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Georgia Medicaid

Does Georgia Medicaid cover Ozempic for Type 2 Diabetes?

Yes. Georgia Medicaid covers Ozempic for type 2 diabetes 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 4, 2026. How we verify · Check your exact plan · Medicaid card names in Georgia

Full requirements: Ozempic for Type 2 Diabetes (1 plan type)

Applies to Medicaid plans.

Covered with requirements

Qualification pathways

You can qualify through any one of these.

T2DM on background antidiabetic therapy with prior GLP-1 failure

All of:

  • Age ≥ 18 years
  • Diagnosis of type 2 diabetes mellitus
  • HbA1c ≥ 7%
  • Currently on metformin, SGLT2 inhibitor, sulfonylurea, or thiazolidinedione therapy
  • Inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to exenatide AND Victoza

T2DM with CKD with prior preferred SGLT2 and GLP-1 failure

All of:

  • Age ≥ 18 years
  • Diagnosis of type 2 diabetes mellitus
  • Chronic kidney disease (CKD)
  • HbA1c ≥ 7%
  • Inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to metformin AND SGLT2 inhibitor (Farxiga, Xigduo XR, or Jardiance)

T2DM with established cardiovascular disease with prior GLP-1 failure

All of:

  • Age ≥ 18 years
  • Diagnosis of type 2 diabetes mellitus
  • HbA1c ≥ 7%
  • Established cardiovascular disease (history of coronary artery disease, stroke, cerebrovascular disease, or peripheral artery disease)
  • Inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effect with Victoza

Documentation to bring

  • Documentation of type 2 diabetes mellitus diagnosis
  • HbA1c lab result ≥ 7%
  • For standard pathway: documentation of current background antidiabetic therapy (metformin, SGLT2 inhibitor, sulfonylurea, or thiazolidinedione)
  • Documentation of inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to exenatide
  • Documentation of inadequate response, allergy, contraindication, drug-drug interaction, or intolerable side effects to Victoza
  • For CKD pathway: documentation of CKD diagnosis and failure of metformin and an SGLT2 inhibitor (Farxiga, Xigduo XR, or Jardiance)
  • For CVD pathway: documentation of established cardiovascular disease (coronary artery disease, stroke, cerebrovascular disease, or peripheral artery disease)

Policy note: Ozempic is listed as non-preferred under Miscellaneous Antidiabetic Agents. Three separate qualifying pathways exist: (1) standard T2DM on background therapy with exenatide and Victoza failure; (2) T2DM with CKD requiring metformin and SGLT2 inhibitor failure; (3) T2DM with established CVD requiring only Victoza failure. Ozempic itself is named as a required prior failure step for Mounjaro and Trulicity. Quantity level limits are referenced externally.

Policy effective December 8, 2025 · verified June 4, 2026 · source: Georgia Medicaid Medicaid prior authorization policy · View policy document (PDF)

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Questions people ask
Does Georgia Medicaid cover Ozempic?
Yes. Georgia Medicaid covers Ozempic for type 2 diabetes with prior authorization. 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 Georgia

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

Also under Georgia Medicaid: Mounjaro

Ozempic under other plans: Elevance Health, Alabama Medicaid, Arkansas Medicaid, California Medicaid, Clover Health, Colorado Medicaid, Connecticut Medicaid, Delaware Medicaid

All insurance plans · All medications

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