How long does a Ozempic approval last with Connecticut Medicaid?

Initial approvals last 12 months, and renewals are granted in 12-month periods.

What does Connecticut Medicaid require to renew Ozempic?

Improvement in A1C and Documented improvement in hemoglobin A1c; submission of baseline AND recent (within 180 days) lab values with dates documenting improvement in glycemic control or maintenance of glycemic goal required. Patient must not be on concomitant DPP-4 inhibitor therapy. T2DM diagnosis must still be documented.

How current is this information?

This page reflects Connecticut Medicaid's written policy as of January 1, 2026, last verified against the source document on June 3, 2026.

Does Connecticut Medicaid cover Ozempic?

Ozempic for Type 2 Diabetes

What Connecticut Medicaid requires, by plan type. Open this indication on its own page →

Medicaid

Covered (preferred drug)

What you need to qualify

A1C of 6.5% or higher
Diagnosis documented with a code
Lab results confirming eligibility

Qualification pathways

You can qualify through any one of these.

Initial approval — preferred agent (Ozempic injection) for T2DM

All of:

Appropriate diagnosis code on prescription
Documented diagnosis of type 2 diabetes mellitus confirmed by: A1c ≥6.5%, OR fasting plasma glucose ≥126 mg/dL, OR 2-hour plasma glucose ≥200 mg/dL during OGTT, OR classic hyperglycemia symptoms with random plasma glucose ≥200 mg/dL
Provider attests GLP-1 receptor agonist will be used alongside diet and exercise
Prescribed medication will not be used with another GLP-1 receptor agonist
Patient does not have personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2)
Patient is not on concomitant DPP-4 inhibitor therapy OR provider attests patient is transitioning from a DPP-4 inhibitor to a GLP-1 receptor agonist

Documentation to bring

Appropriate diagnosis code on prescription
Chart note or laboratory results documenting T2DM diagnosis (A1c ≥6.5%, fasting glucose ≥126 mg/dL, 2-hour OGTT glucose ≥200 mg/dL, or classic hyperglycemia symptoms with random glucose ≥200 mg/dL)
Provider attestation that GLP-1 will be used alongside diet and exercise
Provider attestation that prescribed medication will not be used with another GLP-1 receptor agonist
For continuation: baseline AND recent (within 180 days of submission) A1c/glycemic lab values with dates

Approval and renewal

Initial approval: 12 months
Renewal: every 12 months
To renew, the plan looks for improvement in A1C and Documented improvement in hemoglobin A1c; submission of baseline AND recent (within 180 days) lab values with dates documenting improvement in glycemic control or maintenance of glycemic goal required. Patient must not be on concomitant DPP-4 inhibitor therapy. T2DM diagnosis must still be documented.

Not covered when

Personal or family history of medullary thyroid carcinoma (MTC)
Personal or family history of multiple endocrine neoplasia syndrome type 2 (MEN 2)
Concomitant use of another GLP-1 receptor agonist containing product
Concomitant DPP-4 inhibitor use (unless transitioning)

Policy note: Ozempic (semaglutide) injection is a PREFERRED agent; no step therapy or prior GLP-1 trial required for initial approval — only T2DM diagnosis confirmation and appropriate diagnosis code. Ozempic tablets (oral semaglutide) are a separate non-preferred listing with age minimum of 18 years — see Rybelsus entry for those criteria (both are listed under the same non-preferred category as 'Ozempic tablets'). The injection formulation has no stated minimum age in this document. Document notes Ozempic tablets were added to the criteria document in V3 (4/29/2026). Gastrointestinal side effects are noted as expected class effects and not considered intolerance unless medical justification for discontinuation is provided. Use of samples to initiate therapy does not meet step therapy requirements.

Policy effective January 1, 2026 · verified June 3, 2026 · source: GLP-1.pdf

Why Ozempic requests get denied by Connecticut 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.
No recent A1C result on file.

Frequently asked questions

Does Connecticut Medicaid cover Ozempic?: Connecticut Medicaid covers Ozempic for type 2 diabetes with prior authorization on Medicaid.
How long does a Ozempic approval last with Connecticut Medicaid?: Initial approvals last 12 months, and renewals are granted in 12-month periods.
What does Connecticut Medicaid require to renew Ozempic?: Improvement in A1C and Documented improvement in hemoglobin A1c; submission of baseline AND recent (within 180 days) lab values with dates documenting improvement in glycemic control or maintenance of glycemic goal required. Patient must not be on concomitant DPP-4 inhibitor therapy. T2DM diagnosis must still be documented.
How current is this information?: This page reflects Connecticut Medicaid's written policy as of January 1, 2026, last verified against the source document on June 3, 2026.