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Checked November 13, 2026

Medicaid GLP-1 coverage changes by state

Since 2025, 8 state Medicaid programs stopped covering GLP-1s for weight loss: Rhode Island, Massachusetts, Utah, California, New Hampshire, Pennsylvania, South Carolina and North Carolina. Over the same time, Mississippi, Wisconsin, North Carolina and Utah started or restored it. The latest change is Rhode Island on October 1, 2026.

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2026

  • October 1, 2026, Rhode Island: Stopped. Rhode Island Medicaid stopped covering Wegovy, Zepbound, Saxenda and Foundayo for weight loss alone, under a state memo dated August 5, 2026.
  • October 1, 2026, Colorado: New rule. Health First Colorado made the Zepbound multidose KwikPen preferred with criteria and kept the weekly single-use pens non-preferred (bulletin B2600542).
  • October 1, 2026, Iowa: New rule. Iowa Medicaid changed its prior authorization rules for GLP-1s prescribed for something other than diabetes (pharmacy program changes dated August 20, 2026).
  • July 30, 2026, Indiana: Announced. Indiana said it will join the federal BALANCE model to cover GLP-1s for obesity, paying $85.16 of a $245 monthly cost. No start date was published as of November 11, 2026.
  • July 16, 2026, Mississippi: New rule. Mississippi's updated drug list approves Zepbound, Foundayo, Wegovy and Saxenda at BMI 30 or higher.
  • July 6, 2026, Delaware: New rule. Delaware's drug list puts Wegovy and Zepbound on the approved side at BMI 30 or higher with a weight-related condition.
  • July 3, 2026, Massachusetts: Stopped. MassHealth ended Wegovy, Zepbound and Saxenda for obesity and overweight (Pharmacy Facts 271). Heart protection, MASH and sleep apnea uses stay covered.
  • July 1, 2026, Mississippi: Started. Mississippi Medicaid began covering GLP-1s for weight loss.
  • July 1, 2026, Wisconsin: Started. Wisconsin began covering Zepbound for weight management with prior authorization (ForwardHealth Update 2026-15). Wegovy moved to heart protection, MASH and teens only.
  • July 1, 2026, Michigan: Tightened. Michigan tightened its weight-loss rules a second time. The rules now ask for a starting BMI of 40 or higher, and five other drugs on its list tried first.
  • July 1, 2026, Virginia: New rule. Virginia's BMI rule became over 40 on its own, or over 37 with high cholesterol, high blood pressure or type 2 diabetes.
  • June 30, 2026, Utah: Stopped. Utah's one-year weight-loss pilot ended and was not renewed. The obesity criteria came off its prior-authorization form on June 1.
  • January 1, 2026, California: Stopped. Medi-Cal Rx ended Wegovy, Zepbound and Saxenda for weight loss only, and approvals expired December 31, 2025. Members under 21 keep coverage.
  • January 1, 2026, New Hampshire: Stopped. New Hampshire stopped covering Saxenda, Wegovy and Zepbound prescribed only for weight loss, after a notice on October 9, 2025.
  • January 1, 2026, Pennsylvania: Stopped. Pennsylvania stopped covering GLP-1s for overweight and obesity (MA Bulletin, November 24, 2025). Approvals ended December 31, 2025.
  • January 1, 2026, South Carolina: Stopped. South Carolina dropped Wegovy and Saxenda for weight loss after 14 months of coverage.
  • January 1, 2026, Michigan: Tightened. Michigan tightened its rules for Wegovy and Zepbound for weight loss, the first of two changes in 2026.
  • January 1, 2026, Tennessee: Tightened. TennCare limited a first approval for weight loss to three months.

2025

  • December 12, 2025, North Carolina: Restored. NC Medicaid put Wegovy and Zepbound for weight loss back at BMI 30 or higher, two months after cutting them. No law locks it in.
  • December 2025, Tennessee: Tightened. TennCare began allowing one GLP-1 at a time.
  • October 2025, North Carolina: Stopped. NC Medicaid cut Wegovy and Zepbound coverage for weight loss.
  • July 1, 2025, Utah: Started. Utah began a one-year pilot covering GLP-1s for weight loss, for fee-for-service members only.
  • June 2025, Kansas: Eased. Kansas moved Wegovy out of its stricter BMI 40 review, so BMI 30 became the bar.
  • February 5, 2025, Maryland: New rule. Maryland began covering Zepbound for moderate to severe sleep apnea. It is not covered for weight loss.

2024

  • November 1, 2024, South Carolina: Started. South Carolina began covering Wegovy and Saxenda for weight loss.
  • September 15, 2024, Maryland: New rule. Maryland set that Wegovy is not covered when weight management is the only reason (transmittal PT 35-25).
  • April 2024, Kansas: Eased. Kansas moved Zepbound out of its stricter BMI 40 review.

How to read this list

Each line comes from the state's own drug list, bulletin or prior-authorization form, as recorded on its state page. Where a state gave only the month, the month is shown. A change for weight loss does not touch diabetes coverage, which every state still has.

For today's rules in each state, open Medicaid by state. No coverage and money is tight? Free and low-cost help by state lists clinics that charge by income.