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

Does Colorado Medicaid cover Zepbound for Obstructive Sleep Apnea (OSA)?

Yes. Colorado Medicaid covers Zepbound for obstructive sleep apnea (OSA) with prior authorization if your BMI is 30 or higher. Other policy requirements and your plan's benefits also apply.

Policy on file; the document isn't available to view online yet.

Medicaid: Covered with requirements. BMI of 30 or higher

Earliest policy review June 4, 2026. How we verify · Check your exact plan · Medicaid card names in Colorado

Full requirements: Zepbound for Obstructive Sleep Apnea (OSA) (1 plan type)

Applies to Medicaid plans.

Covered with requirements

What you need to qualify

Age 18 and older
BMI of 30 or higher
Diagnosis documented with a code
Diagnosed obstructive sleep apnea, with a documented trial of PAP therapy

Policy note: Non-preferred. OSA: age ≥18, BMI ≥30 documented, OSA confirmed by approved sleep test, not pregnant, MTC/MEN2 counseling, engaged in lifestyle modification, AND failed a 6-month trial of CPAP. Reauthorization requires documented clinical improvement in OSA symptoms + adherence.

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

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Questions people ask

Does Colorado Medicaid cover Zepbound?: Yes. Colorado Medicaid covers Zepbound for obstructive sleep apnea (OSA) with prior authorization if your BMI is 30 or higher. 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 4, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Card and program names on file in Colorado

These names map to Colorado Medicaid, including older names and spelling variants. This is not a list of plans currently accepting members.

Also under Colorado Medicaid: Mounjaro, Ozempic, Wegovy

Zepbound under other plans: Elevance Health, Alabama Medicaid, California Medicaid, Connecticut Medicaid, Delaware Medicaid, Illinois Medicaid, Indiana Medicaid, Iowa Medicaid

All insurance plans · All medications

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