Does Medicaid Cover Ozempic, Wegovy, and Other Medications Taken for Weight Loss?
Key takeaways:
Weight-loss medications can cost more than $1,000 a month without insurance. Medicaid may cover Wegovy (semaglutide), Saxenda (liraglutide), and other medications taken for weight loss depending on your state’s program.
Glucagon-like peptide-1 (GLP-1) receptor agonists like Ozempic (semaglutide) are increasingly prescribed off-label for weight loss. These medications are usually covered by Medicaid if they’re taken for an FDA-approved use like treating Type 2 diabetes.
State Medicaid programs that cover weight-loss medications may require prior authorizations and have other restrictions in place.
Table of contents
Medications like Ozempic (semaglutide), Wegovy (semaglutide), and Zepbound (tirzepatide) have recently grown in popularity as they have proven to be successful at helping people lose weight. But these medications, which are intended for long-term use, can cost over $1,000 per month without insurance.
Although many insurance plans do not cover popular glucagon-like peptide-1 (GLP-1) receptor agonists when they’re taken for weight loss, there are some state Medicaid programs that may cover them for people who meet certain requirements. The decision to cover medications that are taken for weight loss is left up to individual states.
Does Medicaid cover weight-loss medications?
As mentioned, whether or not Medicaid covers weight-loss medications depends on the state running the program. Medicaid is a joint federal and state program that provides health insurance coverage to eligible low-income individuals and families in the U.S. Some benefits are mandatory and must be provided by each state’s Medicaid program, while other benefits, such as prescription medication coverage, are optional.
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In addition to deciding whether their program will cover weight-loss medications, states can select which medications will be covered. For example, your state may not cover Wegovy, but it may cover a medication that’s FDA approved for chronic weight management, such as Saxenda (liraglutide).
Your state may also provide Medicaid coverage for Type 2 diabetes medications that cause weight loss as a side effect. However, you’re not likely to qualify for coverage if you don’t have diabetes. For example, if you want to take Ozempic to lose weight, but you don’t have Type 2 diabetes or another FDA-approved indication, you may have issues getting Ozempic covered.
Many programs also require prior authorizations before covering weight-loss medications. In general, programs typically cover the cost of preferred medications without prior authorization. These medications are listed as preferred because of cost, efficacy, safety, rebate programs, or alignment with evidence-based treatment guidelines. Nonpreferred medications usually mandate prior authorization and cost more out of pocket.
If your medication is not listed on your program's formulary, you can contact your state agency to find out whether it may still be possible to get coverage. Sometimes, state Medicaid programs will cover medications not listed on their formularies. However, they may assign higher copays and/or require prior authorization
Does Medicaid cover Ozempic?
Ozempic is a medication that’s FDA approved for Type 2 diabetes and for reducing the likelihood of significant cardiovascular events in adults with Type 2 diabetes and a preexisting heart condition. The once-weekly noninsulin injection helps improve blood glucose (sugar) levels and lower the risk of heart attacks, strokes, and death related to heart issues. It can also affect the regions of the brain that control hunger and fullness, which can lead to weight loss. Without insurance, the retail price of Ozempic ranges from $1,000 to $1,200 or more for 1 pen.
You can find out whether your Medicaid program covers Ozempic by checking your state’s preferred drug list, or formulary.
Will your insurance cover weight-loss medications? Coverage for weight-loss medications varies by plan but here are some general facts you should know about cost and coverage.
Got Medicare? Medicare, by law, is prohibited from covering weight-loss medications unless you meet these requirements.
Ways to save on Ozempic (semaglutide): From downloading a GoodRx coupon to using a copay savings card, there are many ways to save on Ozempic.
Based on a review of preferred drug lists, most state Medicaid programs list Ozempic as a preferred or nonpreferred medication on their formularies. For example, the medication is listed as a preferred agent in North Carolina, but it’s listed as nonpreferred in Arizona and Wyoming.
However, as mentioned, this medication is FDA approved for Type 2 diabetes, not chronic weight management. Therefore, you’ll have to reach out to your state Medicaid agency to determine if Ozempic is covered for weight loss if you do not have Type 2 diabetes. Obesity is often considered a lifestyle issue by insurance plans rather than a medical condition.
In some cases, Medicaid programs also require enrollees to meet certain criteria before covering Ozempic. In addition to having a Type 2 diabetes diagnosis, this criteria may include:
Being age 18 or older
Trying an alternative medication, such as metformin, first
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Does Medicaid cover Mounjaro?
Mounjaro (tirzepatide) is another medication that’s FDA approved to treat Type 2 diabetes. The once-weekly injection can help lower your hemoglobin A1C (HbA1c or A1C). But it’s also been linked to significant body weight reduction. The average monthly cost of Mounjaro is between $1,000 to $1,200 without insurance.
Check your state Medicaid program’s formulary to see if your plan covers Mounjaro. Mounjaro is listed as a nonpreferred medication on various state Medicaid formularies, including the formularies for Delaware, North Carolina, and Wyoming.
Like with Ozempic, some Medicaid programs require prior authorization before covering Mounjaro. Enrollees may also be subject to the criteria listed above.
Does Medicaid cover Wegovy?
