Kaiser Permanente Southern California coverage for Ozempic (Type 2 Diabetes)

No additional clinical requirements are listed beyond the diagnosis.

Qualification pathways

You can qualify through any one of these.

Documentation to bring

• Medical records or chart notes confirming type 2 diabetes diagnosis

Policy note: Policy applies to the GLP-1 Agonist class as a group. The named guideline covers Bydureon BCise, Byetta (exenatide), Mounjaro, Ozempic, Rybelsus, Trulicity, and Victoza (liraglutide) under a single shared rule requiring T2DM diagnosis confirmed by medical records or chart notes. No additional step therapy, BMI, A1C, or lifestyle requirements are specified. Wegovy and Zepbound are not listed in the policy; no criteria for weight_loss or cv_risk_reduction indications are established.

Policy effective April 27, 2026 · verified June 5, 2026 · source: Standard-Commercial-Guidelines-6-1-26-EXCERPTED.pdf