Coverage summary
| Indication | Coverage |
|---|---|
| Wegovy (weight loss) | No |
| Zepbound (weight loss) | No |
| Ozempic or Mounjaro (type 2 diabetes) | Yes |
If Texas 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 Texas 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 Texas 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 | Hard |
| BMI threshold (weight-loss path) | Not applicable (weight-loss path not covered) |
| Last PDL update reviewed | between October and December 2025 |
If the plan denies it, the appeal letter templates cover the reasons plans give and what to send back.
What Texas Medicaid paid for GLP-1s
Texas Medicaid reported 40,953 GLP-1 prescriptions to CMS in 2025's last quarter and paid pharmacies $41.1 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
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.
Managed-care organizations in Texas
Texas Medicaid pays private health plans, called managed-care organizations or MCOs, to run its coverage. The state contracts with 17, and these are the 6 largest. 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.
- Superior HealthPlan (Centene)
- Molina Healthcare of Texas
- Amerigroup Texas (Anthem)
- UnitedHealthcare Community Plan Texas
- Aetna Better Health of Texas
- Driscoll Health Plan
Cash-pay alternatives if Medicaid does not cover you
Texas covers the diabetes path at A1c 7.5 or higher with a documented metformin trial. There is no weight-loss path to appeal into.
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 Texas, see the cheapest GLP-1 in Texas guide.
56 GLP-1 clinical trials are recruiting in Texas, and a study supplies its own study medication. Every site is listed on GLP-1 clinical trials in Texas.
Texas Medicaid GLP-1 FAQ
Does Texas Medicaid cover Wegovy for weight loss?
Does Texas Medicaid cover Zepbound for weight loss?
Does Texas Medicaid cover Ozempic or Mounjaro for diabetes?
What if Texas 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 Texas Medicaid, email hello@glpchart.com with the details and we will check it.