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Centene

Does Centene cover Ozempic for Kidney Disease (CKD)?

Yes. Centene covers Ozempic for kidney disease (CKD) with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • 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 Kidney Disease (CKD) (1 plan type)

Applies to ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

T2DM with CKD — Ozempic injection only (step therapy bypassed)

All of:

  • Diagnosis of type 2 diabetes mellitus
  • Age ≥ 18 years
  • Diagnosis of chronic kidney disease
  • Request is for Ozempic injection (the only GLP-1 with FDA-approved CKD indication)
  • Failure of ≥ 3 consecutive months of SGLT2 inhibitor or SGLT2-containing product unless clinically significant adverse effects or all contraindicated
  • Not prescribed concurrently with another GLP-1 receptor agonist or DPP-4 inhibitor
  • Dose does not exceed FDA-approved maximum (2 mg/week)
  • Step therapy through liraglutide (Victoza) and Trulicity is BYPASSED for Ozempic injection in members with CKD

Documentation to bring

  • Office chart notes or clinical documentation of type 2 diabetes mellitus diagnosis
  • Documentation of chronic kidney disease diagnosis
  • Documentation of failure or contraindication/adverse effects for SGLT2 inhibitor trial ≥ 3 months
  • Confirmation of no concurrent GLP-1 receptor agonist or DPP-4 inhibitor use
  • Ozempic injection specified (not Ozempic tablets) — only injection has FDA-approved CKD indication

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: Member is responding positively to therapy. No concurrent use with another GLP-1 or DPP-4 inhibitor.

Not covered when

  • Concurrent use with another GLP-1 receptor agonist
  • Concurrent use with a DPP-4 inhibitor
  • Dose exceeding FDA-approved maximum recommended dose
  • Type 1 diabetes

Policy note: Ozempic injection is the ONLY GLP-1 receptor agonist with an FDA-approved indication for CKD (to reduce risk of sustained eGFR decline, ESKD, and CV death in adults with T2DM and CKD). When requesting Ozempic injection for CKD, the step therapy requirement through liraglutide (Victoza) and Trulicity is explicitly bypassed per criterion I.A.4.d. Dosing for CKD patients: increase to maintenance dose of 1 mg once weekly after at least 4 weeks on 0.5 mg.

Policy effective February 26, 2026 · verified June 2, 2026 · source: Cp.Pmn.183 · View policy document (PDF)

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Questions people ask
Does Centene cover Ozempic?
Yes. Centene covers Ozempic for kidney disease (CKD) with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Ozempic approval last with Centene?
Kidney Disease (CKD) — Applies to ACA Marketplace plans. Initial approval: 12 months. Renewal: every 12 months.
What does Centene require to renew Ozempic?
Kidney Disease (CKD) — Applies to ACA Marketplace plans. Member is responding positively to therapy. No concurrent use with another GLP-1 or DPP-4 inhibitor.
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 Centene: Mounjaro, Wegovy, Zepbound

Ozempic under other plans: Aetna, Cigna, Humana, UnitedHealthcare, Alabama Medicaid, Arkansas Medicaid, BCBS Alabama, BCBS Arizona

All insurance plans · All medications

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