Zepbound is a different story. It is covered for weight management at BMI 30, or 27 with a weight-related condition like high blood pressure. Your doctor has to get the plan to sign off first, which is what prior authorization means. So in Missouri, Zepbound is the GLP-1 to ask your doctor about. |
| Montana | No | No | Yes | not published | Montana Medicaid operates primarily as fee-for-service. The PDL excludes weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Nebraska | No | No | Yes | not published | Nebraska Heritage Health MCOs follow the state PDL exclusion of weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Nevada | No | No | Yes | not published | Nevada Medicaid (Nevada Check Up and the contracted MCOs) follows the standard weight-loss exclusion. Diabetes coverage with PA is standard. |
| New Hampshire | No | Limited | Yes | not published | New Hampshire Medicaid stopped covering GLP-1s prescribed solely for weight loss on January 1, 2026 (DHHS notice, October 9, 2025): Saxenda, Wegovy and Zepbound are named. Coverage continues for diabetes, heart protection, severe sleep apnea and MASH (a fatty liver disease). |
| New Jersey | No | Limited | Yes | not published | NJ FamilyCare covers GLP-1s only for FDA-approved uses other than weight loss: Wegovy for cardiovascular disease, Zepbound for sleep apnea, plus pediatric EPSDT cases. A weight-loss expansion exists only as a state budget study so far. |
| New Mexico | No | No | Yes | not published | New Mexico Turquoise Care MCOs follow the state PDL exclusion of weight-loss GLP-1. The state PDL committee has reviewed the question but has not added obesity coverage. Diabetes coverage with PA is standard. |
| New York | No | No | Yes | not published | New York Medicaid (NYRx) does not cover GLP-1s for weight loss alone. State law does not let Medicaid pay for a drug whose only job is weight loss. Two narrow exceptions sit on the drug list revised July 16, 2026. Wegovy if you have diagnosed heart disease. Zepbound if you have diagnosed sleep apnea. Both need a BMI of 40, and New York allows only two rounds of treatment in your lifetime. Obesity on its own does not qualify at any BMI. If you were denied, an appeal is the realistic next move. |
| North Carolina | Limited | Limited | Yes | 30 | NC Medicaid covers Wegovy and Zepbound for weight loss at BMI 30 or higher. You do not need a second condition on top of the weight, which most states do require. Your doctor files for approval first. That filing is the prior authorization. One caution. The state cut this coverage in October 2025 and put it back on December 12, 2025. The agency did that on its own and no law locks it in, so it can move again. Ask your plan to confirm before you count on it long term. |
| North Dakota | No | No | Yes | not published | North Dakota Medicaid is primarily fee-for-service with a single MCO partner for Medicaid Expansion. The PDL excludes weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Ohio | No | No | Yes | not published | Ohio Medicaid Next Generation MCOs follow the state PDL exclusion of weight-loss GLP-1. Diabetes coverage requires PA with step therapy through metformin. |
| Oklahoma | No | No | Yes | not published | Oklahoma SoonerSelect MCOs follow the state PDL exclusion of weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Oregon | No | Limited | Yes | not published | The Oregon Health Plan does not cover GLP-1s for weight loss in adults. Wegovy is covered only for heart protection (established cardiovascular disease) and Zepbound only for sleep apnea (BMI 30 or higher). MASH, a fatty liver disease, is also a covered use. Children under 21 may qualify case by case (EPSDT). |
| Pennsylvania | No | Limited | Yes | not published | Pennsylvania Medicaid stopped covering GLP-1s for overweight and obesity on January 1, 2026 (MA Bulletin, November 24, 2025). Prior approvals ended December 31, 2025. Coverage continues with prior authorization for sleep apnea (BMI 35 or higher), heart protection (BMI 27 or higher with cardiovascular disease) and MASH, a fatty liver disease. |
| Rhode Island | Limited | Limited | Yes | not published | Rhode Island Medicaid covers GLP-1s for weight loss until October 1, 2026. After that date it stops. The cut is in the state budget the governor already signed. This is not a proposal that might fall through. If you are on a GLP-1 right now, use the weeks before October to plan. Ask your doctor what happens to your prescription on October 1, and whether type 2 diabetes on your chart would keep you covered. If not, the cash-pay options below start around $149 a month. |
| South Carolina | No | No | Yes | not published | South Carolina Medicaid does not cover GLP-1s for weight loss. It did for 14 months. Wegovy and Saxenda were covered starting November 1, 2024 and dropped on January 1, 2026. The state drug list effective July 1, 2026 has no weight-loss GLP-1 on it. If you have type 2 diabetes, that path is still covered, and your doctor gets it approved through prior authorization. |
