Louisiana Medicaid

Does Louisiana Medicaid cover Ozempic?

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Quick answer · Type 2 Diabetes

Louisiana Medicaid covers Ozempic for type 2 diabetes with prior authorization on Medicaid.

  • Medicaid: Covered with requirements. A1C of 6.5% or higher

Last verified June 2, 2026. Policy effective November 15, 2024. Source: MMA_and_POS_GLP_and_A1C_NOV_2024_10-11-24_Criteria.pdf. How we verify this data →

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Ozempic for Type 2 Diabetes

What Louisiana Medicaid requires, by plan type. Open this indication on its own page →

Medicaid

Covered with requirements

What you need to qualify

  • A1C of 6.5% or higher
  • Lab results confirming eligibility

Qualification pathways

You can qualify through any one of these.

Initial Approval - Preferred GLP-1 Agent

All of:

  • Recipient meets minimum age requirement per POS Edits
  • Recipient has a diagnosis of type 2 diabetes mellitus

Plus any one of:

  • A1C >= 6.5% obtained within the previous 6 months
  • A1C < 6.5% obtained within previous 6 months AND history of A1C >= 6.5% AND established cardiovascular disease (prior MI, prior stroke [ischemic or hemorrhagic], or peripheral arterial disease)

Documentation to bring

  • Diagnosis of type 2 diabetes mellitus
  • A1C lab result obtained within the previous 6 months (>= 6.5%); OR A1C < 6.5% within 6 months plus documentation of historical A1C >= 6.5% plus documentation of established CVD (prior MI, prior stroke, or PAD)
  • Minimum age verification per POS Edits

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months
  • To renew, the plan looks for Prescriber attests that recipient is established on the medication with evidence of a positive response to therapy. Subsequent approval criteria only used if recipient previously obtained initial approval.

Not covered when

  • Type 1 diabetes

Policy note: Ozempic is specifically named as eligible for the lower A1C pathway (A1C < 6.5% with history of A1C >= 6.5%) when the recipient has established cardiovascular disease, alongside Trulicity and Victoza. If Ozempic is non-preferred on the PDL, additional step therapy through a preferred GLP-1 agent is required (failure, intolerance, contraindication, or no preferred product appropriate). Preferred vs. non-preferred status not specified in this document; see the Single PDL at ldh.la.gov for current status.

Policy effective November 15, 2024 · verified June 2, 2026 · source: MMA_and_POS_GLP_and_A1C_NOV_2024_10-11-24_Criteria.pdf

Why Ozempic requests get denied by Louisiana Medicaid

Based on what this policy asks for. Fix these before the first submission.

  1. Wrong brand for the diagnosis. Ozempic and Wegovy are the same molecule with different approved uses; a request for Ozempic under a diagnosis that matches Wegovy is routinely denied.
  2. No recent A1C result on file.

Frequently asked questions

Does Louisiana Medicaid cover Ozempic?
Louisiana Medicaid covers Ozempic for type 2 diabetes with prior authorization on Medicaid.
How long does a Ozempic approval last with Louisiana Medicaid?
Initial approvals last 12 months, and renewals are granted in 12-month periods.
What does Louisiana Medicaid require to renew Ozempic?
Prescriber attests that recipient is established on the medication with evidence of a positive response to therapy. Subsequent approval criteria only used if recipient previously obtained initial approval.
How current is this information?
This page reflects Louisiana Medicaid's written policy as of November 15, 2024, last verified against the source document on June 2, 2026.

Other medications under Louisiana Medicaid

Ozempic coverage under other plans

All insurance plans · All medications

This page summarizes Louisiana Medicaid's written prior-authorization policy. It is not a guarantee of coverage; plans vary by employer and benefit design. Verify with your plan before relying on it.