Colorado Medicaid coverage for Zepbound (Osa)

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%20PDL%20V1.pdf