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Connecticut Medicaid

Does Connecticut Medicaid cover Wegovy for Liver Disease (MASH)?

Yes. Connecticut Medicaid covers Wegovy for liver disease (MASH) with prior authorization. Other policy requirements and your plan's benefits also apply.

Policy document

  • Medicaid: Covered with requirements. See the qualification pathways below.

Earliest policy review June 3, 2026. How we verify · Check your exact plan

Full requirements: Wegovy for Liver Disease (MASH) (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

MASH – histologically confirmed with NAS, MELD, and liver enzyme criteria

All of:

  • Adult patient age 18 or older
  • Histologically documented steatohepatitis
  • NAFLD Activity Score (NAS) greater than or equal to 4
  • Hepatic decompensation or MELD score less than or equal to 12 points
  • AST and ALT levels less than or equal to 5 times upper limit of normal
  • Diagnosis code indicating established MASH submitted on PA form
  • Does NOT have Type 1 or Type 2 diabetes
  • Not prescribed exclusively for weight management

Documentation to bring

  • Completed 'Wegovy for MASH Prior Authorization Form'
  • Documentation of histologically documented steatohepatitis (liver biopsy)
  • NAFLD Activity Score (NAS) ≥ 4
  • Hepatic decompensation or MELD score ≤ 12
  • AST and ALT levels ≤ 5x upper limit of normal
  • Valid ICD-10-CM diagnosis code indicating established MASH (from ctdssmap.com Pharmacy ICD-10-CM-Therapeutic Class Product Diagnosis List)
  • PA form must be submitted for each new therapy request and annually thereafter

Approval and renewal

  • Renewal: every 12 months

Not covered when

  • Type 2 diabetes
  • Exclusively for weight management
  • Type 1 diabetes

Policy note: Document is a Connecticut Medicaid (HUSKY Health A, C, D) Provider Bulletin effective November 3, 2025. Diagnosis code is required in addition to prior authorization. PA must be submitted for new therapy and annually thereafter. The document does not specify explicit fibrosis staging (F1–F3) but requires histologic confirmation with NAS ≥ 4 and MELD ≤ 12. Specific payable ICD-10 codes are published separately on ctdssmap.com. Any PA form submitted without required information will be denied.

Policy effective November 3, 2025 · verified June 3, 2026 · source: Get Download File · View policy document (PDF)

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Questions people ask
Does Connecticut Medicaid cover Wegovy?
Yes. Connecticut Medicaid covers Wegovy for liver disease (MASH) with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Wegovy approval last with Connecticut Medicaid?
Liver Disease (MASH) — Applies to Medicaid plans. Renewal: every 12 months.
How current is this information?
The oldest review date among the policies on this page is June 3, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Connecticut Medicaid: Mounjaro, Ozempic, Zepbound

Wegovy under other plans: Elevance Health, Alabama Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Delaware Medicaid, EmblemHealth, Fallon Health Plan

All insurance plans · All medications

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