Does Medicaid cover Wegovy for heart disease?

Yes, for adults with established cardiovascular disease and obesity or overweight: that use is not weight loss, so no state may exclude it, though every state can require prior authorization.

Does Medicaid cover Wegovy for weight loss?

Only in the minority of states that cover a GLP-1 for obesity at all, where Wegovy is usually on the list and often the preferred product. The state documents on this page say what each asks.

Does Medicaid cover Wegovy for fatty liver disease?

The MASH indication — noncirrhotic, with fibrosis at stages F2 to F3 — is not weight loss either, so a state cannot exclude it. Expect the request to need the fibrosis stage documented and cirrhosis ruled out.

← Medicaid, state by state

Does Medicaid cover Wegovy?

Wegovy is the GLP-1 that state Medicaid programs write the most criteria for, and not only the states that cover weight loss. Two of its three uses are ones no state can exclude, so even programs that refuse obesity treatment have had to say when they will pay for Wegovy.

Does Medicaid cover Wegovy?

Yes to reduce the risk of heart attack, stroke and cardiovascular death in adults with established cardiovascular disease and obesity or overweight, and for noncirrhotic MASH with F2 to F3 fibrosis: neither is weight loss, so no state can exclude them. For weight alone it depends on the state, and the documents quoted below say what each one asks. 11 of 51 state programs cover a GLP-1 for obesity at all, and the documents of 10 of them mention Wegovy by name — set out below, because mentioning is not always covering.

Heart risk and MASH: the uses no state can exclude

Two of Wegovy's three indications are not weight loss: reducing the risk of heart attack, stroke and cardiovascular death in adults with established cardiovascular disease and either obesity or overweight, and noncirrhotic MASH with fibrosis at stages F2 to F3, approved on an accelerated basis. A state's option to exclude weight-loss drugs does not reach either, so a program that covers nothing for obesity still covers Wegovy for those uses, behind prior authorization.

That is why the documents below include states that cover no GLP-1 for weight at all: they name Wegovy because they had to write criteria for the cardiovascular use. The trial behind it, SELECT, enrolled people 45 or older with a BMI of 27 or more, a prior heart attack, stroke or peripheral arterial disease, and no diabetes.

Read from FDA prescribing information for WEGOVY, via DailyMed and Social Security Act §1927(d)(2).

What each state's document says about Wegovy

What this site recorded for 16 of the 51 programs names Wegovy. Each line is from what this site recorded for that state, read from the document linked under it — covering states first.

DelawareCovered, with prior authorization for obesity

Two preferred products first — Wegovy, Wegovy HD, Zepbound, Contrave and phentermine are the preferred ones; Saxenda, Foundayo, Xenical and the oral Wegovy are not.
The PDL, now effective 7 September 2026, is what makes Wegovy, Wegovy HD, Zepbound, Contrave and phentermine preferred and requires two preferred products before any non-preferred one; every agent in the class needs prior authorization either way.

Delaware DMAP prior authorization request: GLP-1 agonist for weight management, MASH or prevention of MACE, dated 2026-04-20; read 2026-09-05.

KansasCovered, with prior authorization for obesity

The one number the form prints, a BMI of 40 or more (at 12–17, 40 or 140% of the 95th percentile), applies only to the 'high cost' agents in Table 4 of the clinical criteria — and the form states that Zepbound has not been in that table since 1 April 2024, nor Wegovy since 1 June 2025.
Saxenda, Wegovy and Zepbound each need prior authorization; a non-preferred choice needs written clinical rationale, and the treatment plan has to include diet and physical activity.

KDHE Anti-Obesity Medications Prior Authorization Form, dated 2025-06-01; read 2026-09-05.

MinnesotaCovered, with prior authorization for obesity

The covered list runs Saxenda, Wegovy, Zepbound, Contrave, Xenical, orlistat and the phentermine class.

