Coverage summary
| Indication | Coverage |
|---|---|
| Wegovy (weight loss) | Limited |
| Zepbound (weight loss) | Limited |
| Ozempic or Mounjaro (type 2 diabetes) | Yes |
If Delaware Medicaid says no, two cash programs to check.
No insurance needed.
- Strut Health$149 a month, with auto-refillcompounded semaglutideCheck price →You pick Weight Loss, then a five-minute online visit
- Shed$199 a month30% off first month with code Shed10compounded semaglutideCheck price →A health form first, then you choose your plan
Cheapest GLP-1 without insurance compares the three cash routes, and cheapest GLP-1 in Delaware prices each drug that ships there.
A clinical trial costs nothing, and nobody checks your income.
Prior-authorization criteria
These rules come from the state preferred drug list (PDL), the list of drugs Delaware Medicaid has agreed to pay for. Prior authorization means your doctor asks the plan to approve the drug before the pharmacy fills it. Nearly every state covers the diabetes path that way.
| Criterion | Value |
|---|---|
| How hard the approval is | Medium |
| BMI threshold (weight-loss path) | BMI 30+ |
| Comorbidity required | Yes |
| Last PDL update reviewed | July 6, 2026 |
If the plan denies it, the appeal letter templates cover the reasons plans give and what to send back.
What Delaware Medicaid paid for GLP-1s
Delaware Medicaid reported 14,438 GLP-1 prescriptions to CMS in 2025's last quarter and paid pharmacies $4.1 million.
Counts Wegovy, Zepbound, Ozempic, Mounjaro, Saxenda and Rybelsus, in fee-for-service and managed care, before rebates. CMS blanks its smallest rows, so the real figures are higher. Source: CMS State Drug Utilization Data.
What this means in practice
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.
Managed-care organizations in Delaware
Delaware Medicaid pays private health plans, called managed-care organizations or MCOs, to run its coverage. An MCO has to cover at least what the state list covers and can add rules of its own. Check your own plan's current rules before you send anything in.
- Highmark Health Options
- AmeriHealth Caritas Delaware
Cash-pay alternatives if Medicaid does not cover you
If your MCO denies the weight-loss indication, the diabetes path applies for T2D.
If you end up paying cash, the GLP-1 cost guide has what each cash route costs, from the compounded floor to the manufacturer-direct brand prices. Federal law bars manufacturer savings cards for anyone on Medicaid.
If a supply gap rather than cost is blocking your refill, the GLP-1 shortage tracker shows which formulations the FDA lists as in shortage now. And if you are 65 or older and also have Medicare, the senior GLP-1 hub lays out the Medicare coverage paths for dual-eligible patients.
For the full cash-pay picture specific to Delaware, see the cheapest GLP-1 in Delaware guide.
One GLP-1 clinical trial is recruiting in Delaware, and a study supplies its own study medication. Every site is listed on GLP-1 clinical trials in Delaware.
Delaware Medicaid GLP-1 FAQ
Does Delaware Medicaid cover Wegovy for weight loss?
Does Delaware Medicaid cover Zepbound for weight loss?
Does Delaware Medicaid cover Ozempic or Mounjaro for diabetes?
What if Delaware Medicaid does not cover my GLP-1?
Other state Medicaid pages
See the full 51-state coverage table for the side-by-side view across every US state.
How we built this page
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.
Checked August 24, 2026. We check each state Medicaid PDL and PA criteria quarterly. If you have recently had a different experience with Delaware Medicaid, email hello@glpchart.com with the details and we will check it.