| South Dakota | No | No | Yes | not published | South Dakota Medicaid is fee-for-service. The PDL excludes weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Tennessee | Limited | Limited | Yes | 30 | TennCare, which is Tennessee Medicaid, covers Wegovy and Zepbound for weight loss, and it survived the July 2026 budget. Your doctor files for approval first, the step called prior authorization. Two rules catch people out. You have to be 21 or older, where most states say 18, and children qualify only if the drug's label covers their age. Your first approval runs three months, a limit that started January 1, 2026. Since December 2025 you can be on just one GLP-1 at a time. |
| Texas | No | No | Yes | not published | Texas Medicaid follows the federal restriction on weight-loss medications and does not cover Wegovy or Zepbound. The diabetes indication is the practical path: Ozempic and Mounjaro require PA with A1c at least 7.5 percent and documented metformin trial. Texas STAR MCOs follow the state PDL. |
| Utah | No | No | Yes | not published | Utah Medicaid stopped covering GLP-1s for weight loss on June 30, 2026. A one-year pilot ran July 1, 2025 through June 30, 2026, funded by an appropriation rather than standing law, and it was not renewed. It also only ever applied to fee-for-service members, so anyone in a managed-care plan (Molina, SelectHealth, Healthy U, Health Choice) never had it. Utah's prior-authorization form was renamed 'GLP-1 Medications for Weight-related Comorbidities' on June 1, 2026 and the obesity approval criteria were removed, so there is no approval path left. Other uses continue: type 2 diabetes, heart-attack and stroke risk reduction (Wegovy injection or pill, BMI 27 or higher with a prior heart attack, stroke or symptomatic peripheral artery disease, and you must already be on prevention therapy), sleep apnea (Zepbound, BMI 30 or higher with an AHI of 15 or higher) and MASH, a fatty liver disease (Wegovy injection, fibrosis F2 to F3). |
| Vermont | No | No | Yes | not published | Vermont Medicaid excludes drugs used for weight loss. Wegovy is covered only for heart protection: a BMI over 27 plus a prior heart attack, stroke or symptomatic peripheral artery disease (poor leg circulation), and not for weight loss alone. |
| Virginia | Limited | Limited | Yes | over 40 alone, or over 37 with a comorbidity | Virginia Medicaid covers Wegovy and Zepbound for weight loss. The BMI rule effective July 1, 2026 is over 40 on its own. At over 37 you also qualify if you have high cholesterol, high blood pressure or type 2 diabetes. Virginia calls the approval step service authorization. Other states call the same thing prior authorization, and your doctor files it. |
| Washington | No | No | Yes | not published | Washington Apple Health does not cover Wegovy for weight loss (policy effective February 1, 2026). It is covered only for heart-attack and stroke risk reduction (BMI 27 or higher with established cardiovascular disease, no diabetes) and for MASH, a fatty liver disease. |
| West Virginia | No | No | Yes | not published | West Virginia Mountain Health Trust MCOs follow the state PDL exclusion of weight-loss GLP-1. Diabetes coverage with PA is standard. |
| Wisconsin | Limited | No | Yes | 30 | Wisconsin ForwardHealth covers Wegovy and Saxenda for weight management with prior authorization, and has since 2023: adults with a BMI of 30 or higher, or 27 to 29.9 with two or more risk factors. Teens 12 to 17 qualify at the 95th percentile. A 6-month weight-loss plan is required. |
| Wyoming | No | No | Yes | not published | Wyoming Medicaid is fee-for-service. The PDL excludes weight-loss GLP-1. Diabetes coverage with PA is standard. |
What this means in practice
If your state shows yes or limited for the indication you need, the insurance route is worth pursuing. Find a telehealth program that bills your state Medicaid and run the prior authorization. If your state shows no, the realistic options are: (1) the diabetes path if you qualify with type 2 diabetes documented by A1c, (2) cash-pay compounded GLP-1, or (3) a GLP-1 clinical trial, many of which provide the study medication at no cost, though a trial may assign you to a placebo group.
For the cash-pay path, see programs under $150/mo or our full cash-pay rankings. For branded Wegovy specifically, the Wegovy cost guide covers NovoCare, compounded semaglutide, and telehealth program prices at each dose. For a full cost breakdown, see every cost-reduction pathway in 2026.
For commercial and Medicare Advantage plans, the prior authorization route is often the cheapest if your plan covers GLP-1. We maintain a PA letter librarywith plan-and-condition letter templates for Aetna, Cigna, UnitedHealthcare, Anthem BCBS, Kaiser, Humana, Tricare, FEHB, and Medicare Advantage. Each template cites the plan's actual policy document, the qualifying ICD-10 codes, and the registration-trial evidence. Take it to your prescriber. For the full commercial and Medicare coverage paths, see the GLP-1 insurance guide.
