Does Colorado Medicaid cover Wegovy?

Yes. Colorado Medicaid covers Wegovy for weight loss with prior authorization if your BMI is 30 or higher, or 27 or higher with a related condition. Other policy requirements and your plan's benefits also apply.

How long does a Wegovy approval last with Colorado Medicaid?

Weight Loss — Applies to Medicaid plans. Initial approval: 6 months. Renewal: every 12 months.

What does Colorado Medicaid require to renew Wegovy?

Weight Loss — Applies to Medicaid plans. At least 5% reduction in BMI. Adults (≥18): at least 5% weight loss during initial approval period. Pediatric (12-17): at least 5% reduction in baseline BMI during initial approval period. Subsequent renewals (beyond 18 months) also require documentation that patient maintains weight loss achieved during the initial approval period.

How current is this information?

The oldest review date among the policies on this page is June 4, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Colorado Medicaid coverage for Wegovy (Weight Loss)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

Adult weight loss (age ≥ 18)

All of:

Age ≥ 18 years
BMI ≥ 30 kg/m2 with no risk factors OR BMI ≥ 27 kg/m2 with at least one weight-related comorbid condition (hypertension, T2DM, or dyslipidemia)
Documentation of initiation of or ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
Documentation of initiation of or ongoing increased physical activity unless medically contraindicated by comorbidity
No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks
No concurrent use of any other weight loss drug(s)
Patient's baseline weight (in kg) submitted at time of request

Pediatric weight loss (age 12-17)

All of:

Age 12-17 years
BMI ≥ 30 kg/m2 AND body weight above 60 kg
Documentation of initiation of or ongoing reduced calorie diet OR ongoing care of a registered dietitian nutritionist
Documentation of initiation of or ongoing increased physical activity unless medically contraindicated by comorbidity
No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks
No concurrent use of any other weight loss drug(s)
Patient's baseline weight (in kg) submitted at time of request

Documentation to bring

Baseline BMI documentation (≥ 30 kg/m2 without comorbidities, or ≥ 27 kg/m2 with qualifying comorbidity; ≥ 30 kg/m2 and weight > 60 kg for ages 12-17)
Patient's baseline body weight in kg
Documentation of initiation of or ongoing reduced calorie diet OR documentation of ongoing care of a registered dietitian nutritionist
Documentation of initiation of or ongoing increased physical activity (or documentation of medical contraindication to physical activity)
Documentation that no contraindications exist, or prescriber attestation that benefits outweigh risks
Confirmation of no concurrent use of other weight loss drugs

Quantity limits

all strengths — Per FDA-approved label

Approval and renewal

Initial approval: 6 months
Renewal: every 12 months
Renewal: At least 5% reduction in BMI.
Renewal: Adults (≥18): at least 5% weight loss during initial approval period. Pediatric (12-17): at least 5% reduction in baseline BMI during initial approval period. Subsequent renewals (beyond 18 months) also require documentation that patient maintains weight loss achieved during the initial approval period.

Not covered when

No concurrent use of any other weight loss drug(s)
No contraindications (disease state or current therapy) unless prescriber documents benefits outweigh risks

Policy note: Policy effective date listed for Anti-Obesity Medications section is March 2023; the Weight Management Agents section (which covers MACE, MASH, and OSA indications) is dated May 2026. Initial approval is 6 months; renewal is 12 months. After lapses in therapy, additional trials may be approved if initial criteria are met. Subsequent renewals beyond 18 months require meeting all renewal criteria plus documentation of maintained weight loss. The Anti-Obesity Medications PDL page lists Wegovy as a covered drug requiring PA.

Policy effective March 1, 2023 · verified June 4, 2026 · source: 04 01 26%20 Pdl%20 V1

Does Colorado Medicaid cover Wegovy for Weight Loss?