Wegovy is an FDA-approved medication for chronic weight management. It contains the same active ingredient as Ozempic. The once-weekly injection slows the movement of food out of the stomach. It also helps control appetite and reduce cravings. Wegovy has a list price of about $1,350 a month, but the retail price can vary depending on the pharmacy you choose.
You can find out whether your plan covers Wegovy by checking your state Medicaid program’s formulary. Some states list Wegovy as a preferred medication, including:
States change their Medicaid benefits from time to time. For example, as of January 1, 2025, adults in Massachusetts can no longer get Wegovy covered through Medicaid for weight management. Adults who were being prescribed Wegovy were required to switch to Zepbound, which became a preferred medication in October 2024. Adolescents ages 12 to 17 can still get coverage for Wegovy. And adults who have an established heart condition and either obesity or overweight can get coverage if they’re prescribed the medication to reduce the risk of major cardiovascular events.
Does Medicaid cover Zepbound?
Zepbound is a medication that was FDA approved for chronic weight management in late 2023. It contains the same active ingredient as Mounjaro. The once-weekly injection helps lower blood glucose and promotes weight loss. The list price for Zepbound is about $1,086 for a 28-day supply without insurance.
Based on a review of preferred medication lists, some state Medicaid programs now list Zepbound as a preferred or nonpreferred medication on their formularies. For example, the medication is listed as a preferred agent in California and Delaware, but it’s listed as nonpreferred in North Carolina. To find out whether your state has added the medication to its formulary, you can
Go to Zepbound’s coverage and savings website.
Scroll down the page and click “I have insurance through Medicaid.”
Use the locator to find your program’s formulary.
You can also contact your state agency to find out whether getting coverage for Zepbound is possible. If your request for coverage is denied, speak with your healthcare professional about appealing the decision.
Other weight-loss and Type 2 diabetes medications covered by Medicaid
Wegovy and Zepbound aren't the only FDA-approved weight-loss medications. Your Medicaid plan may cover other medications for chronic weight management, including:
Xenical (orlistat), an oral medication that’s taken 3 times a day
Saxenda, a once-daily injection
Contrave (naltrexone / bupropion), an oral medication that’s taken 2 times a day
Your Medicaid plan may also cover other Type 2 diabetes medications that cause weight loss as a side effect, such as:
Trulicity (dulaglutide), a once-weekly injection
Victoza (liraglutide), a once-daily injection
Rybelsus (semaglutide), a once-daily oral medication
With any of these medications, you may still need to meet certain criteria or be subject to prior authorization requirements.
Frequently asked questions
A manufacturer savings card for Ozempic is available to people with Type 2 diabetes. If you have private or commercial insurance that covers Ozempic, you may qualify to pay as little as $25 for a 1-, 2-, or 3-month prescription using the Ozempic copay savings card. This offer is valid for up to 48 months from the date of enrollment and is specifically intended for diabetes management, not weight loss.
People who qualify for the program are entitled to a maximum savings of $100 per 1-month prescription, $200 per 2-month prescription, or $300 per 3-month prescription of Ozempic. If you don’t qualify for the savings card, there are other ways you can save on Ozempic.
No, you do not qualify for the Ozempic savings card if you are enrolled in Medicaid. The savings card is only available to individuals with private or commercial insurance. People who have prescription medication coverage through a federal or state healthcare program, such as Medicaid, Medicare, or Tricare, do not qualify for this offer.
The bottom line
Your state Medicaid program may cover medications, such as Wegovy (semaglutide) and Saxenda (liraglutide), that are FDA approved for chronic weight management. But if you are prescribed a GLP-1 medication, such as Ozempic (semaglutide) or Mounjaro (tirzepatide), off-label for weight loss, there's a good chance that you may not receive coverage. It's important to review your Medicaid plan details or contact your state Medicaid agency to determine which medications are covered.
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References
Arizona Medicaid. (2025). Preferred drug list (PDL). UnitedHealthcare Community Plan of Arizona.
California Department of Health Care Services. (2025). Medi-Cal Rx contract drugs list.
Delaware Health and Social Services. (2025). 2025 Delaware Medicaid preferred drug list (PDL).
Eli Lilly and Company. (n.d.). How much should I expect to pay for Zepbound® (tirzepatide)?
Eli Lilly and Company. (2023). Lilly's tirzepatide shows additional 21.1% weight loss after 12 weeks of intensive lifestyle intervention, for a total mean weight loss of 26.6% from study entry over 84 weeks.
Forrester, C. (2020). Benefits of prior authorizations. Journal of Managed Care & Specialty Pharmacy.
KFF. (2019). State Medicaid preferred drug lists.
Massachusetts Executive Office of Health and Human Services. (2024). Upcoming changes to MassHealth coverage of weight loss drugs. The Prescriber e-Letter.
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Virginia Department of Medical Assistance Services. (2024). Virginia preferred drug list (PDL) / common core formulary quick list.
Wilding, J. P. H., et al. (2021). Once weekly semaglutide in adults with overweight or obesity. The New England Journal of Medicine.
Williams, E., et al. (2024). Medicaid coverage of and spending on GLP-1s. KFF.
Wyoming Medicaid. (2024). Preferred drug list (PDL). Wyoming Department of Health.
Zepbound. (n.d.). Savings card, cost, and coverage support. Eli Lilly and Company.
