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BCBS Massachusetts

Does BCBS Massachusetts cover Ozempic for Heart Disease Risk Reduction?

No. BCBS Massachusetts's policies on file exclude Ozempic for heart disease risk reduction 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. Coverage for non-diabetic indications includi...

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

Full requirements: Ozempic for Heart Disease Risk Reduction (1 plan type)

Applies to Employer plans.

Not covered

This policy covers Ozempic only for Type 2 Diabetes Mellitus. Coverage for non-diabetic indications including CV risk reduction is found in related policy #572. The diabetes policy does reference ASCVD as a qualifying condition to bypass metformin step therapy, but does not separately authorize a CV risk reduction indication.

Policy note: CV risk reduction as a standalone indication for Ozempic is not addressed by this policy; this policy is exclusively for T2DM. CV risk reduction coverage would be governed by related 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 heart disease risk reduction 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 heart disease risk reduction 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.