Minnesota Health Care Programs PA criteria: Anti-Obesity Medications, dated 2026-08-01; read 2026-09-05.

MississippiCovered, with prior authorization for obesity

At 12–17 Saxenda needs body weight above 60 kg and a BMI of 30 or more; Wegovy needs a BMI above the 95th percentile for age and sex.
Saxenda or Wegovy only, and one covered obesity product at a time
The criteria cover Saxenda and Wegovy as preferred and Xenical as non-preferred, and name Qsymia, phentermine and Evekeo/amphetamine as not covered at all — Qsymia because it is not rebated through CMS.

Anti-obesity Select Agents PA Criteria, dated 2024-03-12; read 2026-09-05.

MissouriCovered, with prior authorization for obesity

Wegovy is non-preferred and not covered for weight reduction at all — only for cardiovascular risk.

MO HealthNet GLP-1 Receptor Agonists for All Indications prior authorization form, dated 2024-10-01; read 2026-09-10.

North CarolinaCovered, with prior authorization for obesity

Wegovy and Saxenda 12+, Zepbound 18+

NC Medicaid Outpatient Pharmacy Prior Approval Criteria — GLP-1s for Weight Management, dated 2024-08-01; read 2026-09-05.

Rhode IslandCovered, with prior authorization for obesity

Wegovy is the only preferred agent; Zepbound, Saxenda, oral Wegovy, Xenical, orlistat, phentermine/topiramate and Imcivree are non-preferred

Rhode Island Medicaid Fee for Service Preferred Drug List, dated 2026-01-13; read 2026-09-05.

TennesseeCovered, with prior authorization for obesity

Wegovy and Saxenda start at 12, Zepbound at 18.
Wegovy and Zepbound are preferred and need prior authorization.

Clinical Criteria, Step Therapy, and Quantity Limits for the TennCare PDL, dated 2026-09-01; read 2026-09-05.

VirginiaCovered, with prior authorization for obesity

Wegovy and Saxenda 12+, Zepbound, Wegovy HD and Foundayo 18+

Virginia Medicaid Service Authorization — Weight Loss Management, dated 2026-07-01; read 2026-09-05.

WisconsinCovered, with prior authorization for obesity

At 12–17, Saxenda needs body weight above 132 lb and a BMI matching 30 for adults; orlistat, phentermine/topiramate, Wegovy and Xenical need the 95th percentile standardized for age and gender.
18 and over for anti-obesity drugs generally; 12 and over for Evekeo, orlistat, phentermine/topiramate, Saxenda, Wegovy and Xenical.
Those six — Evekeo, orlistat, phentermine/topiramate, Saxenda, Wegovy and Xenical — are the only products the form names anywhere, as the agents a member under 18 may be approved for.

Prior Authorization Drug Attachment for Weight Management Agents (F-00163), dated 2025-11-01; read 2026-09-05.

CaliforniaNot covered for obesity

Wegovy, Zepbound and Saxenda approvals ended on 31 December 2025 and there is no continuing care.
Wegovy stays covered for MASH and, with prior authorization, for cardiovascular disease; Zepbound for obstructive sleep apnea; the diabetes GLP-1s on a diabetes diagnosis code.

Medi-Cal Rx: Changes to GLP-1 Drug Coverage, effective 1 January 2026, dated 2026-01-01; read 2026-08-20.

New MexicoA weight-loss drug, but no GLP-1 for obesity

Fee-for-service covers phentermine, orlistat, benzphetamine and phendimetrazine among others, with prior authorization at a BMI over 40, or over 35 with hypertension, diabetes or dyslipidemia, for three months at a time; Wegovy, Zepbound and Saxenda are listed by name as not covered.

New Mexico Health Care Authority: Weight Reduction Medications, dated 2025-03-04; read 2026-09-10.

New YorkNot covered for obesity

Wegovy needs a confirmed cardiovascular-disease diagnosis, a BMI over 40 and documented participation in lifestyle modification.

