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BCBS Massachusetts

Does BCBS Massachusetts cover Wegovy for Liver Disease (MASH)?

Yes. BCBS Massachusetts covers Wegovy for liver disease (MASH) with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • 572%20 GLP-1%20and%20 GLP-1%20 %20 Gip%20 Agonist%20 Drugs%20for%20 Anti Obesity%20 Management%20and%20 Other%20 Non Obesity%20 Conditions

    BCBS Massachusetts · PA policy · Employer

    Verified June 2, 2026.

    View PDF Download Original insurer source
  • Employer: Covered (preferred drug). See the qualification pathways below.

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

Full requirements: Wegovy for Liver Disease (MASH) (1 plan type)

Applies to Employer plans.

Covered (preferred drug)

Qualification pathways

You can qualify through any one of these.

MASH with moderate to advanced fibrosis

All of:

  • Patient is 18 years of age or older
  • Diagnosis of MASH (metabolic dysfunction-associated steatohepatitis), noncirrhotic, with moderate to advanced liver fibrosis consistent with stages F2 and F3
  • Fibrosis confirmed by a non-invasive test (NIT): VCTE, MRE, or historical liver biopsy
  • Actively engaged in comprehensive lifestyle modification plan (reduced calorie diet, increased physical activity, behavioral modifications)

Plus any one of:

  • Fibrosis confirmed by vibration-controlled transient elastography (VCTE)
  • Fibrosis confirmed by magnetic resonance elastography (MRE)
  • Fibrosis confirmed by historical liver biopsy

Documentation to bring

  • Documentation of diagnosis of MASH (metabolic dysfunction-associated steatohepatitis), previously known as noncirrhotic nonalcoholic steatohepatitis (NASH)
  • Documentation of moderate to advanced liver fibrosis consistent with stages F2 and F3
  • Results from one qualifying non-invasive test (NIT): vibration-controlled transient elastography (VCTE), magnetic resonance elastography (MRE), or historical liver biopsy
  • Confirmation that patient is 18 years of age or older
  • Physician attestation or documentation that member is actively engaged in comprehensive lifestyle modification plan (reduced calorie diet, increased physical activity, behavioral modifications)
  • For continuation: documentation of positive clinical response (MASH resolution with no worsening of liver fibrosis OR improvement in liver fibrosis)
  • For continuation: physician attestation of continued active engagement in comprehensive lifestyle modification plan
  • For continuation: documentation of FDA approved maintenance dose (1.7 or 2.4 mg subcutaneous injection)

Quantity limits

  • all strengths — 1-month supply (28 to 30 days); 75% of days must be exhausted before refill

Approval and renewal

  • Initial approval: 6 months
  • Renewal: every 12 months
  • Renewal: Patient must have achieved or maintained a positive clinical response to therapy, such as MASH resolution with no worsening of liver fibrosis OR improvement in liver fibrosis. Patient must also be actively engaged in comprehensive lifestyle modification plan and be on FDA approved maintenance dose (1.7 or 2.4 mg subcutaneous injection).
  • Renewal: Staying on a maintenance dose of at least 1.7 mg.

Not covered when

  • Wegovy oral tablet and Wegovy HD are NOT FDA approved for MASH — subcutaneous Wegovy only
  • Cirrhotic NASH/MASH excluded (must be noncirrhotic)
  • Mail order pharmacy benefit excluded
  • Members with BCBSMA Focused Formulary: not a covered benefit effective 1/1/2026
  • Requests based exclusively on use of samples will not meet coverage criteria

Policy note: Policy specifies F2 and F3 fibrosis only (moderate to advanced, noncirrhotic). F4 (cirrhosis) is not covered under this indication. No lookback period specified for biopsy or imaging. FIB-4 and ELF test are not listed as acceptable confirmation methods — only VCTE, MRE, and historical liver biopsy qualify. MASH indication applies only to subcutaneous Wegovy (not oral or HD formulations).

Policy effective May 1, 2026 · verified June 2, 2026 · source: 572%20 GLP-1%20and%20 GLP-1%20 %20 Gip%20 Agonist%20 Drugs%20for%20 Anti Obesity%20 Management%20and%20 Other%20 Non Obesity%20 Conditions · View policy document (PDF)

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Questions people ask
Does BCBS Massachusetts cover Wegovy?
Yes. BCBS Massachusetts covers Wegovy for liver disease (MASH) with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Wegovy approval last with BCBS Massachusetts?
Liver Disease (MASH) — Applies to Employer plans. Initial approval: 6 months. Renewal: every 12 months.
What does BCBS Massachusetts require to renew Wegovy?
Liver Disease (MASH) — Applies to Employer plans. Patient must have achieved or maintained a positive clinical response to therapy, such as MASH resolution with no worsening of liver fibrosis OR improvement in liver fibrosis. Patient must also be actively engaged in comprehensive lifestyle modification plan and be on FDA approved maintenance dose (1.7 or 2.4 mg subcutaneous injection). Staying on a maintenance dose of at least 1.7 mg.
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, Ozempic, Zepbound

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

All insurance plans · All medications

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