Medicaid
Covered (preferred drug)What you need to qualify
- Diagnosis documented with a code (E11)
Qualification pathways
You can qualify through any one of these.
Preferred agent — T2DM diagnosis
All of:
- ICD-10 diagnosis of type 2 diabetes mellitus in member's record or submitted with pharmacy claim
Documentation to bring
- ICD-10 diagnosis code for type 2 diabetes mellitus in member's record or submitted with pharmacy claim
Policy note: Ozempic is listed as a Preferred Agent under the GLP-1 Receptor Agonists class on the Idaho Medicaid PDL. The only stated PA criterion is an ICD-10 type 2 diabetes diagnosis. The document does not establish PA criteria for non-diabetes indications. Last revised March 2, 2026; PDL effective January 1, 2026.
Policy effective January 1, 2026 · verified June 4, 2026 · source: policy-396.html