BCBS Massachusetts coverage for Ozempic (Kidney Disease (CKD))

This policy covers Ozempic only for Type 2 Diabetes Mellitus. CKD is referenced only as a qualifying comorbidity that allows bypass of metformin step therapy within the T2DM indication, not as a standalone CKD indication. Coverage for non-diabetic indications is found in related policy #572.

Policy note: CKD as a standalone indication for Ozempic is not separately authorized by this T2DM policy. The 8/1/2025 update added CKD as a qualifying comorbidity under the T2DM step-4 criteria (allowing bypass of metformin step therapy), but this does not constitute a separate CKD indication coverage. Non-diabetic indications are handled by policy #572.

Policy effective May 1, 2026 · verified June 2, 2026 · source: 056%20Glucagon-like%20Peptide-1%20(GLP-1)%20Receptor%20Agonists%20and%20Related%20Drugs%20for%20the%20Treatment%20of%20Type%202%20Diabetes.pdf