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Does Elevance Health cover Wegovy for Liver Disease (MASH)?

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

Policy document

  • Employer and ACA Marketplace: Covered with requirements. See the qualification pathways below.

Earliest policy review June 2, 2026. How we verify · Check your exact plan

Full requirements: Wegovy for Liver Disease (MASH) (2 plan types)

Applies to Employer and ACA Marketplace plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

MASH diagnosis verification via imaging alone

All of:

  • Age ≥ 18 years
  • Diagnosis of noncirrhotic, nonalcoholic MASH
  • Steatosis confirmed by FibroScan VCTE or MRE within the past year
  • Moderate to advanced liver fibrosis consistent with stages F2 or F3
  • Prior trial and inadequate response to healthcare provider supervised comprehensive lifestyle program
  • Will continue to be maintained on healthcare provider supervised comprehensive lifestyle program

MASH diagnosis verification via liver biopsy with NAS score

All of:

  • Age ≥ 18 years
  • Diagnosis of noncirrhotic, nonalcoholic MASH
  • Liver biopsy within the past 3 years
  • NAS score ≥ 4
  • Score of at least 1 in two or more NAS components (steatosis, hepatocellular ballooning, lobular inflammation)
  • Moderate to advanced liver fibrosis consistent with stages F2 or F3
  • Prior trial and inadequate response to healthcare provider supervised comprehensive lifestyle program
  • Will continue to be maintained on healthcare provider supervised comprehensive lifestyle program

Documentation to bring

  • Documentation of age ≥ 18 years
  • Diagnosis of noncirrhotic MASH (formerly NASH)
  • Imaging or biopsy confirming diagnosis: FibroScan VCTE or MRE within the past year, OR liver biopsy within the past 3 years with NAS score ≥ 4 and score of at least 1 in two or more NAS components
  • Documentation of moderate to advanced liver fibrosis (F2 or F3)
  • Documentation of prior trial and inadequate response to healthcare provider supervised comprehensive lifestyle program (worsening or no improvement in NAS score, NAS components, or fibrosis stage)
  • Documentation that individual will continue to be maintained on healthcare provider supervised comprehensive lifestyle program

Quantity limits

  • 0.25mg, 0.5mg, 1mg, 1.7mg, 2.4mg — Subject to quantity limit (specific limit not detailed in document)

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • Renewal: Improvement from baseline in NAFLD Activity Score (NAS) without worsening of fibrosis stage; OR improvement from baseline in fibrosis stage with no worsening of NAS; OR improvement in fibrosis stage based on FibroScan VCTE or MRE. Continued enrollment in healthcare provider supervised comprehensive lifestyle program required.

Not covered when

  • BMI < 18.5 kg/m2
  • Cirrhosis (stage 4 fibrosis)
  • Evidence of other forms of chronic liver disease
  • Personal or family history of Medullary Thyroid Carcinoma (MTC)
  • Diagnosis of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • History of pancreatitis
  • Severe gastroparesis
  • History of suicide attempts or active suicidal ideation
  • Concurrent use of other semaglutide-containing products or any other GLP-1 receptor agonist (including Ozempic, Rybelsus, Zepbound, Mounjaro, Saxenda, Victoza)
  • Type 1 diabetes

Policy note: Diagnosis must be noncirrhotic MASH. Imaging confirmation (FibroScan VCTE or MRE) lookback is 12 months; liver biopsy lookback is 36 months. Continuation requires improvement in NAS or fibrosis stage. Pregnancy exclusion not explicitly listed in document but is a standard GLP-1 exclusion; document does not state it explicitly so set to false.

Policy effective April 3, 2026 · verified June 2, 2026 · source: Elevance Health ACA Marketplace prior authorization policy · View policy document (PDF)

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Questions people ask
Does Elevance Health cover Wegovy?
Yes. Elevance Health 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 Elevance Health?
Liver Disease (MASH) — Applies to Employer and ACA Marketplace plans. Initial approval: 12 months. Renewal: every 12 months.
What does Elevance Health require to renew Wegovy?
Liver Disease (MASH) — Applies to Employer and ACA Marketplace plans. Improvement from baseline in NAFLD Activity Score (NAS) without worsening of fibrosis stage; OR improvement from baseline in fibrosis stage with no worsening of NAS; OR improvement in fibrosis stage based on FibroScan VCTE or MRE. Continued enrollment in healthcare provider supervised comprehensive lifestyle program required.
How current is this information?
The oldest review date among the policies on this page is June 2, 2026. Each policy's effective and verification dates appear with its requirements. Confirm current benefits with your plan.

Also under Elevance Health: Mounjaro, Ozempic, Zepbound

Wegovy under other plans: California Medicaid, Colorado Medicaid, Connecticut Medicaid, EmblemHealth, Excellus BCBS, Highmark, Independent Health, Indiana Medicaid

All insurance plans · All medications

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