Coverage hub · Updated 2026-05-10
State Medicaid GLP-1 coverage by state
Every state Medicaid program writes its own rules for whether Wegovy, Zepbound, Saxenda, and the diabetes-indication GLP-1s (Ozempic, Mounjaro, Trulicity) are covered for weight loss. We’ve published verbatim primary-source coverage analyses for 23 states — PDLs, provider notices, federal statute, and state regulation all anchored against the actual policy documents. Find your state below.
Positive obesity-indication coverage
States where Medicaid covers Wegovy, Zepbound, or Saxenda for the chronic-weight-management indication, with verifiable PDL Preferred status and primary-source PA criteria. Patients in these states have the most direct path to coverage.
Conditional coverage (restrictive BMI threshold above FDA label)
States that cover GLP-1s for chronic weight management under some conditions, but with BMI thresholds or step-therapy requirements that are strictly more restrictive than the FDA label. KFF classifies these as 'covering' states, but patients with BMI below the state threshold are not eligible even if they meet FDA label criteria.
Indication-anchored coverage (non-obesity FDA indications only)
States that publicly cover Wegovy or Zepbound for non-weight-loss FDA indications — cardiovascular risk reduction (MACE), MASH, or obstructive sleep apnea — but explicitly DO NOT cover the chronic-weight-management indication. Reading KFF's coverage tracker without checking the underlying PA criteria is the YMYL trap this group exemplifies.
Nullified-amendment exclusion state
States where a sitting governor's administration formally proposed regulatory adoption of GLP-1 chronic-weight-management coverage and was extinguished by legislative veto override. Kentucky is the first confirmed state in this cluster: the Beshear DMS proposed 907 KAR 23:010 amendment (filed Sep 9, 2025) was nullified by SB 65 veto override April 14, 2026. The categorical exclusion remains intact; DMS is prohibited from re-promulgating until June 1, 2027.
Explicit non-coverage (including recent terminations)
States with explicit primary-source exclusion of GLP-1s for weight loss — anchored in state administrative code, regulatory bulletin, or contractor brand-named exclusion language. Includes policy-reversal states (PA, MA) that previously covered the obesity indication and terminated due to fiscal pressure.
Silent operational exclusion
States that do not publish an explicit weight-loss-drug exclusion bulletin but operationalize non-coverage by absence in the PDL plus plan-level deferrals. Patients searching for ‘does my state Medicaid cover Wegovy’ will not find a clear NO — they have to infer it from the absence of a YES.
All 50 states (alphabetical)
Every state we’ve published is linked. States marked “coverage analysis pending” are next in our verifier-brief queue — we’re shipping new state analyses on a rolling cadence.
23 of 50 states with full primary-source coverage analysis · 27 pending.
Comprehensive coverage table
Per-state coverage pattern at a glance. Each row links to the full deep-dive article with verbatim primary-source quotes from the state PDL, provider notices, and PA criteria documents.
| State | Coverage pattern | Last verified |
|---|---|---|
| Alabama (AL) | PDL-enumerated OSA-only Zepbound carve-out + off-PDL Cardiac-criteria Wegovy MACE exclusion | 2026-05-10 |
| Arizona (AZ) | Agency-manual explicit exclusion | 2026-05-10 |
| California (CA) | Reversed course | 2026-05-09 |
| Florida (FL) | Silent operational exclusion | 2026-05-09 |
| Georgia (GA) | Dual-level operational exclusion | 2026-05-10 |
| Illinois (IL) | Strictest doubly-anchored exclusion | 2026-05-09 |
| Indiana (IN) | Regulatory exclusion + Zepbound-preferred anomaly | 2026-05-10 |
| Kentucky (KY) | Nullified-amendment exclusion state | 2026-05-10 |
| Maryland (MD) | Regulatory exclusion + HCPCS J3490 dual-indication carve-out | 2026-05-10 |
| Massachusetts (MA) | Two-phase termination | 2026-05-10 |
| Michigan (MI) | Partial retainment with morbid-obesity gate | 2026-05-10 |
| Minnesota (MN) | Positive coverage + dedicated Weight Management Agents PDL class + active hostile exclusion bill | 2026-05-10 |
| Missouri (MO) | Positive coverage with Wegovy demoted to MACE/MASH-only + Foundayo Preferred (first in 22-state series) | 2026-05-10 |
| New Jersey (NJ) | Dual-authority explicit exclusion + fiscal transparency | 2026-05-10 |
| New York (NY) | Strongest-evidenced triple-anchor exclusion | 2026-05-09 |
| North Carolina (NC) | Double reversal (positive coverage) | 2026-05-10 |
| Ohio (OH) | Triple-anchor + Jan 2026 carve-back-in | 2026-05-10 |
| Pennsylvania (PA) | Policy reversal (inverse of California) | 2026-05-10 |
| Tennessee (TN) | Positive-coverage expansion | 2026-05-10 |
| Texas (TX) | Explicit non-coverage | 2026-05-09 |
| Virginia (VA) | Conditional coverage at BMI > 40 floor | 2026-05-10 |
| Washington (WA) | YMYL trap — indication-anchored | 2026-05-10 |
| Wisconsin (WI) | Positive coverage with 2-lifetime-attempts cap + BMI < 24 renewal-revocation | 2026-05-10 |