Medicaid GLP-1 coverage by state, 2026.
What your state Medicaid actually covers for Wegovy, Zepbound, Ozempic and Mounjaro. Most states still exclude weight-loss-indication GLP-1, but the diabetes path is covered nearly everywhere with prior authorization. The cardiovascular indication for Wegovy is being added state by state. Here is the current 2026 reality.
| State | Obesity | T2D | CV | Notes |
|---|---|---|---|---|
| Alabama | no | yes (PA) | limited | Alabama Medicaid does not cover weight-loss GLP-1. Diabetes coverage with PA. |
| Alaska | no | yes (PA) | limited | Standard Medicaid weight-loss exclusion. |
| Arizona (AHCCCS) | no | yes (PA) | no | AHCCCS does not cover GLP-1 for weight loss. |
| Arkansas | no | yes (PA) | no | Standard exclusion of weight-loss meds. |
| California (Medi-Cal) | limited | yes (PA) | limited | Medi-Cal added limited Wegovy coverage in 2024 for BMI 40+ patients. Strict criteria. |
| Colorado | no | yes (PA) | limited | Diabetes coverage standard; weight-loss not on PDL. |
| Connecticut | limited | yes (PA) | yes (PA) | Connecticut Medicaid added weight-loss GLP-1 coverage in 2024 with BMI 35+ and at least one comorbidity. |
| Delaware | no | yes (PA) | limited | Standard exclusion. |
| Florida | no | yes (PA) | no | Florida Medicaid does not cover GLP-1 for weight loss. |
| Georgia | no | yes (PA) | limited | Diabetes coverage with PA; weight-loss excluded. |
| Hawaii | no | yes (PA) | limited | Standard exclusion. |
| Idaho | no | yes (PA) | no | Standard exclusion. |
| Illinois | limited | yes (PA) | limited | Illinois Medicaid added Wegovy coverage in late 2024 for BMI 40+ with comorbidities. Strict PA. |
| Indiana | no | yes (PA) | no | Standard exclusion. |
| Iowa | no | yes (PA) | limited | Standard exclusion. |
| Kansas | no | yes (PA) | no | Standard exclusion. |
| Kentucky | no | yes (PA) | limited | Standard exclusion. |
| Louisiana | no | yes (PA) | no | Standard exclusion. |
| Maine | limited | yes (PA) | yes (PA) | Maine added Wegovy weight-loss coverage in 2024 for BMI 35+ with comorbidities. |
| Maryland | limited | yes (PA) | yes (PA) | Maryland Medicaid covers Wegovy with strict PA for BMI 35+ plus comorbidity. |
| Massachusetts (MassHealth) | yes (PA) | yes (PA) | yes (PA) | MassHealth covers both Wegovy and Zepbound for weight loss with PA. Among the most generous Medicaid plans nationally. |
| Michigan | no | yes (PA) | limited | Michigan Medicaid does not cover GLP-1 for weight loss as of 2026 reviews. Diabetes only. |
| Minnesota | limited | yes (PA) | yes (PA) | Minnesota Medicaid added Wegovy coverage in 2024 with BMI 40+ criteria. |
| Mississippi | no | yes (PA) | no | Mississippi Medicaid does not cover weight-loss GLP-1. Diabetes only with strict PA. |
| Missouri | no | yes (PA) | limited | Standard exclusion of weight-loss medications. |
| Montana | no | yes (PA) | limited | Standard exclusion. |
| Nebraska | no | yes (PA) | no | Standard exclusion. |
| Nevada | no | yes (PA) | limited | Standard exclusion. |
| New Hampshire | no | yes (PA) | limited | Standard exclusion. |
| New Jersey | limited | yes (PA) | yes (PA) | New Jersey Medicaid covers Wegovy for cardiovascular indication and Zepbound for sleep-apnea indication; weight-loss-only coverage limited. |
| New Mexico | no | yes (PA) | limited | Standard exclusion. |
| New York | limited | yes (PA) | yes (PA) | NY Medicaid covers Wegovy for BMI 35+ with comorbidities under strict PA. |
| North Carolina | no | yes (PA) | limited | Standard exclusion. |
| North Dakota | no | yes (PA) | no | Standard exclusion. |
| Ohio | no | yes (PA) | limited | Standard exclusion. |
| Oklahoma | no | yes (PA) | no | Standard exclusion. |
| Oregon | limited | yes (PA) | yes (PA) | Oregon Medicaid covers weight-loss GLP-1 for BMI 35+ with comorbidities. PA required. |
| Pennsylvania | no | yes (PA) | limited | Standard exclusion as of 2026; PDL committee reviewing for 2027. |
| Rhode Island | limited | yes (PA) | yes (PA) | Rhode Island Medicaid added Wegovy weight-loss coverage in 2024 with BMI 35+. |
| South Carolina | no | yes (PA) | limited | Standard exclusion. |
| South Dakota | no | yes (PA) | no | Standard exclusion. |
| Tennessee | no | yes (PA) | no | Standard exclusion. |
| Texas | no | yes (PA) | limited | Texas Medicaid covers diabetes-indicated GLP-1 with PA. No weight-loss coverage. |
| Utah | no | yes (PA) | limited | Standard exclusion. |
| Vermont | limited | yes (PA) | yes (PA) | Vermont Medicaid added Wegovy coverage in 2024 with strict PA criteria. |
| Virginia | no | yes (PA) | limited | Standard exclusion. Diabetes coverage standard. |
| Washington | limited | yes (PA) | yes (PA) | Washington Apple Health covers Wegovy for BMI 35+ plus comorbidity. |
| West Virginia | no | yes (PA) | no | Standard exclusion. |
| Wisconsin | no | yes (PA) | limited | Standard exclusion. |
| Wyoming | no | yes (PA) | no | Standard exclusion. |
| District of Columbia | limited | yes (PA) | yes (PA) | DC Medicaid covers weight-loss GLP-1 for BMI 35+ with comorbidity. |
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 an A1c documenting prediabetes or T2D, (2) cash-pay compounded GLP-1 or (3) manufacturer patient-assistance programs.
For the cash-pay path, see programs under $150/mo or our full cash-pay rankings. For patient assistance, 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 60 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.
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 yes (PA, BMI 30+ with comorbidity, six-month intervention). CV yes.
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 (Wyoming, Vermont, North Dakota, Montana, Alaska, Idaho, New Mexico, Mississippi, West Virginia, Arkansas, Maine, New Hampshire, Rhode Island, Delaware, South Dakota, Nebraska, Hawaii, Utah, Iowa, Kansas, Kentucky, Louisiana, Alabama, South Carolina, Oklahoma, Connecticut, Minnesota, Maryland, Massachusetts, Wisconsin, Indiana, Colorado, Missouri, Nevada, Oregon) follow their state PDL more closely with fewer MCO carve-outs. If your state appears in the 51-state table at the top of this page as yes or limitedfor your indication, the PA 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, 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, DC
How we built this table
Compiled from each state Medicaid's published preferred drug list, prior-authorization criteria and recent PDL committee minutes. Drug name presence on a PDL does not guarantee approval for any individual patient. Always verify with your state Medicaid plan before relying on this table.
Last updated: 2026-05-23. We re-verify quarterly by checking each state Medicaid PDL and PA criteria. If you've recently had a different experience with your state Medicaid, email hello@glpchart.com with the details and we'll re-verify.
