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BCBS Michigan

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

Yes. BCBS Michigan covers Wegovy for liver disease (MASH) 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: Wegovy for Liver Disease (MASH) (2 plan types)

Applies to Employer and ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

MASH with Moderate to Advanced Liver Fibrosis (F2-F3)

All of:

  • Diagnosis of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH)
  • Moderate to advanced liver fibrosis consistent with stages F2 to F3
  • Adult (age ≥ 18 years old)
  • Current baseline weight documented
  • Used in combination with reduced calorie diet and increased physical activity
  • Physician attestation that member will participate in lifestyle modifications
  • Not to be used in combination with other weight loss products
  • Cannot be used in combination with other GLP-1 agonist-containing products

Documentation to bring

  • Documentation of diagnosis of noncirrhotic MASH with moderate to advanced liver fibrosis (F2 to F3)
  • Documentation of current baseline weight
  • Physician attestation of member participation in lifestyle modifications (reduced calorie diet and increased physical activity)
  • Attestation that medication will not be combined with other weight loss products
  • Attestation that medication will not be combined with other GLP-1 agonist-containing products
  • For continuation: Physician attestation of current weight submitted to plan
  • For continuation: Attestation of continued active participation in lifestyle modifications
  • For continuation: BMI ≥ 18.5 kg/m2

Approval and renewal

  • Initial approval: 12 months
  • Renewal: For MASH continuation: Physician attestation of current weight submitted to plan, attestation of continued active participation in lifestyle modifications that support weight loss, BMI ≥ 18.5 kg/m2. No explicit weight loss percentage threshold required for MASH continuation (unlike obesity/CV pathways which require 5% weight loss).

Not covered when

  • Cirrhotic MASH is excluded (noncirrhotic only)
  • Cannot be used in combination with other weight loss products
  • Cannot be used in combination with other GLP-1 agonist-containing products

Policy note: The policy specifies noncirrhotic MASH only, with fibrosis stages F2 to F3. No specific fibrosis confirmation methods (biopsy, FibroScan, FIB-4, MRE, ELF) are specified in the policy. No lookback periods for diagnostic tests are specified. Continuation criteria for MASH differ from obesity/CV pathways — no explicit weight loss percentage threshold is required; instead physician attestation of current weight and continued lifestyle modifications are required along with BMI ≥ 18.5 kg/m2.

Policy effective June 1, 2026 · 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 Wegovy?
Yes. BCBS Michigan 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 Michigan?
Liver Disease (MASH) — Applies to Employer and ACA Marketplace plans. Initial approval: 12 months.
What does BCBS Michigan require to renew Wegovy?
Liver Disease (MASH) — Applies to Employer and ACA Marketplace plans. For MASH continuation: Physician attestation of current weight submitted to plan, attestation of continued active participation in lifestyle modifications that support weight loss, BMI ≥ 18.5 kg/m2. No explicit weight loss percentage threshold required for MASH continuation (unlike obesity/CV pathways which require 5% weight loss).
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, Ozempic, Zepbound

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

All insurance plans · All medications

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