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California Medicaid

Does California Medicaid cover Wegovy for Liver Disease (MASH)?

Yes. California Medicaid covers Wegovy for liver disease (MASH) 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 Liver Disease (MASH) (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

MASH without cirrhosis — no PA required with correct diagnosis code

All of:

  • Noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) diagnosis
  • Claim submitted with ICD-10-CM diagnosis code K76.0 and/or K75.8

Documentation to bring

  • ICD-10-CM diagnosis code K76.0 (Fatty (change of) liver, not elsewhere classified) and/or K75.8 (Other specified inflammatory liver diseases) submitted on claim

Not covered when

  • Cirrhotic MASH not addressed; document specifies noncirrhotic MASH only

Policy note: Effective April 1, 2026. No PA required when claim is submitted with the appropriate ICD-10-CM diagnosis code (K76.0 and/or K75.8). Claims without the appropriate code will deny with Reject Code 80. Document does not specify detailed clinical criteria (fibrosis stage, confirmation methods, etc.) beyond the diagnosis code requirement.

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 liver disease (MASH) 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.