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Michigan Medicaid

Does Michigan Medicaid cover Ozempic?

Yes. Michigan 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 Michigan

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.

Preferred Agent Criteria

All of:

  • Diagnosis of type 2 diabetes
  • Discontinuation of other GLP-1 agonists
  • Discontinuation of DPP-4 inhibitors

Non-Preferred Agent Criteria

All of:

  • Diagnosis of type 2 diabetes
  • Discontinuation of other GLP-1 agonists
  • Discontinuation of DPP-4 inhibitors

Plus any one of:

  • Allergy to the preferred medications
  • Contraindication or drug-to-drug interaction with the preferred medications
  • History of unacceptable side effects
  • Trial and failure with one preferred medication within same subgroup

Documentation to bring

  • Documentation of type 2 diabetes diagnosis
  • Documentation of discontinuation of other GLP-1 agonists
  • Documentation of discontinuation of DPP-4 inhibitors
  • If non-preferred: documentation of allergy, contraindication, drug interaction, unacceptable side effects, or trial and failure with a preferred agent in the same subgroup

Quantity limits

  • all strengths — 3 pens per 84 days (84-day)

Approval and renewal

  • Initial approval: 12 months
  • Renewal: every 12 months

Policy note: Ozempic is listed in the Michigan Medicaid PDL under 'Diabetes: Incretin Mimetics and Combinations'. Preferred vs. non-preferred status is determined by the Michigan Preferred Drug List (PDL), which is referenced but not fully reproduced in this document. The criteria apply to the PDL class broadly. The 'discontinuation of other GLP-1 agonists' criterion means the patient must not be on another GLP-1 concurrently.

Policy effective July 1, 2026 · verified June 4, 2026 · source: Mi Rx Clinical Criteria · View policy document (PDF)

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Questions people ask
Does Michigan Medicaid cover Ozempic?
Yes. Michigan Medicaid covers Ozempic for type 2 diabetes with prior authorization. Other policy requirements and your plan's benefits also apply.
How long does a Ozempic approval last with Michigan Medicaid?
Type 2 Diabetes — Applies to Medicaid plans. Initial approval: 12 months. Renewal: every 12 months.
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 Michigan

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

Also under Michigan Medicaid: Mounjaro, Wegovy, Zepbound

Ozempic under other plans: BCBS Michigan, Molina Healthcare, Priority Health, Alabama Medicaid, Arkansas Medicaid, California Medicaid, Clover Health, Colorado Medicaid

All insurance plans · All medications

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