NYRx Drug Coverage Overview: Wegovy, dated 2026-07-16; read 2026-08-20.

North DakotaA weight-loss drug, but no GLP-1 for obesity

No GLP-1 is covered for weight; Wegovy is approved only to reduce cardiovascular risk, for members aged 55 to 74 without diabetes, with a BMI of 27 to 35 and established cardiovascular disease, and only after Ozempic at 2 mg has been tolerated.

North Dakota Medicaid Preferred Drug List and Prior Authorization Criteria, version 2026.6, dated 2026-07-31; read 2026-09-10.

TexasA weight-loss drug, but no GLP-1 for obesity

Wegovy is approved only with a cardiovascular-disease diagnosis recorded in the past 730 days alongside a diagnosis of obesity or overweight, no concurrent GLP-1, and no history of pancreatitis, gastroparesis, medullary thyroid carcinoma or MEN 2 in the past 180 days.

Texas Prior Authorization Program Clinical Criteria — Wegovy, dated 2024-10-25; read 2026-09-05.

UtahNot covered for obesity

For the indications Utah still covers: Wegovy for a prior major adverse cardiovascular event needs a BMI of 27 or more with a documented MI, stroke or symptomatic peripheral arterial disease and guideline-directed secondary prevention; Zepbound for sleep apnea needs a BMI of 30 or more, an apnea-hypopnea index of 15 or higher on an attended study, a sleep specialist and 70% adherence to PAP; Wegovy for MASH needs stage F2 to F3 fibrosis confirmed two ways and a liver specialist.
On the other indications: Wegovy for cardiovascular risk renews for 12 months on 5% weight loss held from week 20; Zepbound for sleep apnea on a 20% fall in the apnea-hypopnea index; Wegovy for MASH on documented clinical response.

Utah Medicaid pharmacy prior authorization request form: GLP-1 medications for weight-related comorbidities, last updated 1 June 2026 (read via the Internet Archive), dated 2026-06-01; read 2026-09-05.

Also covering a GLP-1 for obesity, with nothing recorded here that names Wegovy: Michigan. Their preferred-drug lists decide which products are on it.

The card, and the cash price

The maker's savings card is not an option on Medicaid. Every manufacturer excludes government beneficiaries, because federal anti-kickback rules bar a maker from subsidizing a federal program's copay. If your state says no and you pay cash, Wegovy is $349 a month once titrated, read from its own published page on 2026-09-11.

If Medicaid says no

Federal Medicaid law requires an answer to a drug prior authorization within 24 hours, and a 72-hour emergency supply while it is pending. In a managed care plan you have 60 days from a denial to appeal to the plan, which must decide within 30 days, or 72 hours if it is urgent. On a decision the state makes itself, it may allow up to 90 days to ask for a fair hearing. Social Security Act §1927(d)(5); 42 CFR 438.402; 42 CFR 438.408; 42 CFR 431.221

What a Wegovy request has to show → The appeal letter builder fills in your state's own criteria and the fair-hearing rules.

All 51 programs →Wegovy with commercial insurance →Medicare and Wegovy →Medicaid and Zepbound →Medicaid and Ozempic →Medicaid and Mounjaro →

Medicaid and Wegovy, answered

Does Medicaid cover Wegovy for heart disease?: Yes, for adults with established cardiovascular disease and obesity or overweight: that use is not weight loss, so no state may exclude it, though every state can require prior authorization.
Does Medicaid cover Wegovy for weight loss?: Only in the minority of states that cover a GLP-1 for obesity at all, where Wegovy is usually on the list and often the preferred product. The state documents on this page say what each asks.
Does Medicaid cover Wegovy for fatty liver disease?: The MASH indication — noncirrhotic, with fibrosis at stages F2 to F3 — is not weight loss either, so a state cannot exclude it. Expect the request to need the fibrosis stage documented and cirrhosis ruled out.