California Medicaid coverage for Wegovy (Weight Loss)

Effective January 1, 2026, Wegovy is no longer eligible for coverage for weight loss or weight loss-related indications.

Exceptions

• under_21_epsdt: Effective January 1, 2026, PA requests submitted for weight loss or weight loss-related indications will be reviewed for medical necessity for members younger than 21 years of age pursuant to the federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit.

Policy note: Removal from coverage effective January 1, 2026. EPSDT exception applies for members under age 21.

Policy effective April 6, 2026 · verified June 3, 2026 · source: 12_A_GLP-1_Coverage_Considerations.pdf