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California Medicaid

Does California Medicaid cover Wegovy for Heart Disease Risk Reduction?

Yes. California Medicaid covers Wegovy for heart disease risk reduction with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered with requirements. See the qualification pathways below.

Earliest policy review June 3, 2026. How we verify · Check your exact plan

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

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Non-weight-loss indication (e.g., cardiovascular disease) — PA required, reviewed for medical necessity

All of:

  • PA request submitted for non-weight-loss-related cardiovascular disease indication
  • Medical necessity review required

Documentation to bring

  • PA request for cardiovascular disease or other non-weight-loss indication
  • Documentation supporting medical necessity

Policy note: Document states 'PA requests submitted for non-weight loss-related indications, such as cardiovascular disease, will be reviewed for coverage consideration based on medical necessity.' No specific clinical criteria are defined in this document; medical necessity review is indicated. PA is required.

Policy effective April 6, 2026 · verified June 3, 2026 · source: 12 A GLP-1 Coverage Considerations · View policy document (PDF)

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Questions people ask
Does California Medicaid cover Wegovy?
Yes. California Medicaid covers Wegovy for heart disease risk reduction with prior authorization. Other policy requirements and your plan's benefits also apply.
How current is this information?
The oldest review date among the policies on this page is June 3, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under California Medicaid: Mounjaro, Ozempic, Zepbound

Wegovy under other plans: Elevance Health, Kaiser Permanente Northern California, Kaiser Permanente Southern California, Molina Healthcare, Alabama Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid

All insurance plans · All medications

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