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BCBS Massachusetts

Does BCBS Massachusetts cover Ozempic for Kidney Disease (CKD)?

No. BCBS Massachusetts's policies on file exclude Ozempic for kidney disease (CKD) on Employer plans.

Policy document

  • 056%20 Glucagon Like%20 Peptide 1%20(GLP-1)%20 Receptor%20 Agonists%20and%20 Related%20 Drugs%20for%20the%20 Treatment%20of%20 Type%202%20 Diabetes

    BCBS Massachusetts · PA policy · Employer

    Verified June 2, 2026.

    View PDF Download Original insurer source
  • Employer: Not covered. This policy covers Ozempic only for Type 2 Diabetes Mellitus. CKD is referenced only as a qualifying comorb...

Earliest policy review June 2, 2026. How we verify · Check your exact plan

Full requirements: Ozempic for Kidney Disease (CKD) (1 plan type)

Applies to Employer plans.

Not covered

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%20 Glucagon Like%20 Peptide 1%20(GLP-1)%20 Receptor%20 Agonists%20and%20 Related%20 Drugs%20for%20the%20 Treatment%20of%20 Type%202%20 Diabetes · View policy document (PDF)

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If kidney disease (ckd) isn't covered on your plan

A prior authorization can't override a benefit exclusion. Ask BCBS Massachusetts about a formulary exception.

Questions people ask
Does BCBS Massachusetts cover Ozempic?
No. BCBS Massachusetts's policies on file exclude Ozempic for kidney disease (CKD) on Employer plans.
How current is this information?
The oldest review date among the policies on this page is June 2, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under BCBS Massachusetts: Mounjaro, Wegovy, Zepbound

Ozempic under other plans: Fallon Health Plan, Massachusetts Medicaid, BCBS Alabama, BCBS Arizona, BCBS Arkansas, BCBS Kansas, BCBS Louisiana, BCBS Michigan

All insurance plans · All medications

Summary of BCBS Massachusetts's written policy, not a guarantee of coverage. Plans vary by employer and benefit design.