Medicaid GLP-1 coverage: 13 states covered obesity GLP-1s as of January 2026
Medicaid must cover GLP-1s for diabetes, and Wegovy and Zepbound for their cardiovascular and sleep-apnea uses, but coverage for obesity is optional. KFF counted 13 state Medicaid programs covering GLP-1s for obesity as of January 2026, down from 16 in October 2025.
Why coverage differs by state
Under the Medicaid Drug Rebate Program, states must cover nearly all FDA-approved drugs for medically accepted uses, but weight-loss drugs are in a small group states may exclude[1]. So coverage for obesity is optional, while coverage is required for diabetes and, since March 2024 and December 2024, for cardiovascular disease (Wegovy) and moderate to severe obstructive sleep apnea in adults with obesity (Zepbound)[1].
How many states cover GLP-1s for obesity?
KFF’s count: 16 programs as of October 2025; since then California, New Hampshire, Pennsylvania and South Carolina eliminated coverage. North Carolina dropped coverage in October 2025 and reinstated it in December 2025, for 13 as of January 2026[1]. KFF reports that a few other states were planning or considering restrictions[1]. When covered, GLP-1s typically need prior authorization[1].
We have not published a state-by-state list because we could not verify each state’s current status from a primary source on our check date. Check your state Medicaid agency’s preferred drug list.
What is the BALANCE Model for Medicaid?
BALANCE is a voluntary CMS Innovation Center model in which CMS negotiated lower GLP-1 prices for participating state Medicaid programs, with lifestyle support programs provided by manufacturers[2]. For Medicaid it runs May 2026 through December 2031, and states had until July 31, 2026 to notify CMS of interest[2]. Participation doesn’t automatically mean your state covers GLP-1s for obesity.
What does a Medicaid enrollee pay?
KFF notes Medicaid enrollees already pay little or no copay for covered prescriptions, and that TrumpRx’s direct-purchase prices will likely still be prohibitive for people on Medicaid[1]. Manufacturer savings cards exclude people in government-funded programs, including Medicaid[3][4].
Questions people ask
Does Medicaid cover Wegovy?
For cardiovascular risk reduction, Medicaid coverage is required. For weight loss, it depends on your state; 13 states covered GLP-1s for obesity as of January 2026, per KFF.
Does Medicaid cover Zepbound?
For moderate to severe obstructive sleep apnea in adults with obesity, coverage is required. For obesity alone, it is a state option.
Can I use a manufacturer savings card with Medicaid?
No. Lilly and Novo savings cards exclude people enrolled in government-funded programs, including Medicaid.
Sources
Every price above links to one of these pages. We loaded each one and saved a copy on the date shown.
- Medicaid Coverage of and Spending on GLP-1s . KFF, published Jan 16, 2026. Checked .https://www.kff.org/medicaid/medicaid-coverage-of-and-spending-on-glp-1s/
- What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge . KFF, published May 11, 2026. Checked .https://www.kff.org/medicare/what-to-know-about-the-balance-model-for-glp-1s-in-medicare-and-medicaid/
- Mounjaro savings and coverage . Eli Lilly and Company. Checked .https://mounjaro.lilly.com/savings-resources
- Foundayo coverage and savings (self-pay terms) . Eli Lilly and Company. Checked .https://foundayo.lilly.com/coverage-savings