BCBS Massachusetts coverage for Ozempic (Heart Disease Risk Reduction)

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%20Glucagon-like%20Peptide-1%20(GLP-1)%20Receptor%20Agonists%20and%20Related%20Drugs%20for%20the%20Treatment%20of%20Type%202%20Diabetes.pdf