Medicaid and GLP-1s for weight loss, state by state

Which state Medicaid programs cover Wegovy, Zepbound and other GLP-1s for obesity alone in 2026, read from each agency’s own drug list or notice, with the date we checked it.

Map · Kymata Health Checked Oct 23, 2026 51 programs, 50 states and DC

What this shows

Coverage rules as published by each state’s Medicaid program for its fee-for-service drug list; managed care plans in most states follow the same list. The plan decides each request.

Coverage for obesity alone

Choose a state for its rule, its source and the date we read it.

  • Covered with prior authorization 6Covered for obesity with prior authorization (BMI and other criteria).
  • Covered with narrower rules 2Covered for obesity only under stricter criteria than BMI 30, or 27 with a related condition.
  • Closed to new starts 1People already approved may renew; no new starts for obesity alone.
  • Coverage ended in 2026 6The program stopped covering these drugs for obesity alone during 2026.
  • Not covered for obesity alone 34Not covered for obesity alone. Federal law lets states exclude these drugs only when used for weight loss; most of these states’ documents list other FDA-approved uses, with prior authorization.
  • Not yet re-verified 2We couldn’t open the agency’s current document, so no status is shown.

Choose a state on the map, in the list or with the picker to see its rule, its source and the date we checked it.

Covered with prior authorization 6

Covered with narrower rules 2

Closed to new starts 1

Coverage ended in 2026 6

Not covered for obesity alone 34

Not yet re-verified 2

What changed

Each state rule change we have recorded, newest first, with the agency’s own notice.

Timeline

  1. New York: New York’s heart-disease (Wegovy) and sleep apnea (Zepbound) routes now need a BMI of 40 or more, with two treatment attempts per lifetime; no obesity-only route. NYRx PDP/PDL, revised Oct 22, 2026 (opens in new tab)
  2. Rhode Island: Rhode Island Medicaid stopped covering Foundayo, Saxenda, Wegovy and Zepbound when prescribed solely for weight loss. RI EOHHS provider memo, Aug 5, 2026 (opens in new tab)
  3. Indiana: Indiana announced it will join the federal BALANCE model for GLP-1 obesity coverage; no implementation bulletin yet. State of Indiana release, Jul 30, 2026 (opens in new tab)
  4. Massachusetts: MassHealth stopped covering drugs used to treat obesity or overweight; other approved uses continue with prior authorization. MassHealth Pharmacy Facts #271 (corrected), Mar 12, 2026 (opens in new tab)
  5. Virginia: Virginia Medicaid narrowed weight-loss GLP-1 coverage to a BMI over 40, or over 37 with a related condition, after a non-GLP-1 drug. DMAS service authorization form, Weight-Loss Management, eff. 07/01/2026 (opens in new tab)
  6. Utah: Utah’s legislative pilot for weight-loss GLP-1s (fee-for-service) reached its end date; the form allows renewals only. Utah Medicaid PA form, updated 6-1-26 (opens in new tab)
  7. California: Medi-Cal Rx stopped covering GLP-1s used for weight loss. DHCS Medi-Cal Rx alert, Oct 21, 2025 (opens in new tab)
  8. New Hampshire: New Hampshire Medicaid stopped covering GLP-1s prescribed solely for weight loss. NH Division of Medicaid Services notice, Oct 9, 2025 (opens in new tab)
  9. Pennsylvania: Pennsylvania Medical Assistance stopped covering GLP-1s for overweight and obesity. PA DHS Medical Assistance Bulletin, Nov 24, 2025 (opens in new tab)
  10. South Carolina: South Carolina Medicaid removed GLP-1 coverage for weight loss (added Nov 1, 2024). SCDHHS Pharmacy Services manual, change control record (opens in new tab)
  11. Michigan: Michigan Medicaid narrowed obesity-only GLP-1 coverage to morbid obesity after all other options, to avert bariatric surgery. MDHHS letter L 25-73, Dec 8, 2025
  12. North Carolina: NC Medicaid reinstated GLP-1 coverage for obesity, cut on Oct 1, 2025. NC Medicaid bulletin, Dec 19, 2025 (opens in new tab)

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Questions this map answers

Which state Medicaid programs cover GLP-1s for weight loss in 2026?

As of Oct 23, 2026, 6 state Medicaid programs cover GLP-1s for obesity with prior authorization: Delaware, Minnesota, Missouri, North Carolina, Tennessee and Wisconsin. Michigan and Virginia cover them only under narrower rules, and Utah is closed to new starts. 34 programs do not cover them for obesity alone, and 2 (Kansas and Mississippi) could not be re-verified from the agency’s current document.

Which states ended Medicaid coverage of GLP-1s for weight loss?

6 programs stopped covering GLP-1s for obesity alone during 2026: California (Jan 1, 2026), New Hampshire (Jan 1, 2026), Pennsylvania (Jan 1, 2026), South Carolina (Jan 1, 2026), Massachusetts (Jul 3, 2026), Rhode Island (Oct 1, 2026). The notices from California, Massachusetts, New Hampshire, Pennsylvania and Rhode Island say other FDA-approved uses stay covered with prior authorization.

Does Medicaid cover Wegovy or Zepbound for other conditions?

Federal Medicaid law lets a state exclude these drugs only “when used for anorexia, weight loss, or weight gain”; their use for type 2 diabetes is not on that list, though a state may require prior authorization. (Social Security Act §1927(d)(1)(A) and (d)(2)(A), 42 U.S.C. 1396r-8(d).) In most of the 34 programs that do not cover them for obesity alone, the agency’s documents list Wegovy for lowering heart risk or for MASH and Zepbound for moderate to severe sleep apnea, each with prior authorization. The drawer for each state gives its own rule.

How the map is built

Method

  • One row per state and DC, read from the Medicaid agency’s own preferred drug list, prior authorization criteria, rule or provider notice, or the same document on the state’s pharmacy vendor portal (labelled with the vendor’s name). Each row gives its source and the date we read it.
  • What is tracked is coverage for obesity alone. Federal Medicaid law lets a state exclude these drugs only “when used for anorexia, weight loss, or weight gain”; their use for type 2 diabetes is not on that list, though a state may require prior authorization. Social Security Act §1927(d)(1)(A) and (d)(2)(A), 42 U.S.C. 1396r-8(d), read Oct 23, 2026. Where a state’s document lists other FDA-approved uses, its drawer says which.
  • Where we could not open a state’s current document, the state shows as “Not yet re-verified” with no colour, never a guess.
  • A rule can change between checks. The plan decides each request, and the state’s own pages are the final word.

Paying without coverage: what self-pay costs now and online GLP-1 programs compared.

Educational only. Not medical advice. Some links earn us a commission: kymatahealth.com/affiliate-disclosure.