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GLP-1 Medicaid coverage by state (2026)
Of these 10 large states, only North Carolina covers GLP-1s for weight loss under Medicaid, and Michigan covers them only for morbid obesity. California and Pennsylvania ended coverage on January 1, 2026. Every row links to the state rule or tracker it comes from, checked 2026-09-15. Free to cite under CC BY 4.0; please link back.
| State | Medicaid covers weight-loss GLP-1 | What the rule says | IMLC member | Adult obesity (2024) |
|---|---|---|---|---|
| California | No | Since January 1, 2026, Medi-Cal Rx no longer covers Wegovy, Zepbound, or Saxenda for weight loss for members 21 and older. Prior authorization is reviewed case by case for Wegovy to treat MASH or reduce cardiovascular risk, and for Zepbound to treat obstructive sleep apnea. Members under 21 can still be reviewed under EPSDT. GLP-1s for type 2 diabetes remain covered. [Medi-Cal Rx: GLP-1s for weight loss not a covered benefit (October 2025)] | Not checked | 29.1% |
| Florida | No | Florida Medicaid does not cover GLP-1s for obesity. GLP-1s prescribed for type 2 diabetes remain covered. [KFF: Medicaid coverage of GLP-1s (January 2026)] | Yes | 29.6% |
| Georgia | No | Georgia Medicaid does not cover GLP-1s for obesity. GLP-1s prescribed for type 2 diabetes remain covered. [KFF: Medicaid coverage of GLP-1s (January 2026)] | Not checked | 35.4% |
| Illinois | No | Illinois Medicaid is not among the states KFF lists as covering GLP-1s for obesity. GLP-1s prescribed for type 2 diabetes remain covered. [KFF: Medicaid coverage of GLP-1s (January 2026)] | Yes | 34.2% |
| Michigan | Limited | Since January 1, 2026, Michigan Medicaid covers GLP-1s for obesity only for morbid obesity, after documented failure of other weight-loss interventions including PDL-preferred anti-obesity drugs, and only to avoid bariatric surgery. Prior authorizations approved before the change stay valid until their 6-month term ends. [MDHHS bulletin L 25-73][University of Michigan: Medicaid's new GLP-1 limits explained] | Yes | 36.1% |
| New York | No | NY Medicaid (NYRx) excludes drugs used for weight loss under 18 NYCRR §505.3(g)(3). GLP-1s are covered only for Medicaid-covered indications such as type 2 diabetes. [NYRx notification on GLP-1 coverage] | Not checked | 29.5% |
| North Carolina | Yes, with prior authorization | NC Medicaid covers GLP-1s for weight management with prior authorization (criteria effective August 1, 2024). Coverage was paused on October 1, 2025 and reinstated on December 12, 2025. Wegovy is the preferred drug; Zepbound and Saxenda require a trial of Wegovy first. [NC Medicaid: GLP-1 coverage for weight management reinstated (December 2025)] | Yes | 34.5% |
| Ohio | No | Ohio Administrative Code 5160-9-03(B)(1) lists drugs for the treatment of obesity as not covered by Ohio Medicaid. GLP-1s prescribed for type 2 diabetes remain covered. [Ohio Admin. Code 5160-9-03] | Yes | 36.9% |
| Pennsylvania | No | Pennsylvania Medical Assistance ended GLP-1 coverage for weight loss on January 1, 2026, after covering it since January 2023. GLP-1s for other indications are still covered with prior authorization. [Pennsylvania Bulletin, 55 Pa.B. 8828] | Not checked | 34.2% |
| Texas | No | Texas Medicaid does not cover any GLP-1 for obesity. GLP-1s prescribed for type 2 diabetes remain covered. [KFF: Medicaid coverage of GLP-1s (January 2026)] | Not checked | 35.6% |
Obesity rates: CDC Adult Obesity Prevalence Maps (BRFSS 2024). Other states are not in the table because we have not verified them. KFF counted 13 states whose Medicaid covered GLP-1s for obesity in January 2026; Massachusetts ended that coverage on July 3, 2026. Coverage rules changed repeatedly in 2025 and 2026, so cite the date.
Compounding: a federal question, not a state one
On April 30, 2026, FDA proposed not to include semaglutide, tirzepatide, and liraglutide on the 503B bulks list, which would stop outsourcing facilities from compounding them from bulk ingredients. The comment period was extended to July 30, 2026. As of September 15, 2026, no final decision has been published. The proposal does not address 503A compounding for an individual patient's documented clinical need.
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