Does my state Medicaid cover GLP-1s for weight loss, CV, OSA, MASH, pediatric, or T2D?

How to read the coverage status

• Covered with PA — On the state Medicaid Preferred Drug List (PDL) for this indication. The prescriber must submit a prior-authorization request documenting BMI, comorbidities, and (for OSA / MASH / pediatric) the indication-specific clinical criteria.
• Covered (sunset pending) — Currently covered, but the state Medicaid agency has announced an end date. PAs filed before the sunset date may still pay through the announced cutoff; new starts may be denied.
• Carve-out only (PA required) — Not covered for chronic weight management as a primary indication, but covered for a specific carve-out (e.g., cardiovascular risk reduction with established CVD, or OSA with apnea-hypopnea index above the state threshold). PA criteria are narrower and indication-specific.
• Not covered — Excluded from the state Medicaid PDL for this indication. The patient pays cash, uses a manufacturer self-pay program, or pursues a telehealth cash-pay route. Some states with categorical chronic-weight-management exclusions still cover CV / OSA / MASH carve-outs — check the other tabs.
• Dropped — The state Medicaid agency previously covered this indication and has since terminated coverage. All prior PAs expire on the stated cutoff date.
• Unverified — The WLR editorial team has not yet confirmed coverage for this specific indication against the state Medicaid agency's primary source. Confirm with your prescriber or the state Medicaid PBM before assuming coverage.

How this data is verified

The 50-state coverage dataset is backfilled from the WLR state-Medicaid research series, where every state brief anchors on the state Medicaid agency's published Preferred Drug List (PDL), State Plan Amendments (SPAs), PA criteria documents, and managed-care PBM formularies. For broader context the dataset also references the Kaiser Family Foundation January 16, 2026 issue brief (“Medicaid Coverage of and Spending on GLP-1s”) and the Stateline April 30, 2025 reporting on state sunset proposals. Every state row carries a verified-date badge in lastVerified ISO format; click through to the linked state article for the deeper editorial review.

What this tool is NOT

This tool is a data lookup, not a coverage predictor. It will not tell you whether your specific prior-authorization request will be approved — that depends on your individual eligibility category, managed-care plan assignment, BMI, comorbidities, fibrosis stage (for MASH), apnea-hypopnea index (for OSA), prior weight-management history, and the clinical judgment of the state Medicaid medical director or PBM reviewer. Always confirm coverage directly with your state Medicaid program before assuming a result. Coverage policies can change mid-year via PDL updates, SPA filings, or PBM contract renegotiations.

Related tools and articles

• State Medicaid GLP-1 coverage hub — all 50 state research briefs
• GLP-1 insurance coverage landscape (Medicare, Medicaid & commercial)
• GLP-1 insurance-dropped-coverage appeal playbook
• Insurance employer checker (commercial GLP-1 coverage)
• WLR methodology and verification standard

Important disclaimer

This tool is for informational and educational use only and does not constitute medical, legal, or benefits advice. State Medicaid coverage information is sourced from publicly published PDLs, SPAs, and PA criteria; it is not authoritative and may not reflect last-minute policy changes. Weight Loss Rankings is not affiliated with any state Medicaid agency. Always verify coverage with your state Medicaid program, your managed-care plan's member services line, or your prescriber before making any treatment decisions. For appeals timelines and procedures, consult the state regulation cited in your specific state row.