MCO-level coverage in the 15 highest-population states
State Medicaid programs operate as a fee-for-service (FFS) component plus contracted managed-care organizations (MCOs). MCO formularies must meet or exceed the state PDL but can layer in additional criteria. The 15 states below cover roughly 75 percent of US Medicaid lives. For each state we show the FFS baseline plus the dominant MCOs and where to submit a PA.
Compiled from each state's Medicaid PDL plus the dominant MCO formularies. Most state Medicaid programs operate as a fee-for-service (FFS) component plus contracted MCOs (managed care organizations), Centene/WellCare, Molina, UnitedHealthcare Community Plan, Anthem affiliates, Aetna Better Health, Humana Healthy Horizons and state-specific plans. MCO formularies must meet or exceed the state PDL but can add criteria. The 15 highest-population states cover roughly 75 percent of US Medicaid lives.
California
Fee-for-service baseline: Medi-Cal FFS: T2D yes with PA. Obesity no (state exclusion). CV indication limited.
Texas
Fee-for-service baseline: Texas Medicaid FFS: T2D yes (PA, A1c threshold). Obesity no. CV no.
Florida
Fee-for-service baseline: Florida Medicaid FFS: T2D yes (PA, strict step therapy). Obesity no. CV pending.
New York
Fee-for-service baseline: New York Medicaid FFS: T2D yes with PA. Obesity yes with PA (BMI 30+, six-month documented intervention). CV yes under SELECT label.
Pennsylvania
Fee-for-service baseline: Pennsylvania Medicaid FFS: T2D yes (PA). Obesity yes (PA, BMI 30+ with comorbidity). CV yes pending update.
Illinois
Fee-for-service baseline: Illinois Medicaid FFS: T2D yes with PA. Obesity no (state exclusion). CV limited.
Ohio
Fee-for-service baseline: Ohio Medicaid FFS: T2D yes (PA, OhioRISE for behavioral). Obesity no. CV no.
Georgia
Fee-for-service baseline: Georgia Medicaid FFS: T2D yes (PA). Obesity no (state exclusion). CV no.
North Carolina
Fee-for-service baseline: North Carolina Medicaid FFS: T2D yes (PA). Obesity yes with PA (BMI 30+, comorbidity). CV pending.
Michigan
Fee-for-service baseline: Michigan Medicaid FFS: T2D yes (PA). Obesity no (state exclusion). CV no.
New Jersey
Fee-for-service baseline: New Jersey FamilyCare FFS: T2D yes (PA). Obesity yes (PA, BMI 30+ with comorbidity). CV yes under SELECT.
Virginia
Fee-for-service baseline: Virginia Medicaid FFS: T2D yes (PA). Obesity no. CV no.
Washington
Fee-for-service baseline: Washington Apple Health FFS: T2D yes (PA). Obesity no. Apple Health stopped covering Wegovy for weight loss effective February 1, 2026. Wegovy is still covered for heart-attack and stroke risk reduction (BMI 27 or higher with established cardiovascular disease, no diabetes) and for MASH, a fatty liver disease.
Arizona (AHCCCS)
Fee-for-service baseline: AHCCCS FFS: T2D yes (PA). Obesity no. CV no.
Tennessee (TennCare)
Fee-for-service baseline: TennCare FFS: T2D yes (PA). Obesity no. CV no.
We've built MCO-level coverage for the 15 highest-population states because they cover roughly 75 percent of US Medicaid lives. The remaining 35 states (Alabama, Alaska, Arkansas, Colorado, Connecticut, Delaware, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Utah, Vermont, West Virginia, Wisconsin, Wyoming) follow their state PDL more closely with fewer MCO carve-outs. 12 of them still cover a GLP-1 for obesity: Connecticut, Delaware, Kansas, Maine, Maryland, Minnesota, Mississippi, Missouri, New Hampshire, Oregon, Rhode Island, Wisconsin. If your state shows limited or variesin the table above, the prior-authorization path works the same way regardless of which MCO you're assigned to.
What works in every state: (1) check the 51-state table above for your indication, (2) find your prescriber, (3) file the PA using the universal Medicaid template path. If you get a denial, the appeal letter library applies in every state because the federal appeals process is statutorily uniform. Email hello@glpchart.com with your state + MCO and we'll add it to the next quarterly refresh.
Jump to your state: AL, AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY
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How we built this table
Compiled from each state Medicaid's published preferred drug list, PA criteria and PDL committee minutes. State Medicaid programs are not federally required to cover obesity drugs; the diabetes indication is covered nearly everywhere with PA. State-level data is point-in-time and shifts each PDL cycle. Always verify with your state Medicaid plan before relying on this page.
Last updated: 2026-07-20. We check each state Medicaid PDL and PA criteria quarterly. If you've recently had a different experience with your state Medicaid, email hello@glpchart.com with the details and we'll check it.
