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BCBS Michigan

Does BCBS Michigan cover Ozempic for Type 2 Diabetes?

Yes. BCBS Michigan covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Employer and ACA Marketplace: Covered with requirements. See the qualification pathways below.

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

Full requirements: Ozempic for Type 2 Diabetes (2 plan types)

Applies to Employer and ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Type 2 Diabetes with or without step therapy

All of:

  • Diagnosis of Type 2 Diabetes OR trial of one generic or preferred medication for the treatment of Type 2 Diabetes
  • Cannot be used in combination with other GLP-1 agonist-containing products

Documentation to bring

  • Documentation of Type 2 Diabetes diagnosis OR documentation of trial of one generic or preferred medication for Type 2 Diabetes
  • Confirmation that Ozempic will not be used in combination with other GLP-1 agonist-containing products

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: Renewal requires that current criteria are met, medication is providing clinical benefit, and member is not experiencing serious adverse events.

Not covered when

  • Combination use with other GLP-1 agonist-containing products is not permitted

Policy note: The document lists both 'Ozempic' (injectable) and 'Ozempic tablets' as separate line items with identical criteria. 'Ozempic tablets' likely refers to Rybelsus (oral semaglutide), but is labeled as 'Ozempic tablets' in this document. Step therapy requires a trial of one generic or preferred medication for T2DM, but does not specify metformin specifically. The document is dated March 2019 with a revision date of 06-01-2026 noted in the footer.

Policy effective March 1, 2019 · verified June 2, 2026 · source: Prior Authorization And Step Therapy Guidelines · View policy document (PDF)

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Questions people ask
Does BCBS Michigan cover Ozempic?
Yes. BCBS Michigan covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Ozempic approval last with BCBS Michigan?
Type 2 Diabetes — Applies to Employer and ACA Marketplace plans. Initial approval: 12 months. Renewal: every 12 months.
What does BCBS Michigan require to renew Ozempic?
Type 2 Diabetes — Applies to Employer and ACA Marketplace plans. Renewal requires that current criteria are met, medication is providing clinical benefit, and member is not experiencing serious adverse events.
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 Michigan: Mounjaro, Wegovy, Zepbound

Ozempic under other plans: Michigan Medicaid, Molina Healthcare, Priority Health, BCBS Alabama, BCBS Arizona, BCBS Arkansas, BCBS Kansas, BCBS Louisiana

All insurance plans · All medications

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