Policy note: Preferred GLP-1; approved for members with a diagnosis of type 2 diabetes. PA required (preferred products must meet eligibility criteria).
Policy effective March 1, 2023 · verified June 4, 2026 · source: 04-01-26%20PDL%20V1.pdf
Why Ozempic requests get denied by Colorado Medicaid
Based on what this policy asks for. Fix these before the first submission.
Wrong brand for the diagnosis. Ozempic and Wegovy are the same molecule with different approved uses; a request for Ozempic under a diagnosis that matches Wegovy is routinely denied.
Diagnosis code missing or wrong on the request.
Frequently asked questions
Does Colorado Medicaid cover Ozempic?
Colorado Medicaid covers Ozempic for type 2 diabetes with prior authorization on Medicaid.
How current is this information?
This page reflects Colorado Medicaid's written policy as of March 1, 2023, last verified against the source document on June 4, 2026.
This page summarizes Colorado Medicaid's written prior-authorization policy. It is not a guarantee of coverage; plans vary by employer and benefit design. Verify with your plan before relying on it.